牙髓血运重建术中不同根管消毒剂对治疗效果的影响

Effects of different root canal disinfectants on the therapeutic effect of dental pulp revascularization

目的探讨不同根管消毒剂在牙髓血运重建术中对治疗效果的影响。方法回顾性选取120例牙髓血运重建术患儿,依据根管消毒剂不同分为二联抗生素糊剂组、三联抗生素糊剂组,各60例。二联抗生素糊剂组按1∶1比例配置盐酸环丙沙星片、甲硝唑片根管封药,三联抗生素糊剂组按1∶1∶1比例配置盐酸米诺环素胶囊、盐酸环丙沙星片、甲硝唑片根管封药。比较两组患儿临床疗效、牙齿恢复情况、满意度、不良反应发生情况、牙体变色情况、复发情况及手术前后根管壁厚度、牙根长度、龈沟液生长因子[血管内皮生长因子(VEGF)、碱性成纤维细胞生长因子(bFGF)]水平。结果手术后,两组患儿的根管壁厚度、牙根长度均大于手术前,龈沟液VEGF、bFGF水平均高于手术前,且二联抗生素糊剂组的龈沟液VEGF、bFGF水平均高于三联抗生素糊剂组,差异具有统计学意义(P<0.05);两组患儿手术后的根管壁厚度、牙根长度比较,差异无统计学意义(P>0.05)。二联抗生素糊剂组患儿的总有效率96.67%(58/60)与三联抗生素糊剂组的93.33%(56/60)比较,差异无统计学意义(P>0.05)。两组患儿的牙骨质样组织沉积率比较,差异无统计学意义(P>0.05);二联抗生素糊剂组患儿的色泽、咬合度、咀嚼功能满意度评分分别为(8.45±0.78)、(8.57±1.15)、(8.74±0.62)分,均高于三联抗生素糊剂组的(7.90±0.50)、(7.23±1.01)、(7.74±0.53)分,差异具有统计学意义(P<0.05)。二联抗生素糊剂组患儿的不良反应发生率10.00%(6/60)与三联抗生素糊剂组的13.33%(8/60)比较,差异无统计学意义(P>0.05)。二联抗生素糊剂组患儿的牙体变色率10.00%(6/60)低于三联抗生素糊剂组的33.33%(20/60),差异具有统计学意义(P<0.05);二联抗生素糊剂组患儿的复发率0与三联抗生素糊剂组的3.33%(2/60)比较,差异无统计学意义(P>0.05)。结论二联和三联抗生素糊剂在牙髓血运重建术中的治疗效果相当,但前者较后者更能有效提升患儿家属满意度,降低患儿牙体变色率。

Objective To discuss effects of different root canal disinfectants on the therapeutic effect of dental pulp revascularization.Methods A total of 120 children with dental pulp revascularization were retrospectively selected and divided into dual antibiotic paste group and triple antibiotic paste group,with 60 cases in each group.In the double antibiotic paste group,ciprofloxacin hydrochloride tablets and metronidazole tablets were prepared in the ratio of 1:1 as root canal sealing,while in the triple antibiotic paste group,minocycline hydrochloride capsules,ciprofloxacin hydrochloride tablets and metronidazole tablets were prepared in the ratio of 1:1:1 as root canal sealing.The clinical efficacy,tooth recovery,satisfaction,incidence of adverse reactions,tooth discoloration,recurrence,root canal wall thickness,root length,and levels of gingival crevicular fluid growth factors[vascular endothelial growth factor(VEGF),basic fibroblast growth factor(bFGF)]were compared between the two groups.Results The root canal wall thickness and root length of the two groups after the operation were greater than those before the operation,and the levels of VEGF and bFGF in gingival crevicular fluid of the two groups after the operation were higher than those before the operation;the levels of VEGF and bFGF in gingival crevicular fluid of the dual antibiotic paste group were higher than those of the triple antibiotic paste group;and the differences were statistically significant(P<0.05).The differences in root canal wall thickness and root length after the operation between the two groups were not statistically significant(P>0.05).The overall efficacy of the dual antibiotic paste group was 96.67%(58/60),while the overall efficacy of the triple antibiotic paste group was 93.33%(56/60);and the difference was not statistically significant(P>0.05).The difference in the deposition rate of cementoid tissue between the two groups was not statistically significant(P>0.05).The satisfaction scores of color,occlusal degree and masticatory function of the dual antibiotic paste group were(8.45±0.78),(8.57±1.15)and(8.74±0.62)points,respectively,which were higher than(7.90±0.50),(7.23±1.01)and(7.74±0.53)points of the triple antibiotic paste group;and the differences were statistically significant(P<0.05).The incidence of adverse reactions of the dual antibiotic paste group was 10.00%(6/60),and the incidence of adverse reactions of the triple antibiotic paste group of the triple antibiotic paste group was 13.33%(8/60),and the difference was not statistically significant(P>0.05).The tooth discoloration rate of the dual antibiotic paste group was 10.00%(6/60),which was lower than 33.33%(20/60)of the triple antibiotic paste group,and the difference was statistically significant(P<0.05).The recurrence rate of the dual antibiotic paste group was 0,while the recurrence rate of the triple antibiotic paste group was 3.33%(2/60),and the difference was not statistically significant(P>0.05).Conclusion The therapeutic effect of the dual antibiotic pastes and the triple antibiotic pastes is the same in pulp revascularization,but the former one is more effective than the latter one in improving parental satisfaction and reducing the tooth discoloration rate.