三联抗生素糊剂联合牙髓血运重建术治疗牙髓炎坏死恒牙的疗效及对龈沟液中细胞因子的影响

Effect of Triple Antibiotic Paste Combined with Pulp Revascularization in Treatment of Pulpitis and Necrotic Permanent Teeth and Its Influence on Cytokines in Gingival Crevicular Fluid

目的:探究三联抗生素糊剂联合牙髓血运重建术治疗牙髓炎坏死恒牙的疗效以及对龈沟液中血管内皮细胞生长因子(Vascular endothelial growth factor,VEGF)、碱性成纤维细胞生长因子(Basic fibroblast growth factor,bFGF)的影响。方法:选取2019年6月-2022年6月笔者医院收治的60例行牙髓血运重建术的牙髓炎坏死恒牙患者,随机分为观察组和对照组,每组30例。对照组应用氢氧化钙糊剂,观察组应用三联抗生素糊剂。监测两组患者治疗前后的临床疗效,术后1个月、2个月、3个月的疼痛视觉模拟(Visual analogue scale,VAS)评分,龈沟液中VEGF、bFGF和血小板衍生生长因子(Platelet-derived growth factor,PDGF)水平。调查两组患者治疗后满意度及不良反应发生情况。结果:治疗后,观察组总有效率、满意度、VEGF水平、bFGF和PDGF水平均高于对照组(P<0.05);患者术后1个月、2个月、3个月VAS评分低于对照组(P<0.05);两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:三联抗生素糊剂联合牙髓血运重建术治疗牙髓炎坏死恒牙效果良好,可以帮助修复牙髓组织和根尖组织,有效减轻患者疼痛程度,促进牙根发育。

Objective To explore the effect of of triple antibiotic paste combined with dental pulp revascularization on permanent necrotic teeth with pulpitis and its effect on vascular endothelial growth factor(VEGF)and basic fibroblast growth factor(bFGF)in gingival crevicular fluid.Methods A total of 60 patients with permanent necrotic teeth with pulpitis in author's hospital from June 2019 to June 2022 were selected and randomly divided into study group(n=30)and control group(n=30).The control group received calcium hydroxide combined with dental pulp revascularization,the study group was treated with triple antibiotic paste combined with dental pulp revascularization.Compare the clinical efficacy,the visual analogue scale(VAS)at the first month,the 2th month and the 3th month after operation,the levels of VEGF,bFGF and platelet derived growth factor(PDGF).The satisfaction and adverse reactions of the two groups were investigated.Results After treatment,the total effective rate,the satisfaction,the level of VEGF,the level of bFGF and the level of PDGF were higher,the the VAS score at the first month,at the 2th month and the 3th month of the study group were lower than those of the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion The triple antibiotic paste combined with dental pulp revascularization in the treatment of permanent necrotic teeth with pulpitis have a good effect which can effectively reduce the pain of patients,repair pulp and apical tissue and promote root development.