牙髓血运重建术治疗对年轻恒牙根尖周病变患者临床疗效、疼痛及细胞生长因子的影响

Effect of pulp revascularization on the clinical efficacy, pain and cell growth factors of patients with periapical lesion of young permanent teeth

目的研究牙髓血运重建术治疗对年轻恒牙根尖周病变患者临床疗效、疼痛及细胞生长因子的影响。方法回顾性分析96例年轻恒牙根尖周病变患者的临床资料。根据不同的治疗方法分为对照组(根尖诱导成形术治疗)和研究组(牙髓血运重建术治疗)。比较2组临床疗效、治疗前后龈沟液血管内皮生长因子(vascular endothelial growth factor,VEGF)和碱性成纤维细胞生长因子(basic fibroblast growth factor,bFGF)水平、VAS评分、牙根生长发育情况及并发症发生率。结果对照组治疗后总有效率为76.09%,明显低于研究组的92.00%(P<0.05);且研究组治疗后2、8、24 d的VAS评分显著低于对照组(P<0.05)。随访6个月时,2组VEGF、bFGF水平均较治疗前升高,且研究组显著高于对照组(P<0.05);随访1年时,2组患者患牙管根比、患牙根管壁厚度均较治疗前增加,且研究组患牙管根比、患牙根管壁厚度均明显高于对照组(P<0.05);并发症发生率显著低于对照组(P<0.05)。结论采用牙髓血运重建术治疗年轻恒牙根尖周病变患者可提高其疗效,促进患者牙根生长,减轻其术后疼痛,降低并发症发生率,可能与改善患者牙组织相关细胞生长因子等因素有关。

Objective To study the effect of pulp revascularization on the clinical efficacy, pain and cell growth factors of patients with periapical lesion of young permanent teeth. Methods The clinical data of 96 patients with periapical lesion of young permanent teeth treated in our hospital from January 2018 to November 2019 were retrospectively analyzed.According to different treatments, they were divided into a control group(apexification treatment) and a research group(pulp revascularization treatment). The clinical efficacy, VEGF and bFGF levels in gingival crevicular fluid before and after treatment,VAS score, growth and development of tooth roots and incidence of complications were compared between the two groups.Results The total effective rate of the control group after treatment was 76.09%, which was significantly lower than 92.00% of the study group(P<0.05). Moreover, the VAS scores of the study group 2, 8, 24 d after treatment were significantly lower than those of the control group(P<0.05). After follow-up for 6 months, the levels of VEGF and bFGF in the two groups were higher than those before treatment, and the levels of study group were significantly higher than those of the control group(P<0.05).After follow-up for 1 year, the ratio of root canal roots and wall thickness of affected roots in both groups increased,and the ratio of root canal roots and wall thickness of affected roots in the study group were significantly higher than those in the control group(P<0.05). The incidence of complications was significantly lower than that of the control group(P<0.05). Conclusion The pulp revascularization in the treatment of patients with periapical lesion of young permanent teeth can improve the efficacy, promote root growth, reduce postoperative pain, and reduce the incidence of complications, which may be related to the improvement of cell growth factors related to dental tissue.