根管显微镜技术联合超声技术对牙体牙髓病患者基牙相关指标及咀嚼功能的影响观察

Effect observation of root canal microscopy combined with ultrasound on abutment parameters and masticatory function in patients with dental pulp disease

目的观察对牙体牙髓病患者给予根管显微镜技术联合超声技术治疗的效果,并评价其对患者基牙相关指标、咀嚼功能的影响。方法90例牙体牙髓病患者参与研究,以1∶1比例法分成对照组和观察组,每组45例。对照组给予常规根管治疗,观察组给予根管显微镜技术联合超声技术治疗。比较两组患者的基牙相关指标[牙周袋深度(PD)、龈沟出血指数(SBI)、牙龈指数(GI)、菌斑指数(PLI)]、龈沟液炎性因子[超敏C反应蛋白(hs-CRP)、白细胞介素-1β(IL-1β)、肿瘤坏死因子-α(TNF-α)]水平、疼痛程度、咀嚼功能、口腔健康状况。结果治疗后,观察组PD、SBI、GI、PLI分别为(2.32±0.29)mm、(1.29±0.18)、(0.73±0.10)、(0.86±0.13),均比对照组的(3.50±0.26)mm、(2.30±0.25)、(1.65±0.18)、(1.21±0.17)更低(t=20.323、21.994、29.972、10.971,P<0.05)。治疗后,观察组龈沟液中hs-CRP、IL-1β、TNF-α水平分别为(5.69±1.02)mg/L、(6.75±0.61)pg/ml、(3.60±1.12)ng/ml,均比对照组的(7.13±1.18)mg/L、(7.91±0.82)pg/ml、(5.03±1.51)ng/ml更低(t=6.193、7.614、5.102,P<0.05)。治疗后,观察组疼痛评分(2.39±0.76)分比对照组的(3.51±0.90)分更低(t=6.378,P<0.05)。治疗后,观察组咀嚼速度、咀嚼力度、咀嚼次数评分分别为(70.50±3.82)、(71.23±2.61)、(73.45±3.28)分,均比对照组的(62.62±3.51)、(65.87±3.50)、(66.19±2.71)分更高(t=10.190、8.235、11.447,P<0.05)。治疗后,观察组影响发音、影响味觉、影响饮食、影响日常生活、影响睡眠评分分别为(1.57±0.48)、(1.92±0.21)、(1.23±0.40)、(1.68±0.20)、(1.58±0.28)分,均比对照组的(2.18±0.32)、(2.68±0.30)、(2.35±0.26)、(2.70±0.29)、(2.12±0.16)分更低(t=7.093、13.922、15.748、19.423、11.233,P<0.05)。观察组治疗总有效率93.33%比对照组的73.33%更高(χ2=6.480,P<0.05)。结论根管显微镜技术联合超声技术能够抑制牙体牙髓病患者龈沟液炎性因子水平,改善基牙相关指标,提高咀嚼功能,值得进一步应用。

Objective To observe the effect of root canal microscopy combined with ultrasound on patients with dental pulp disease,and evaluate its influence on abutment parameters and masticatory function of patients.Methods 90 patients with dental pulp disease were selected to participate in the study,and were divided into a control group(45 cases)and an observation group(45 cases)with 1∶1 ratio.The control group was given conventional root canal therapy,and the observation group was given root canal microscopy combined with ultrasound.Patients in both groups were compared in terms of abutment parameters[periodontal probing depth(PD),sulcus bleeding index(SBI),gingival index(GI),plaque index(PLI)],gingival crevicular fluid inflammatory markers[hypersensitive C-reactive protein(hs-CRP),interleukin-1β(IL-1β),tumor necrosis factor-α(TNF-α)]level,pain degree,mastication function and oral health status.Results After treatment,PD,SBI,GI and PLI in the observation group were(2.32±0.29)mm,(1.29±0.18),(0.73±0.10)and(0.86±0.13),which were lower than(3.50±0.26)mm,(2.30±0.25),(1.65±0.18)and(1.21±0.17)in the control group(t=20.323,21.994,29.972,10.971;P<0.05).After treatment,the levels of hs-CRP,IL-1βand TNF-αin gingival crevicular fluid of the observation group were(5.69±1.02)mg/L,(6.75±0.61)pg/ml and(3.60±1.12)ng/ml,which were lower than(7.13±1.18)mg/L,(7.91±0.82)pg/ml and(5.03±1.51)ng/ml of the control group(t=6.193,7.614,5.102;P<0.05).After treatment,the pain score of the observation group was(2.39±0.76)points,which was lower than(3.51±0.90)points of the control group(t=6.378,P<0.05).After treatment,the scores of mastication speed,mastication intensity and mastication frequency in the observation group were(70.50±3.82),(71.23±2.61)and(73.45±3.28)points,which were higher than(62.62±3.51),(65.87±3.50)and(66.19±2.71)points in the control group(t=10.190,8.235,11.447;P<0.05).After treatment,the scores of influence on pronunciation,taste,diet,daily life and sleep in the observation group were(1.57±0.48),(1.92±0.21),(1.23±0.40),(1.68±0.20)and(1.58±0.28)points,which were lower than(2.18±0.32),(2.68±0.30),(2.35±0.26),(2.70±0.29)and(2.12±0.16)points in the control group(t=7.093,13.922,15.748,19.423,11.233;P<0.05).The total effective rate was 93.33%in the observation group,which was higher than 73.33%in the control group(χ2=6.480,P<0.05).Conclusion Root canal microscopy combined with ultrasound can inhibit the level of gingival crevicular fluid inflammatory markers,improve abutment parameters,and enhance masticatory function in patients with dental pulp disease,which is worthy of further application.