氯己定消毒溶液在根尖周炎患牙(伴窦道)的根管治疗中的应用

Application of Chlorhexidine Disinfectant Solution in Root Canal Treatment of Teeth with Periapical Periodontitis(Accompanied By Sinus Tract)

目的探讨氯己定消毒溶液在伴窦道形成的根尖周炎患牙显微根管治疗中的应用。方法选取2020年6月—2021年6月在本院牙体牙髓科就诊的42例有窦道形成的慢性根尖周炎的患者为研究对象,并对患者进行简单随机分组,分为观察组和对照组,进行规范的显微根管治疗。其中,对照组患者的患牙采用3%次氯酸钠+17%EDTA溶液交替进行根管化学消毒,观察组患者采用3%次氯酸钠+17%EDTA溶液+2%氯己定消毒溶液交替进行根管化学消毒。术后定期复查随访,观察两组患者治疗前后患牙疼痛数字评价表(NRS)、窦道愈合率、窦道愈合时间、就诊次数及患牙根尖周病变预后,并对收集数据进行统计学分析。结果治疗前,两组患者NRS评分对比,差异无统计学意义(P>0.05)。两组患者窦道愈合率对比,差异无统计学意义(P>0.05)。观察组的窦道愈合时间明显短于对照组(P<0.05)。观察组的患者就诊次数明显少于对照组(P<0.05)。两组患者的患牙根尖周病变预后对比,差异无统计学意义(P>0.05)。结论氯己定消毒溶液应用在伴窦道的慢性根尖周炎患牙的显微根管治疗中,能够使根管化学消毒进行得更加彻底,缩短窦道愈合的时间,减少患者的就诊次数,从而提高患牙根管治疗的成功率,能够更好地实现保存天然牙的治疗目标及愿景。

Objective To explore application of chlorhexidine disinfectant solution in micro root canal treatment of teeth with periapical periodontitis accompanied by sinus formation.Methods The paper chose 42 patients with chronic apical periodontitis with sinus formation in Dentistry and Pulp Medicine Department of our hospital from June 2020 to June 2021,and divided them into observation group and control group randomly for standardized micro root canal treatment.Control group was treated 3%sodium hypochlorite+17%EDTA solution alternately for root canal chemical disinfection,while observation group with 3%sodium hypochlorite+17%EDTA solution+2%chlorhexidine solution alternately for root canal chemical disinfection during micro root canal treatment.Regular postoperative follow-up visits were carried out to observe numerical evaluation table(NRS)of tooth pain,sinus healing rate,sinus healing time,number of visits,and prognosis of periapical lesions in two groups before and after treatment.Collected data were statistically analyzed to draw conclusions.Results There was no significant statistical difference in NRS scores between observation group and control group,no significant statistical difference in healing rate of sinus tract between observation group and control group.Healing time of sinus tract in observation group was significantly shorter than control group(P<0.05).Number of visits in observation group was significantly lower than control group,(P<0.05).There was no significant difference in prognosis of periapical lesions between observation group and control group.Conclusion Chlorhexidine disinfectant solution can achieve thorough chemical disinfection of root canal,shorten healing time of sinus tract,reduce number of visits,thereby improve success rate of root canal treatment in microscopic root canal treatment of chronic apical periodontitis with sinus tract,and achieve treatment goals and vision of preserving natural teeth.