孕早期急性牙髓炎根管治疗的临床疗效观察

Clinical Effect of Endodontics for Acute Pulpitis in Early Pregnancy

目的:针对孕早期罹患急性牙髓炎的患者,探讨一种安全有效的治疗方案。方法:孕早期诊断为急性牙髓炎的患者29例(29颗患牙),术前孕期口腔卫生宣教缓解患者的焦虑情绪,使用无痛局麻仪,待局部麻醉显效后行开髓拔髓,根管预备后置入ApexCal糊剂,暂封,分娩后2~3月完成根管充填;记录术前、术后48 h的VAS疼痛评分,封药期间患牙情况,以及妊娠结局及新生儿情况(Apgar评分表);根管治疗术后12月复查。结果:术前、术后48 h的VAS疼痛评分差异有统计学意义(P<0.001),28例根管预备后有效止痛,且安全度过孕期,有效率96.6%;术后12月复查,27例最终治疗成功,成功率93.1%;所有患者均未出现流产等不良妊娠结局,Apgar评分表评价均为正常新生儿。结论:孕早期急性牙髓炎患者在消除焦虑情绪的前提下,注重术中无痛无菌及微创操作,延期完成根管治疗,方法安全有效。

Objective:To explore a safe and effective treatment for acute pulpitis in early pregnancy.Methods:Twenty-nine patients(29 teeth)with acute pulpitis diagnosed in the early pregnancy were treated with oral hygiene instruction before operation to relieve their anxiety.The access and coronal cavity preparation was performed under Single Tooth Anesthesia System.ApexCal paste was placed with temporary glass ionomer sealers after cleaning and shaping the root canal system.Root canal obturation was completed 2-3 months after delivery.The VAS pain rating scale before and 48 hours after the operation,the condition of teeth during the drug sealing period,and the pregnancy outcome and newborn condition(Apgar rating scale)were recorded.Follow-up was performed 12 months after root canal therapy.Results:There was a significant difference in VAS pain scores before and 48 hours after operation(P<0.001).After root canal preparation,28 cases had effective pain relief and safely passed the pregnancy period.The effective rate was 96.6%.After 12 months of reexamination,27 cases were finally treated successfully,with a success rate of 93.1%.All patients did not have adverse pregnancy outcomes,such as abortion,and Apgar scoring scale assessed normal newborns.Conclusion:The patients with acute pulpitis in early pregnancy can delay the completion of root canal obturation with painless,aseptic,and minimally invasive operation on the premise of eliminating anxiety,which is safe and effective.