牙髓炎合并牙髓根尖周病患者行热牙胶根管充填的效果观察

Application of hot gum root canal filling in patients with pulpitis complicated with periapical pulp disease

目的探讨牙髓炎合并牙髓根尖周病患者行热牙胶根管充填的效果。方法选取2020年2月至2023年3月在河南大学第一附属医院诊治的104例牙髓炎合并牙髓根尖周病患者为研究对象,按照随机数字表法分为对照组与观察组,每组52例。对照组予以冷牙胶侧方加压根管填充,观察组予以热牙胶垂直加压充填。比较两组临床疗效、填充效果和根管填充时间;比较两组治疗前(T0)、治疗1个月后(T1)、治疗3个月后(T2)牙周指数[出血指数(BI)、牙周袋深度(PD)、牙龈指数(GI)、菌斑指数(PLI)];比较两组治疗前、治疗后3、7 d视觉模拟评分法(VAS)评分。结果观察组治疗总有效率高于对照组,适填率高于对照组,超填率、根管填充时间均低于对照组,差异有统计学意义(P<0.05)。重复测量方差分析显示,两组BI、PD、GI、PLI、VAS评分存在时点、交互、组间效应(P<0.05);在T1、T2时点,观察组BI、PD、GI、PLI低于对照组,差异有统计学意义(P<0.05);治疗后3、7 d,观察组VAS评分低于对照组,差异有统计学意义(P<0.05)。结论热牙胶垂直加压充填治疗牙髓炎合并牙髓根尖周病具有较理想的效果,有利于改善牙周情况,减轻疼痛。

Objective To investigate the application of hot gum root canal filling in patients with pulpitis complicated with periapical pulp disease.Methods A total of 104 patients with pulpitis combined with periapical pulp disease diagnosed and treated in the First Affiliated Hospital of Henan University from February 2020 to March 2023 were selected as the study objects,and were divided into control group and observation group according to random number table method,with 52 cases in each group.The control group was treated with cold dental glue lateral compression technique,and the observation group was treated with hot dental glue vertical compression filling.The clinical efficacy,filling effect and filling time of root canal were compared.The periodontal index[bleeding index(BI),periodontal pocket depth(PD),gingival index(GI),plaque index(PLI)]were compared before treatment(T0),1 month after treatment(T1),3 months after treatment(T2),and visual analogue pain scale(VAS)was compared before treatment,3 and 7 days after treatment.Results The total effective rate of observation group was higher than that of control group(P<0.05).The proper filling rate of the observation group was higher than that of the control group,but the overfilling rate and root canal filling time were lower than those of the control group(P<0.05).Repeated measurement ANOVA showed that there were time-point,interaction and intergroup effects in BI,PD,GI,PLI and VAS scores between the two groups(P<0.05).At T1 and T2,BI,PD,GI and PLI in observation group were lower than those in control group(P<0.05).At 3 and 7 days after treatment,the VAS score of the observation group was lower than that of the control group(P<0.05).Conclusions The treatment of pulpitis combined with periapical pulp disease with vertical pressure filling with hot gum has a better effect,which is conducive to improving the periodontal condition and alleviating pain.