氢氧化钙及三重抗生素糊剂联合用于根管消毒的临床疗效观察  

Clinical effect of calcium hydroxide paste combined with triple antibiotic paste on root canal disinfection

作　　者：屈晨[1] 王萍[1] 徐艳[1] 贺龙珠 

机构地区：[1]重庆医科大学附属第一医院口腔科,重庆400016

出　　处：《解放军医学杂志》2014年第2期138-143,共6页Medical Journal of Chinese People's Liberation Army

摘　　要：目的观察比较氢氧化钙糊剂和三重抗生素糊剂(奥硝唑、环丙沙星和米诺环素)单独以及联合用于根管消毒的临床疗效和疼痛控制情况。方法选择235例患有慢性根尖周炎的患者,共235颗患牙,根据有无瘘管分为2个大组:有瘘型(n=118)和无瘘型(n=117)。每个大组又随机分为4个小组:氢氧化钙糊剂组、三重抗生素糊剂组、氢氧化钙+三重抗生素糊剂组及樟脑酚组。患牙常规根管预备后分别于根管内封入沾有4种药物的纸尖,同时让患者填写视觉模拟疼痛量表。1周后复诊,分析封药后疼痛反应及根管消毒效果。结果无论有瘘型还是无瘘型,氢氧化钙糊剂组、三重抗生素糊剂组及氢氧化钙+三重抗生素糊剂组封药7d后疗效差异无统计学意义(P>0.05),且均明显优于樟脑酚组(P<0.05)。VAS评分结果显示,至少在封药后的前3d,无论有瘘型还是无瘘型,氢氧化钙+三重抗生素糊剂组在疼痛控制方面均明显优于其他3组,差异有统计学意义(P<0.05)。结论氢氧化钙糊剂、三重抗生素糊剂、氢氧化钙联合三重抗生素糊剂作为根管消毒药物对慢性有瘘型和无瘘型根尖周炎均有较好的疗效,且氢氧化钙糊剂与三重抗生素糊剂联用时能更有效地控制根管治疗后的疼痛反应,值得临床上推广应用。Objective To compare the efficacy in disinfection and pain control of calcium hydroxide paste and triple antibiotic paste （ornidazole, ciprofloxacin and minocycline） used individually or jointly for root canal disinfection. Methods Two hundred and thirty-five patients with chronic apical periodontitis （235 teeth） were involved in the present study and divided into 2 groups： fistula group （n=118） and no fistula group （n=117）. Each group was then randomly divided into 4 subgroups： calcium hydroxide paste group, triple antibiotic paste group, calcium hydroxide ＋ triple antibiotic paste group, and camphor phenol group. After regular root canal preparation, root canals of patients in 4 groups were filled with tiny paper ends impregnated with fore 4 different drugs respectively. Visual analogue scales （VAS） of pain were given to the patients with a guide for filling the scale. One week later, both the data of the scales and the effects of root canal disinfection were recorded and analyzed. Results Seven days after treatment, the clinical efficacy of calcium hydroxide paste, triple antibiotic paste and calcium hydroxide ＋ triple antibiotic paste was similar （P〉0.05） either in fistula group or in no fistula group, but all better than that of camphor phenol （P〈0.05）. VAS score analysis showed that, at least on the first 3 days after sealing medicine in the root canal, calcium hydroxide ＋ triple antibiotic paste achieved better result of pain control than the other three groups （P〈0.05） no matter with or without fistula. Conclusions Calcium hydroxide paste, triple antibiotic paste, calcium hydroxide ＋ triple antibiotic paste are effective in treatment of chronic apical periodontitis whether with or without fistula. However, the combined use of calcium hydroxide and three antibiotic pastes is better for controlling the pain after root canal preparation than other treatments, which is therefore worthy of clinical application.

关 键 词：根尖周炎 根管冲洗剂 疼痛测定 

分 类 号：R781.05[医药卫生—口腔医学]