一次性根充治疗慢性根尖周炎的临床效果及对血清炎性因子和血管内皮细胞功能的影响

Clinical Effect of One-time Root Filling in Treatment of Chronic Periapical Periodontitis and Its Effect on Serum Inflammatory Factors and Vascular Endothelial Cell Function

目的:探讨一次性根充治疗牙周病逆行感染所致慢性根尖周炎的临床效果。方法:回顾性分析2019年3-12月广州市东升医院口腔科收治的100例牙周病逆行感染所致慢性根尖周炎患者的临床资料,按治疗方法的不同分为观察组(n=50)和对照组(n=50),观察组接受一次性根管填充治疗,对照组接受多次根管治疗。对比两组术后24 h自发痛情况、术后不同时间段叩痛情况、治疗前后PAI分值、治疗前后牙龈情况、治疗前后炎症因子水平及血管内皮细胞功能。结果:观察组术后24 h自发疼痛率低于对照组,差异有统计学意义(P<0.01)。观察组术后6、12、24周叩痛发生率均于对照组,观察组术后1、6、12、24周PAI分值均低于对照组,差异均有统计学意义(P<0.01)。术后24周,观察组PLI、SBI、GI均低于对照组,血清1L-1β、1L-6、TNF-α水平均低于对照组,NO水平高于对照组,ET-1、vWF水平均低于对照组,差异均有统计学意义(P<0.01)。结论:一次性根管填充治疗牙周病逆行感染所致慢性根尖周炎效果显著,治疗周期短,可减轻患者痛苦。

Objective:To investigate the clinical effect of one-time root filling on chronic periapical periodontitis caused by retrograde periodontal disease infection.Method:Clinical data of 100 patients with chronic periapical periodontitis caused by retrograde periodontal disease admitted to the Department of Stomatology,Guangzhou Dongsheng Hospital from March to December 2019 were retrospectively analyzed.According to different treatment methods,they were divided into observation group (n=50) and control group (n=50).The observation group received one-time root filling therapy,while the control group received multiple root canal therapy.The spontaneous pain at 24 h after surgery,knock pain at different time periods after surgery,PAI scores before and after treatment,gingival conditions before and after treatment,levels of inflammatory factors and vascular endothelial cell function before and after treatment were compared between the two groups.Result:The spontaneous pain rate 24 h after surgery in the observation group was lower than that in the control group,the difference was statistically significant (P<0.01).The incidence of percussion pain in the observation group at 6,12 and 24 weeks after surgery was higher than that in the control group,and the PAI scores in the observation group at 1 week,6,12 and 24 weeks after surgery were lower than those in the control group,the differences were statistically significant (P<0.01).At 24 weeks after operation,PLI,SBI and GI in the observation group were lower than those in the control group,serum 1L-1β,1L-6,TNF-α levels were lower than those in the control group,NO level was higher than that in the control group,ET-1,vWF levels were lower than those in the control group,the differences were statistically significant (P<0.01).Conclusion:The treatment of chronic periapical periodontitis caused by infection of periodontal disease with one-time root filling has a significant curative effect,short treatment cycle,and alleviates the pain of patients.