三种方法治疗年轻恒牙根尖周病的效果分析  

Assessment on the effect of three methods in the treatment of immature permanent teeth with apical periodontitis

作　　者：王涛[1] 朱顶贵[1] 郭世梁[1] 张心宇 邢向辉 Wang Tao;Zhu Dinggui;Guo Shiliang;Zhang Xinyu;Xing Xianghui(Department of Pediatric Dentistry,Nanjing Stomatological Hospital,Medical School of Nanjing University,Nanjing 210008,China)

机构地区：[1]南京大学医学院附属口腔医院(南京市口腔医院)儿童口腔科,210008

出　　处：《中华口腔医学研究杂志（电子版）》2021年第6期341-347,共7页Chinese Journal of Stomatological Research(Electronic Edition)

基　　金：江苏省“六大人才高峰”高层次人才项目(2019-WSW-128);南京市口腔疾病临床医学研究中心项目(2019060009)。

摘　　要：目的对比根尖诱导成形术、根尖屏障术及牙髓血运重建术3种治疗方法对年轻恒牙根尖周病的治疗效果。方法选取2019年4月至2020年8月就诊于南京市口腔医院儿童口腔科,因畸形中央尖导致的前磨牙根尖周炎病例共45例,临床表现为患牙有叩痛、松动、肿胀等,影像学检查(X线片)表现为根尖周暗影、根尖孔未闭合、牙根过短等。按随机数字表法平均分为牙髓血运重建组、根尖诱导成形术组和根尖屏障术组,每组15例分别进行治疗。治疗完成后每3~6个月复查1次,随访1~2年(至少1年)。采用SPSS 26.0统计学软件进行统计分析,3组患者临床疗效比较采用χ;检验,牙根长度及根尖孔宽度的比较采用t检验。结果根尖诱导成形术、根尖屏障术及牙髓血运重建术术后即刻的临床症状都消失。术后1年复查,牙髓血运重建组(80%)与根尖诱导成形术组(53.33%)治愈率均高于根尖屏障术组(0%),差异均具有统计学意义(P<0.001);牙髓血运重建组治愈率高于根尖诱导成形术组,但差异不具统计学意义(P=0.146)。根尖发育方面,术后牙髓血运重建组牙根长度为(10.80±1.01)mm,根尖诱导成形术组牙根长度为(10.31±1.08)mm,牙髓血运重建组牙根增长情况优于根尖诱导成形术组,差异有统计学意义(t=2.402,P<0.05);术后牙髓血运重建组根尖孔宽度为(0.21±0.09)mm,根尖诱导成形术组根尖孔宽度为(0.45±0.08)mm,牙髓血运重建组术根尖闭合情况也明显优于根尖诱导成形术组,差异有统计学意义(t=11.201,P<0.001)。结论根尖诱导成形术、根尖屏障术与牙髓血运重建术均为治疗年轻恒牙根尖周炎的有效方法,但牙髓血运重建术在根尖孔闭合及牙根增长方面效果更加显著。Objective To compare the effect of apexification,apical barrier technique and pulp revascularization on the treatment of immature permanent teeth with periapical periodontitis.Methods Immature permanent teeth with periapical periodontitis in 45 patients(caused by abnormal central cusp)at Nanjing Stomatological Hospital from April 2019 to August 2020 were collected.Clinical symptoms include percussive pain,odontoseisis,swelling,etc.X-ray showed periapical shadow,root tip which is not closed as well as not enough root length,etc.All of the 45 patients were divided into 3 groups(n=15 each) according to the method of random number table,apexification group,apical barrier technique group,and pulp revascularization group.Reviewed every 3-6 mouths after treatment,and followed up for1-2 years(at lease 1 year).The data were analyzed with SPSS 26.0,the clinical efficacy of patients in 3 groups was compared by Xz test,and the comparison of root length and root tip width was applied by t test.Results Clinical symptoms of three groups disappeared immediately after surgery.The cure rate of the apexification group(53.33%) and pulp revascularization group(80%) were higher than the apical barrier technique group(0%) one year after surgery,and the difference was statistically significant(P <0.001).The cure rate of the pulp revascularization group was higher than the apexification group,but the difference was not statistically significant(P=0.146).In terms of root tip development,the root length of pulp revascularization group was(10.80±1.01) mm,which in apexification group was(10.31±1.08) mm.The root development of pulp revascularization group was more noteworthy than apexification group(t=2.402,P<0.05).The root tip width was(0.21±0.09) mm in pulp revascularization group and(0.45±0.08) mm in apexification group,and the root tip closure in pulp revascularization group was highly effective against apexification group(t=11.201,P <0.001).Conclusions Apexification,apical barrier technique,and pulp revascularization are all effectiv

关 键 词：根尖周炎 根尖诱导成形术 牙髓血运重建术 根尖屏障术 年轻恒牙 

分 类 号：R781.34[医药卫生—口腔医学]