根管治疗联合牙周翻瓣术治疗牙髓-牙周综合征的临床观察

Clinical effect of root canal therapy combined with periodontal flap surgery in treatment of pulp-periodontal syndrome

目的探讨根管治疗联合牙周翻瓣术治疗牙髓-牙周综合征的临床效果。方法抽取2019年10月至2020年12月漯河市第三人民医院收治的牙髓-牙周综合征患者86例,按随机数字表法分为观察组(43例)与对照组(43例)。对照组采用根管治疗,观察组在对照组基础上采用牙周翻瓣术。对比两组临床效果、龈沟液炎性因子水平、细菌感染率、牙周指数及不同时间段视觉模拟评分法(VAS)评分。结果观察组总有效率(95.35%)较对照组(79.07%)高(P<0.05);治疗后,观察组菌斑指数(PLI)、牙龈指数(GI)较对照组低(P<0.05);治疗后,观察组肿瘤坏死因子(TNF-α)、白细胞介素-6(IL-6)水平较对照组低(P<0.05);治疗后,观察组细菌感染率(4.65%)、细菌清除率(94.12%)较对照组(11.63%、84.85%)低,但两组比较,P>0.05;治疗1、3个月后,观察组视觉模拟评分法(VAS)评分较对照组低(P<0.05)。结论牙周翻瓣术联合根管治疗牙髓-牙周综合征,可提高治疗效果、细菌清除能力,有效抑制细菌感染状况,改善牙周指数,缓解炎症状态,减轻疼痛。

Objective To investigate the clinical effect of root canal therapy combined with periodontal flap surgery in the treatment of pulp-periodontal syndrome.Methods A total of 86 patients with pulp-periodontal syndrome who were admitted to the Third People’s Hospital of Luohe from October 2019 to December 2020 were selected,and divided into observation group(43 cases)and control group(43 cases)according to the random number table method.The control group was treated with root canal therapy,and the observation group was treated with periodontal flap surgery on the basis of the control group.The clinical effects,inflammatory factors in gingival crevicular fluid,bacterial infection rate,periodontal index and VAS scores at different time periods were compared between the two groups.Results The total effective rate of the observation group(95.35%)was higher than that of the control group(79.07%),P<0.05.After treatment,the plaque index(PLI)and gingival index(GI)of the observation group were lower than those of the control group(P<0.05).After treatment,the levels of tumor necrosis factor-α(TNF-α),interleukin-6(IL-6)in observation group were lower than those in control group(P<0.05).After treatment,The bacterial infection rate(4.65%)and bacterial clearance rate(94.12%)in the observation group were lower than those in the control group(11.63%,84.85%),but compared with the two groups,P>0.05.After 1 month and 3 months of treatment,the visual analogue scale(VAS)score of the observation group was lower than that of the control group(P<0.05).Conclusions Periodontal flap surgery combined with root canal therapy in the treatment of pulp-periodontal syndrome can improve the treatment effect and bacterial clearance,effectively inhibit bacterial infection,improve periodontal index,alleviate inflammation and pain.