牙周牙髓联合病变应用综合治疗的效果观察

Observation on the effect of comprehensive treatment of combined periodontic-endodontic lesions

目的 观察牙周牙髓联合病变患者接受综合治疗(根管治疗+龈下刮治+引导组织再生术)的效果。方法 110例牙周牙髓联合病变患者,随机分为观察组和对照组,每组55例。观察组应用综合治疗(根管治疗+龈下刮治+引导组织再生术),对照组应用传统治疗(根管治疗+龈下刮治)。比较两组治疗效果、牙周指数[探诊深度(PD)、出血指数(BI)、菌斑指数(PLI)、牙龈指数(GI)]、咀嚼功能、预后情况。结果 观察组、对照组的总有效率均为96.36%,比较无显著差异(P>0.05)。治疗后,两组PD、BI、PLI、GI较本组治疗前降低,且观察组PD(3.37±0.47)mm、BI(1.68±0.30)、PLI(0.69±0.09)、GI(1.01±0.38)低于对照组的(4.49±0.53)mm、(2.31±0.34)、(1.12±0.12)、(1.64±0.40)(P<0.05)。治疗后6、12个月,观察组咀嚼功能评分分别为(6.05±0.63)、(7.28±0.79)分,显著高于对照组的(4.11±0.67)、(5.52±0.75)分(P<0.05)。随访1年,观察组的牙齿保留率69.09%显著高于对照组的49.09%,牙周炎复发率3.64%、牙髓炎复发率5.45%显著低于对照组的20.00%、21.82%(P<0.05)。结论 根管治疗+龈下刮治+引导组织再生术在治疗牙周牙髓联合病变方面具有明显优势,不仅能够改善患者的牙周指数以及咀嚼功能,同时还可以提高患者的牙齿保留率,减少牙周炎和牙髓炎的复发,具有显著疗效。

Objective To observe the effect of comprehensive treatment of root canal therapy+subgingival curettage+guided tissue regeneration for combined periodontic-endodontic lesions.Methods A total of 110 patients with combined periodontic-endodontic lesions were randomly divided into an observation group and a control group,with 55 cases in each group.The observation group received comprehensive treatment(root canal therapy+subgingival curettage+guided tissue regeneration),and the control group received traditional treatment(root canal therapy+subgingival curettage).The therapeutic effect,periodontal index[probing depth(PD),bleeding index(BI),plaque index(PLI),gingival index(GI)],masticatory function and prognosis of the two groups were compared.Results The total effective rate of the observation group and the control group was both 96.36%,and there was no significant difference(P>0.05).After treatment,PD,BI,PLI and GI in both groups were lower than those before treatment;the observation group had PD of(3.37±0.47)mm,BI of(1.68±0.30),PLI of(0.69±0.09)and GI of(1.01±0.38),which were lower than(4.49±0.53)mm,(2.31±0.34),(1.12±0.12)and(1.64±0.40)in the control group(P<0.05).After 6 and 12 months of treatment,the masticatory function scores of the observation group were(6.05±0.63)and(7.28±0.79)points,which were significantly higher than(4.11±0.67)and(5.52±0.75)points of the control group(P<0.05).After 1 year of follow-up,the tooth retention rate of 69.09%in the observation group was significantly higher than 49.09%in the control group;the recurrence rate of periodontitis and pulpitis were 3.64%and 5.45%,which were significantly lower than 20.00%and 21.82%in the control group(P<0.05).Conclusion Root canal therapy+subgingival curettage+guided tissue regeneration has obvious advantages in the treatment of combined periodontic-endodontic lesions,which can not only improve the patient's periodontal index as well as masticatory function,but also improve the tooth retention rate,reduce the recurrence of periodontitis and pulpitis,which has a remarkable efficacy.