摘要
背景根管治疗是老年人慢性根尖周炎最普遍、最有效的治疗方法。但随着双膦酸盐类药物的应用越来越广泛,使根管治疗对老年人慢性根尖周炎的疗效具有一定的不确定性,也鲜有相关报道。目的初步评价应用双膦酸盐类药物并患有慢性根尖周炎的老年患者的根管治疗疗效。方法本研究为回顾性研究,选取2017年1月-2019年12月在首都医科大学附属北京康复医院口腔科就诊的有使用双膦酸盐类药物治疗骨质疏松病史且患有慢性根尖周炎的35例年龄60~82岁老年人患者作为双膦酸盐药物史(BP)组;选取同期来首都医科大学附属北京康复医院口腔科就诊的未使用双膦酸盐类药物的慢性根尖周炎的70例60~84岁老年患者作为对照(NC)组。分别对其进行根管治疗,并观察术后6个月和12个月根尖周病变愈合情况。结果两组患者根管治疗后根尖周指数(periapical index,PAI)评级明显降低(P<0.01);两组患者根管治疗后6个月的成功率大于77%,术后12个月的成功率大于88%。术后6个月、12个月,BP组的治疗成功率低于NC组,BP组的PAI评级显示根尖周病变骨质破坏较NC组恢复略差,但差异无统计学意义。结论使用双膦酸盐类药物的患者根尖周骨质破坏的恢复有所延缓,但并不影响根管治疗的远期疗效。
Background Root canal therapy is the most common and effective method for the treatment of chronic periapical periodontitis in the elderly.However,with more and more extensive application of bisphosphonates,root canal therapy in the treatment of chronic apical periodontitis in the elderly shows its uncertainty,and there are few relevant reports.Objective To evaluate the efficacy of root canal therapy in chronic periapical periodontitis elderly patients with a history of bisphosphonates.Methods From January 2017 to December 2019,35 elderly patients(age ranged from 60 to 82 years old)with chronic periapical periodontitis and a history of osteoporosis treated with bisphosphonates in Beijing Rehabilitation Hospital of Capital Medical University were selected as BP group.Another 70 elderly patients(age ranged from 60 to 84 years old)with chronic periapical periodontitis who did not use bisphosphonates visited the First Medical Center of Chinese PLA General Hospital were randomly selected as the control group(NC).Root canal therapy was performed,and the healing of periapical lesions was observed at 6 and 12 months after operation.Results PAI score of the two groups decreased significantly after root canal treatment,and the difference was statistically significant(P<0.01).The success rate at 6 months after root canal treatment was greater than 77% and at 12 months after surgery was greater than 88% in both groups.At 6 months and 12 months after operation,the treatment success rate of BP group was lower than that of NC group,and the PAI score of BP group showed that the recovery of periapical lesion bone destruction was worse than that of NC group,but the difference was not statistically significant.Conclusion The recovery of periapical bone destruction is delayed in patients with the history of bisphosphonates,but the long-term efficacy of endodontic therapy is not affected.
作者
徐晨
喻鑫
王家柱
郑颖
XU Chen;YU Xin;WANG Jiazhu;ZHENG Ying(Department of Stomatology,the First Medical Center,Chinese PLA General Hospital,Beijing 100853,China;Department of Stomatology,Beijing Rehabilitation Hospital of Capital Medical University,Beijing 100144,China;Chinese PLA Medical School,Institute of Stomatology&Oral Maxilla Facial Key Laboratory,the First Medical Center,Chinese PLA General Hospital,Beijing 100853,China)
出处
《解放军医学院学报》
CAS
北大核心
2021年第9期918-921,共4页
Academic Journal of Chinese PLA Medical School
关键词
慢性根尖周炎
根管治疗
双膦酸盐
老年人
骨质疏松
chronic periapical inflammation
root canal therapy
bisphosphonates
the aged
osteoporosis