超声冲洗结合氯己定在牙髓炎根管治疗中的应用效果评价

Application of ultrasonic irrigation combined with chlorhexidine in root canal treatment of pulpitis

目的:探讨超声冲洗结合氯己定在牙髓炎根管治疗中的应用效果。方法:将120例牙髓炎根管治疗患者随机分为试验组(n=60,患牙72颗)和对照组(n=60,患牙70颗)。根管预备时,试验组采用氯己定联合超声冲洗,对照组采用氯己定常规冲洗。比较2组患者根管预备前后根管菌落数、内毒素含量,术后根管治疗约诊间疼痛(endodontic inter appointment pain,EIAP)发生率、侧支根管填充率、牙疼痛程度,随访1年,统计治疗成功率。采用SPSS 19.0软件包对数据进行统计学分析。结果:根管预备后,试验组和对照组的菌落数较根管预备前显著减少(P<0.05),且试验组菌落数显著少于对照组(P<0.05);根管预备后,试验组和对照组的内毒素水平较根管预备前显著降低(P<0.05),且试验组显著低于对照组(P<0.05)。试验组和对照组的侧支根管填充率分别为29.17%、11.43%,组间差异有显著性(P<0.05);EIAP发生率分别为4.17%、14.29%,组间差异有显著性(P<0.05)。治疗后48 h,试验组和对照组的疼痛视觉模拟评分(visual analogue scale,VAS)分别为(2.74±0.61)和(3.29±0.68)分,较术前显著降低(P<0.05),2组术后48 h的VAS评分组间差异有显著性(P<0.05);术后1周,试验组和对照组的VAS评分分别为(1.52±0.34)和(1.81±0.42)分,较术前及术后48 h显著降低(P<0.05),2组术后1周的VAS评分组间差异有显著性(P<0.05)。对照组治疗成功率为84.62%,试验组为95.71%,组间差异有显著性(P<0.05)。结论:超声冲洗结合氯己定用于牙髓炎根管治疗,有助于降低根管预备后细菌及内毒素水平,减轻术后牙疼痛程度,提升侧支根管填充率,疗效优越。

PURPOSE:To explore the clinical effect of ultrasonic irrigation combined with chlorhexidine in root canal treatment of pulpitis.METHODS:A total of 120 patients with pulpitis treated with root canal therapy were randomly divided into a study group(n=60,72 affected teeth)and a control group(n=60,70 affected teeth).During root canal preparation,the study group was treated with chlorhexidine combined with ultrasonic irrigation,while the control group was treated with chlorhexidine conventional irrigation.The bacterial count and endotoxin content in the root canal before and after root canal preparation were compared between the two groups,as well as the endodontic inter-appointment pain(EIAP),lateral branch root canal filling rate,and degree of tooth pain after root canal treatment.The success rate of treatment was statistically analyzed after one-year follow-up.Statistical analysis was performed with SPSS 19.0 software package.RESULTS:After root canal preparation,the number of colonies in experimental group and control group was significantly decreased compared with that before root canal preparation(P<0.05),and the number of colonies in experimental group was significantly lower than that in control group(P<0.05).After root canal preparation,endotoxin levels in experimental group and control group were significantly lower than those before root canal preparation(P<0.05),and the level in experimental group was significantly lower than that in control group(P<0.05).The lateral branch root canal filling rate in the study group and the control group was 29.17%and 11.43%,respectively,with significant difference between the groups(P<0.05).The incidence of EIAP was 4.17%and 14.29%,respectively,with significant difference between the two groups(P<0.05).At 48 hours after surgery, the visual analogue score (VAS) of the study group and the control group was (2.74±0.61) and (3.29±0.68), respectively, which were significantly lower than at before surgery(P<0.05). There was a significant difference in VAS score between the two groups 48 hours after surgery(P<0.05). One week after surgery, the VAS score in the study group and the control group was (1.52±0.34) and (1.81±0.42), respectively, significantly lower than that before and 48 hours after surgery(P<0.05). There was a significant difference in VAS score between the two groups at one week after surgery (P<0.05). The successful rate of treatment in the control group was 84.62%, and 95.71% in the study group, with a significant difference between the two groups(P<0.05). CONCLUSIONS: The application of ultrasonic irrigation combined with chlorhexidine in the treatment of pulpitis root canals can help reduce the level of bacteria and endotoxin after root canal preparation, alleviate the degree of postoperative tooth pain, and improve the filling rate of lateral branch root canals, with superior curative effects.