机用镍钛器械与手用镍钛扩大锉在牙根管治疗患儿的应用效果比较  

Comparison of Application Effect of NiTi Rotary Instruments and Hand NiTi Enlarging File in Children with Root Canal Therapy

作　　者：欧晓丽[1] 施春梅[1] 周嫣[1] 赵玮[2] 唐倩[1] 罗菊芬[1] OU Xiao-li SHI Chun-mei ZHOU Yan ZHAO Wei TANG Qian LUO Ju-fen(Department of Stomatology, The People＇s Hospital of Guanxi Zhuang Autonomous Region, Nanning 530021, China Department of Pediatric Dentistry, Guanghua School of Stomatology, Sun Yat-Sen University, Guangzhou 510055, China)

机构地区：[1]广西壮族自治区人民医院口腔科,广西南宁530021 [2]中山大学光华口腔医院儿童牙科,广东广州510055

出　　处：《中山大学学报（医学科学版）》2017年第5期727-731,共5页Journal of Sun Yat-Sen University:Medical Sciences

基　　金：广西卫计委科研课题(Z2012270)

摘　　要：【目的】探讨机用镍钛器械对牙根管治疗患儿应激反应及治疗效果的影响,分析其可能作用机制。【方法】选择2015年3月-2017年3月行根管治疗术乳牙牙髓病或根尖病患儿60例(60颗牙)为研究对象,采用随机数字表法分为观察组和对照组各30例(30颗牙),对照组采用手用镍钛扩大挫,观察组采用机用镍钛器械,比较两组患儿根管预备效果、应激反应、疼痛程度、填充效果及远期疗效等指标。【结果】观察组根管根治术患儿根管预备时间明显短于对照组(P<0.01),根管偏移等根管形态变化发生率6.67%,明显低于对照组26.67%(P<0.05);龈沟液肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、白细胞介素-1β(IL-1β)等含量明显低于对照组(P<0.05,P<0.01);根管预备中、根管预备后疼痛率均明显低于对照组(10.00%vs 33.33%,3.33%vs 23.33%,P<0.05);术后1周,观察组患儿恰填率93.33%,明显高于对照组70.00%(P<0.05);随访6个月,观察组根管术成功率90.00%,明显高于对照组66.67%(P<0.05)。【结论】机用镍钛器械有助于缓解牙根管治疗患儿疼痛程度,提高临床疗效,可能与抑制手术应激反应有关。【Objective】To study effect of pain and stress response of NiTi rotary instrument for children with root canal therapy,and analyzed possible mechanisms.【Methods】60 cases（60 teeth）children with Dental pulp disease or root tip disease by root canal therapy from March 2015 to March 2017 were divided into observation group and control group. The control group used Hand Ni Ti enlarging file,observation group used Ni Ti rotary instruments,then root canal preparation,stress response,pain,filling effect and long-term efficacy were compared between two groups.【Result】The observation group root canal preparation time were significantly shorter than control group（P〈0.01）,root canal deviation etc morphological changes（6.67%）was significantly lower than control group（26.67%,P〈0.05）;gingival crevicular fluid TNF-α,IL-6,IL-1β were significantly lower than control group（P〈0.05,P〈0.01）. In root canal preparation,after root canal preparation,pain rate were significantly lower than control group（10.00% vs33.33%,3.33% vs 23.33%,P〈0.05）;1 week after surgery,just fill rate（93.33%）was significantly higher than control group（70.00%,P〈0.05）. Followed up 6 months,root canal success rate（90.00%）was significantly higher than control group（66.67%,P〈0.05）.【Conclusion】Ni Ti rotary instruments help to reduce the pain in children with root canal,improve clinical efficacy,May be related to inhibition of surgical stress response.

关 键 词：根管治疗 乳牙 机用镍钛器械 疼痛程度 应激反应 

分 类 号：R781.33[医药卫生—口腔医学]