MTA联合不同根管消毒药治疗难治性慢性根尖周炎的效果对比  

Effect of MTA combined with different root canal disinfectants on refractory chronic periapical periodontitis

作　　者：吴浩明 WU Hao-ming(Shunde Hospital affiliated to Guangzhou Medical University,Foshan 528315,China)

机构地区：[1]广州医科大学附属顺德医院,广东佛山528315

出　　处：《中国处方药》2021年第1期154-156,共3页Journal of China Prescription Drug

基　　金：佛山市自筹经费类科技计划项目(2017AB003673)。

摘　　要：目的探索MTA联合不同根管消毒药治疗难治性慢性根尖周炎的效果。方法将2016年7月~2018年7月期间口腔科收治的经根管治疗后无效需行根尖手术治疗的患者152例作为研究对象,共168颗患牙,随机分为A组、B组和C组,所有患者均进行根尖手术治疗且采用MTA填充,三组患者填充前分别采用Ca(OH)2甲硝唑联合糊剂、甲醛甲酚溶液、液樟脑酚液加碘仿进行消毒;术后对患者进行1年的随访,随访间隔为3个月,观察指标包括手术成功率,疼痛评分,咀嚼功能异常发生率,感染、肿胀、疼痛(VAS评分大于2分者)等不良并发症发生率。结果 A组手术成功率为89.29%,B组为74.07%,C组为72.41%,A组手术成功率最高,差异有统计学意义(P <0.05);术后A组疼痛评分为(1.9±0.9)分,B组评分为(2.6±1.3)分,C组评分为(2.8±1.1)分,A组最低,差异有统计学意义(P <0.05),A组术后咀嚼异常发生率为1.79%,B组为11.11%,C组为8.62%,A组最低,差异有统计学意义(P <0.05);术后A组不良并发症发生率为7.02%,B组为22.22%,C组为18.97%,A组最低,且差异均有统计学意义(P <0.05)。结论 Ca(OH)2甲硝唑糊剂联合MTA治疗效果最好,且不良反应少。Objective To explore the effect of MTA combined with different root canal disinfectants in the treatment of refractory chronic periapical periodontitis.Methods From July 2016 to July 2018,152 patients who were ineffective after root canal therapy and needed apical surgery were selected as the study subjects.168 teeth were randomly divided into group A,group B and group C.All patients underwent apical surgery and were filled with MTA.Ca(OH)2 metronidazole combined paste,formaldehyde cresol solution,liquid camphor phenol solution and iodoform for disinfection were used before filling in the three groups;patients were followed up for one year after operation with a follow-up interval of 3 months.Observation indicators included the success rate of surgery,pain score,incidence of abnormal chewing,infection,swelling,pain(VAS score greater than 2 points)and other adverse complications.Results The success rate of operation was 89.29%in group A,74.07%in group B and 72.41%in group C.The highest success rate was found in group A(P<0.05).The pain score of group A was(1.9±0.9)points,that of group B was(2.6±1.3)points,that of group C was(2.8±1.1)points,and that of group A was the lowest(P<0.05).The incidence of abnormal chewing was 1.79%in group A,11.11%in group B and 8.62%in group C.The incidence of adverse complications was 7.02%in group A,22.22%in group B,18.97%in group C and the lowest in group A(P<0.05).Conclusion Ca(OH)2 metronidazole paste combined with MTA has the best therapeutic effect and fewer adverse reactions.

关 键 词：消毒药 根尖周炎 咀嚼异常 CA(OH)2 

分 类 号：R781.05[医药卫生—口腔医学] R781.341[医药卫生—临床医学]