光动力疗法联合氢氧化钙治疗窦道型慢性根尖周炎的临床效果

Clinical effect of photodynamic therapy combined with calcium hydroxide in the treatment of chronic apical periodontitis of sinus type

目的 探讨光动力疗法联合氢氧化钙治疗窦道型慢性根尖周炎的临床效果。方法 选择2022年1月至2023年3月在南京市口腔医院收治的83例窦道型慢性根尖周炎患者作为研究对象,按照随机数字表法将其分为常规组41例和联合组42例。常规组采用常规根管预备及氢氧化钙封药,联合组采用光动力疗法联合氢氧化钙封药。比较两组治疗效果,细菌清除率、根管治疗约诊间疼痛(EIAP)发生率、治疗前后牙周指标[探诊深度(PD)、龈流血指数(GBI)、菌斑指数(PLI)、牙周附着水平(CAL)]、龈沟液中白细胞介素(IL)-6、IL-1β、肿瘤坏死因子-α(TNF-α)水平。结果 联合组的治疗效果优于常规组(P<0.05)。联合组细菌清除率高于常规组(P<0.05)。联合组ELAP总发生率低于常规组(P<0.05)。治疗后1个月,两组PD、GBI、PLI、CAL均较治疗前降低,且联合组低于常规组(P<0.05)。整体分析发现:组间比较、时间点比较及交互作用差异均有统计学意义(P<0.05)。治疗后1个月和3个月两组IL-6、IL-1β、TNF-α水平低于治疗前(P<0.05)。治疗后1个月和3个月联合组IL-6、IL-1β、TNF-α水平低于常规组(P<0.05)。结论 光动力疗法联合氢氧化钙治疗窦道型慢性根尖周炎效果显著,可以提高除菌率,降低EIAP发生率。

Objective To investigate the clinical effect of photodynamic therapy combined with calcium hydroxide in the treatment of chronic apical periodontitis of sinus type.Methods A total of 83 patients with chronic apical periodontitis of sinus type admitted to Nanjing Stomatological Hospital from January 2022 to March 2023 were selected as the study objects,and they were divided into the conventional group(41 cases) and the combined group(42 cases) according to random number table method.The conventional group received conventional root canal preparation and calcium hydroxide sealing,and the combined group received photodynamic therapy combined with calcium hydroxide sealing.The therapeutic effect,bacterial clearance rate,incidence of endodontic interappointment pain(EIAP) after root canal treatment,pericrescent parameters(probing depth [PD],index of gingival bleeding [GBI],plaque index [PLI],clinical attachment level [CAL]),levels of interleukin(IL)-6,IL-1β,and tumor necrosis factor-α(TNF-α) in gingival crevicular fluid before and after treatment.Results The treatment effect of combined group was better than that of conventional group(P<0.05).The bacterial clearance rate of combined group was higher than that of conventional group(P<0.05).The total incidence of ELAP in combined group was lower than that in conventional group(P<0.05).One month after treatment,PD,GBI,PLI,and CAL in both groups were lower than before treatment,and those in combined group were lower than those in conventional group(P<0.05).The overall analysis showed that there were significant differences between groups,time point comparison,and interaction(P<0.05).The levels of IL-6,IL-1β,and TNF-αin one and three months after treatment were lower than those before treatment(P<0.05).The levels of IL-6,IL-1β,and TNF-α in combined group were lower than those in the conventional group at one and three months after treatment(P<0.05).Conclusion Photodynamic therapy combined with calcium hydroxide is effective in the treatment of chronic apical periodontitis of sinus type,which can improve the bactericidal rate and reduce the incidence of EIAP.