牙周翻瓣术联合根管治疗牙髓-牙周综合征患者的效果

Effects of periodontal flap surgery combined with root canal therapy in treatment of patients with pulp-periodontal syndrome

目的:观察牙周翻瓣术联合根管治疗牙髓-牙周综合征患者的效果。方法:选取90例牙髓-牙周综合征患者为研究对象,按照随机数字表法分为对照组和观察组各45例。对照组行根管治疗,观察组在对照组基础上联合牙周翻瓣术治疗。比较两组临床疗效,细菌清除率、复发率,牙周指数水平,治疗前后炎性因子[肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)]水平及疼痛程度[视觉模拟评分法(VAS)]评分。结果:观察组治疗总有效率为95.56%,高于对照组的80.00%,差异有统计学意义(P<0.05);治疗后,观察组细菌清除率为93.33%,高于对照组的77.78%,差异有统计学意义(P<0.05);观察组复发率为20.00%,低于对照组的40.00%,差异有统计学意义(P<0.05);观察组牙龈指数、龈沟出血指数、菌斑指数、牙周袋探诊深度等牙周指数水平均低于对照组,差异有统计学意义(P<0.05);观察组TNF-α、IL-6水平均低对照组,差异有统计学意义(P<0.05);观察组治疗后1、6个月VAS评分均低于对照组,差异有统计学意义(P<0.05)。结论:牙周翻瓣术联合根管治疗牙髓-牙周综合征患者,可提高临床疗效和细菌清除率,改善牙周指数,降低炎性因子水平和复发率,减轻疼痛,其效果优于单纯根管治疗。

Objective: To observe effects of periodontal flap surgery combined with root canal therapy in treatment of patients with pulpperiodontal syndrome. Methods: 90 patients with pulp-periodontal syndrome were selected as the research objects and were divided into control group and observation group according to the random number table method, 45 cases in each group. The control group received root canal therapy, while the observation group was give periodontal flap surgery on the basis of that of the control group. The clinical effects, the bacterial clearance rate, the recurrence rate, the periodontal index level, the inflammatory factor levels [tumor necrosis factor-α(TNF-α), interleukin-6(IL-6)] and the pain degree [visual analogue pain scale(VAS)] score were compared between the two groups before and after the treatment. Results: The total effective rate of treatment in the observation group was 95.56%, which was higher than 80.00% in the control group, and the difference was statistically significant(P<0.05). After the treatment, the bacterial clearance rate in the observation group was 93.33%, which was higher than the control group of 77.78%,and the difference was statistically significant(P<0.05). The recurrence rate of the observation group was 20.00%, which was lower than 40.00%of the control group, and the difference was statistically significant(P<0.05). The levels of periodontal index levels such as gingival index, gingival sulcus bleeding index, plaque index, and periodontal pocket probing depth in the observation group were lower than those in the control group, and the differences were statistically significant(P<0.05). The levels of TNF-α and IL-6 in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05). The VAS scores of the observation group were lower than those of the control group at 1and 6 months after the treatment, and the differences were statistically significant(P<0.05). Conclusions: Periodontal flap surgery combined with root canal therapy in the treatment of the patients with pulp-periodontal syndrome can improve the clinical effects and the bacterial clearance rate, improve the periodontal index, reduce the levels of inflammatory factors and the recurrence rate, and reduce the pain degree. Moreover, it is superior to single root canal therapy.