局麻下牙髓失活术与直接拔髓治疗磨牙急性牙髓炎的疗效对比  

Efficacy of dental pulp devitalization and straight pulp extirpation under local anesthesia in the treatment of acute pulpitis of molars

作　　者：卢霞 范丽苑 邓霞 王中朝 李文慧 LU Xia;FAN Liyuan;DENG Xia;WANG Zhongchao;LI Wenhui(Department of Stomatology, The Second Affiliated Hospital of Chengdu Medical College,416 Hospital of Nuclear Industry, Chengdu 610066, China;Department of Stomatology, Stomatology Hospital Affiliated to Southwest Medical University, Luzhou 646000, Sichuan, China)

机构地区：[1]成都医学院第二附属医院·核工业四一六医院口腔科,四川成都610066 [2]西南医科大学附属口腔医院口腔科,四川泸州646000

出　　处：《西部医学》2021年第5期744-747,共4页Medical Journal of West China

基　　金：虚拟现实技术与系统国家重点实验室基金项目(VRLAB2020D05)。

摘　　要：目的探讨局麻下牙髓失活术治疗磨牙急性牙髓炎的临床疗效,以及对患者围手术期指标、急症的影响。方法选取2016年1月~2020年1月成都医学院第二附属医院收治的磨牙急性牙髓炎患者167例,采用随机数字表法分为观察组84例和对照组83例。对照组患者予以局麻下直接拔髓,观察组患者予以局麻下牙髓失活术。比较两组患者临床缓解率、围术期指标视觉模拟评分(VAS)、首诊治疗时间、术后急症(IAE)等级及发生率、复诊时根管内探痛等级差异性。结果两组患者临床缓解率、IAE等级及发生率比较差异无统计学意义(P>0.05);首诊、复诊治疗后,两组患者VAS评分均较治疗前降低(P<0.05),组间比较差异无统计学意义(P>0.05);观察组患者首诊治疗时间短于对照组(P<0.05),复诊时根管内探痛等级低于对照组(P<0.05)。结论局麻下牙髓失活术和直接拔髓治疗磨牙急性牙髓炎均有较好的止痛效果,但无法避免IAE发生。与直接拔髓比较,牙髓失活术首诊治疗时间较短,复诊时根管内探痛较轻,更适宜于临床应用。Objective To explore the clinical efficacy of dental pulp devitalization under local anesthesia in the treatment of acute pulpitis of molars and its effects on perioperative indexes and emergencies of patients.Methods 167 patients with acute pulpitis of molars admitted to our hospital from January 2016 to January 2020 were selected and divided into observation group(84 cases)and control group(83 cases)according to the random number table method.Patients in control group were given straight pulp extirpation under local anesthesia,and patients in observation group were given dental pulp devitalization under local anesthesia.The clinical remission rate,perioperative indexes[visual analogue score(VAS),treatment time of first visit],inter-appointment emergency(IAE)grades and incidence rate,and root canal pain grades during return visit were compared between the two groups.Results There were no significant differences in clinical remission rate,IAE grades and incidence rate between the two groups(P>0.05).After first visit and return visit,the VAS scores of the two groups were lower than those before treatment(P<0.05),and there was no statistically significant difference between the groups(P>0.05).The treatment time of first visit in observation group was shorter than that in control group(P<0.05),and the root canal pain grade at return visit was lower than that in control group(P<0.05).Conclusion Both dental pulp devitalization and straight pulp extirpation under local anesthesia for acute pulpitis of molars both have good analgesic effects,but cannot avoid IAE.Compared with straight pulp extirpation,dental pulp devitalization has shorter treatment time of first visit and milder root canal pain grade at return visit,and it is more suitable for clinical application.

关 键 词：急性牙髓炎 牙髓失活术 首诊治疗时间 术后急症 根管内探痛 

分 类 号：R781.31[医药卫生—口腔医学]