一次性根管术中填充不同材料在牙体牙髓病患者治疗中的应用比较

Comparison of different materials filled in disposable root canal surgery in treatment of patients with dental pulp disease

目的 探讨牙体牙髓病患者一次性根管术中应用不同材料填充的效果。方法 选取2019年5月至2021年5月河南信合医院接收的94例牙体牙髓病患者,采用随机数字表法分为AH-plus组(使用AH-plus材料填充)和碘仿组(使用碘仿填充),两组各47例。比较两组疗效;比较两组治疗前、治疗1周时视觉模拟评分(VAS);比较两组治疗前、治疗4周时龈沟液肿瘤坏死因子(TNF)-α、超敏C反应蛋白(hs-CRP)水平。结果 治疗6个月时,AH-plus组总有效率(91.49%)与碘仿组(87.23%)比较,差异无统计学意义(P>0.05);治疗1周时,两组VAS评分低于治疗前,且AH-plus组[(3.54±0.67)分]低于碘仿组[(4.01±0.73)分],差异有统计学意义(P<0.05);治疗4周时,两组龈沟液TNF-α、hs-CRP水平均低于治疗前,且AH-plus组[(64.58±14.37)ng/L、(4.17±1.13)mg/L]低于碘仿组[(76.44±17.93)ng/L、(5.04±1.22)mg/L],差异有统计学意义(P<0.05)。结论 与碘仿氧化锌丁香油糊剂比较,一次性根管术采用AH-plus根充糊剂填充治疗牙体牙髓病止痛效果更好,同时具有良好的抗炎效果,两种材料远期疗效相当。

Objective To investigate the effect of different materials in disposable root canal surgery in patients with dental pulp disease.Methods Totally 94 patients with dental pulp disease received by Henan Xinhe Hospital from May 2019 to May 2021 were selected, a random number table method was used to divide them into AH-plus group(filled with AH-plus material) and iodoform group(filled with iodoform),47 cases in each group.The efficacy of the two groups was compared;Visual analogue scale(VAS) was compared between the two groups before treatment and at 1 week after treatment;The levels of tumor necrosis factor(TNF)-α and high-sensitivity C-reactive protein(hs-CRP) in gingival crevicular fluid of both groups were compared before and at 4 weeks after treatment.Results After 6 months of treatment, there was no statistical significant difference in comparison of total effective rate between AH-plus group(91.49%) and iodoform group(87.23%)(P>0.05);At 1 week after treatment, the VAS score of both groups was lower than that before treatment, and the AH-plus group [(3.54±0.67) score] was lower than that of iodoform group [(4.01±0.73) score],the difference was statistically significant(P<0.05);At 4 weeks after treatment, the levels of TNF-α and hs-CRP in gingival crevicular fluid of both groups were lower than those before treatment, and the AH-plus group [(64.58±14.37) ng/L,(4.17±1.13) mg/L] was lower than the iodoform group [(76.44±17.93) ng/L,(5.04±1.22) mg/L],the difference was statistically significant(P<0.05).Conclusion Compared with iodoform zinc oxide clove oil paste, disposable root canal surgery with AH-plus root filling paste has better analgesic effect in the treatment of dental pulp disease, while it has good anti-inflammatory effect, and the long-term efficacy of the two materials are equivalent.