iRoot BP Plus结合热牙胶垂直加压充填术治疗慢性根尖周炎伴根尖未闭合者的疗效

Curative effect of iRoot BP Plus combined with hot gutta percha vertical pressure filling on the treatment of chronic periapical periodontitis with unclosed root tip

目的探讨iRoot BP Plus结合热牙胶垂直加压充填术治疗慢性根尖周炎伴根尖未闭合者的疗效及对龈沟液炎性因子水平的影响。方法选择2019年8月至2020年12月我院收治的慢性根尖周炎伴根尖未闭合患者116例,随机分为研究组和对照组,各58人。对照组接受iRoot BP Plus根尖屏障术治疗,研究组在对照组基础上结合热牙胶垂直加压充填术治疗。比较两组6个月和12个月时的临床疗效、两组手术操作时间、术后疼痛持续时间、治疗平均时间、治疗平均周期、血清炎症因子水平变化及患牙保留率情况。结果6个月复查时,研究组X线检查成功率为91.38%,临床指标成功率为93.10%,高于对照组的84.48%和82.76%(P>0.05);12个月复查时,研究组X线检查成功率为94.83%显著高于对照组的77.59%,临床指标成功率为93.10%,高于对照组的70.69%(P<0.05);研究组术后疼痛持续时间、治疗平均次数及治疗平均周期均低于对照组(P<0.05)。研究组治疗后IL-1β及IL-6水平低于对照组(P<0.05)。研究组患牙保留率为92.65%,高于对照组的80.82%(P=0.010)。结论iRoot BP Plus结合热牙胶垂直加压充填术治疗慢性根尖周炎伴根尖未闭合患者的临床疗效确切,可有效减少患者的平均治疗次数和周期,降低患者龈沟液中炎症因子水平,提高患牙保留率,长期疗效较好,值得推广。

Objective The aim of this study was to explore the curative effect of iRoot BP Plus combined with hot gutta-percha vertical pressure filling on treating chronic periapical periodontitis with unclosed root tip and to analyze its effects on the levels of inflammatory factors in gingival crevicular fluid.Methods A total of 116 patients with chronic apical periodontitis and unclosed apical periodontitis who were admitted to our hospital from August 2019 to December 2020 were prospectively included in the study.They were divided into a research group and a control group,58 in each one,according to the random number table.The patients in the control group were treated with iRoot BP Plus apical barrier therapy,while those in the research group were treated with hot gutta percha vertical pressure filling on the basis of the control group.At the reexamination of 6 months and 12 months,the clinical efficacy,operation time,postoperative pain duration,Endodontic interappointment pain(EIP)grade at 48h after surgery,mean treatment time,mean treatment cycle,changes in serum inflammatory factors and tooth retention rate were compared between the two groups.Results At the six-month reexamination,the success rate of X-ray examination and clinical indexes in the researchgroup was 91.38%and 93.10%,respectively,higher than those in the control groups(84.48%and 82.76%)(P>0.05).At the 12-month reexamination,the success rate of X-ray examination in the research group was 94.83%,significantly higher than 77.59%in the control group,and the success rate of clinical indicators was 93.10%,significantly higher than 70.69%in the control group(P<0.05).The duration of postoperative pain,the average number of treatments and the average treatment cycle in the research group were significantly lower than those in the control group(P<0.05).The levels of IL-1βand IL-6 in the treatment group were lower than those in the control group(P<0.05).The retention rate of diseased teeth in the study group was 92.65%,which was significantly higher than 80.82%(P=0.010).Conclusion The clinical effect of iRoot BP Plus combined with hot gutta percha vertical pressure filling on the treatment of chronic periapical periodontitis with unclosed root tips is reliable.It can effectively reduce the average number and cycle of treatment in patients,reduce the level of inflammatory factors in patients,and improve the retention rate of diseased teeth.The long-term curative effect is good,and it is worthy of promotion.