显微微创根管治疗的临床应用

Clinical application of minimally invasive root canal therapy under microscope

目的:评价显微镜下微创根管治疗的临床应用效果。方法:选取80例2019年1月~2021年6月就诊的牙体缺损不超过1/3的磨牙牙髓炎或根尖周炎患者,实验组采用微创根管治疗并用纳米树脂直接充填髓腔及窝洞,对照组采用常规根管治疗并全冠修复。比较两组根管治疗的操作时间;诊间及治疗后疼痛评分。对比修复完成后6个月、1年、2年的修复体FDI评分及2年后的治疗成功率。结果:实验组根管充填时间和总治疗时间显著短于对照组(P<0.05)。诊间24 h NRS疼痛评分牙髓炎显著高于根尖周炎(P<0.05),但两组之间无统计学差异。术后24 h疼痛评分对照组显著高于实验组(P<0.05),但牙髓炎和根尖炎之间无差异。在6个月,1年,2年复查时两组修复体FDI最终评分以及2年成功率均无差异(P>0.05)。结论:显微微创根管治疗与传统根管治疗成功率接近,能提高治疗效率、降低术后疼痛,牙体缺损不超过1/3的患牙微创治疗后用纳米树脂直接充填髓腔及窝洞可以获得与全冠修复相似的存留效果。

Objective:To evaluate the clinical application effect of minimally invasive root canal treatment under microscope.Methods:A total of 80 patients with dental pulp disease or periapical periodontitis with dental defects of less than 1/3 of molars from January 2019 to June 2021 were selected,and randomly divided into two groups.The experimental group was treated with minimally invasive root canal treatment and the pulp cavity and the cavity were filled directly with nano resin,the control group was treated with conventional root canal treatment and complete coronal restoration.The operation time of root canal treatment,the score of intraoperative pain and postoperative pain,the FDI score of the restoration at 6 months,one year and two years,and 2-year treatment success rate were compared between the two groups.Results:The root canal filling time and total treatment time in the experimental group were significantly shorter(P<0.05).The 24-hour intraoperative NRS pain score of pulpitis was significantly higher than that of periapical periodontitis(P<0.05),but there was no statistical difference between the two groups.The NRS pain scores 24 hours after operation in the control group was significantly higher(P<0.05),but there was no difference between pulpitis and periapical periodontitis.There was no statistical difference in two-year success rate and FDI final score at the review of 6 months,one year and two years between the two groups(P>0.05).Conclusion:Micro-invasive root canal treatment has similar success rate with traditional root canal treatment,and can improve the treatment efficiency,reduce postoperative pain.For the teeth with dental defects of less than 1/3,the pulp cavity and the cavity were filled directly with nano resin after minimally invasive treatment can achieve similar retention effect as the complete coronal restoration.