不同抗菌药物联合CGF应用于年轻恒牙血运重建的效果和IL-17、CCL21及IP-10水平变化

Effects of different antibiotics combined with CGF on revascularization of young permanent teeth and changes of IL⁃17,CCL21 and IP⁃10 levels

目的 分析不同抗菌药物联合浓缩生长因子(CGF)应用于年轻恒牙血运重建的效果和白细胞介素17(IL-17)、趋化因子配体21(CCL21)及干扰素γ诱导蛋白10(IP-10)水平变化。方法 选取2021年1月至2022年6月沧州市人民医院收治的270例年轻恒牙牙髓坏死或根尖周炎患者作为研究对象,均进行牙髓血运重建术治疗。根据不同抗菌药物使用将患者分为A组(n=90)、B组(n=90)及C组(n=90),其中A组使用三联抗生素糊剂,B组使用Vitapex糊剂,C组使用氢氧化钙联合替硝唑糊剂封药。根据不同的支架使用,将A、B、C组患者分为A1组(n=45)、B1组(n=45)、C1组(n=45)及A2组(n=45)、B2组(n=45)、C2组(n=45),其中A1、B1、C1组使用CGF支架,A2、B2、C2组使用血凝块支架。在治疗后对患者随访6个月,比较各组的治疗效果、牙体变色情况、牙根管壁厚度、牙冠根比及龈沟液IL-17、CCL21与IP-10水平。结果 不同组之间的治疗有效率比较,差异有统计学意义(χ^(2)=9.450、6.394,均P<0.05);不同组之间的牙体变色率比较,,差异有统计学意义(χ^(2)=6.625、6.944,均P<0.05);不同组之间的龈沟液IL-17、CCL21、IP-10水平比较,A1组>B1组>C1组,A2组>B2组>C2组(F=13.290,14.842,9.470,12.537,21.416,6.211,均P<0.05)。结论 氢氧化钙联合替硝唑糊剂联合CGF对年轻恒牙血运重建的效果及龈沟液IL-17、CCL21、IP-10水平变化优于三联抗生素、Vitapex糊剂。

Objective To analyze the effects of different antibiotics combined with concentrated growth factor(CGF)on revascularization in young permanent teeth and changes in levels of interleukin-17(IL-17),chemokine ligand 21(CCL21)and interferon-gamma-induced protein 10(IP-10).Methods A total of 270 young patients with pulp necrosis or periapical periodontitis of permanent teeth treated at Cangzhou People's Hospital from January 2021 to June 2022 were selected as the study subjects.All patients were treated with pulp revascularization.Based on the use of different antibiotics,the patients were divided into three groups:group A(n=90),group B(n=90)and group C(n=90).Group A received triple antibiotic paste,group B re-ceived Vitapex paste,and group C received a combination of calcium hydroxide and tinidazole paste.Within each group,patients were further divided into subgroups based on the type of stent used:A1(n=45),B1(n=45),C1(n=45),A2(n=45),B2(n=45)and C2(n=45).CGF stents were used in subgroups A1,B1 and C1,while blood clot stents were used in subgroups A2,B2 and C2.Patients were followed up for 6 months post-treatment,and the study compared the therapeutic outcomes,tooth discoloration,root canal wall thick-ness,crown-to-root ratio,and levels of IL-17,CCL21 and IP-10 in gingival crevicular fluid among all groups.Results There were significant differences in treatment effectiveness among different groups(χ^(2)=9.450,6.394,P<0.05).There was a significant difference in tooth discoloration rates among the different groups(χ^(2)=6.625,6.944,P<0.05).The levels of IL-17,CCL21 and IP-10 in the crevicular fluid of the different groups were compared as follows:Group A1>B1>C1,group A2>B2>C2(F=13.290,14.842,9.470,12.537,21.416,6.211,P<0.05).Conclusion The combination of calcium hydroxide and tinidazole paste with CGF has a more positive effect on the revascularization of young permanent teeth and the levels of IL-17,CCL21 and IP-10 in gingival crevicular fluid compared to triple antibiotics and Vitapex paste.