三种根管封闭剂结合热牙胶垂直加压技术治疗牙髓病的疗效观察  

Efficacy of Three Root Canal Sealants Combined with Hot Gutta-Percha Vertical Compression Technique in the Treatment of Dental Pulp Disease

作　　者：王晓颖[1] 王艳华[1] 王变红[1] WANG Xiaoying;WANG Yanhua;WANG Bianhong(Beijing Friendship Hospital Affiliated to Capital Medical University,Beijing 100050,China)

机构地区：[1]首都医科大学附属北京友谊医院口腔科,北京100050

出　　处：《河北医学》2023年第4期647-652,共6页Hebei Medicine

基　　金：北京市科技计划项目,(编号:Z201100005620009)。

摘　　要：目的:探讨三种根管封闭剂(AH Plus,Gutta Flow,iRoot SP)结合热牙胶垂直加压技术治疗牙髓病的疗效。方法:选取牙髓病患者180例(180颗患牙),采用随机数字表的分组方式随机分为AH Plus组、Gutta Flow组和iRoot SP组,每组60例,三组分别以AH Plus、Gutta Flow及iRoot SP作为根管封闭剂,再联合热牙胶垂直加压技术用于根管填充治疗。对比三组患牙根管填充质量、充填时间、充填面积占比、术后疼痛发生情况(Mohd评分标准)、术前与术后1周的血清炎症因子水平[血清白介素-6(IL-6)和肿瘤坏死因子-α(TNF-α)]、术后6个月后的疗效。结果:AH Plus组、Gutta Flow组和iRoot SP组的恰填率分别为96.67%、98.33%和98.33%,三组填充质量对比,差异无统计学意义(P>0.05);Gutta Flow组和iRoot SP组的充填时间短于AH Plus组,差异有统计学意义(P<0.0167);AH Plus组、Gutta Flow组和iRoot SP组术后1周的疼痛率分别为16.67%、5.00%和3.33%,三组疼痛分级和疼痛率对比差异有统计学意义(P<0.05),其中Gutta Flow组和iRoot SP组的疼痛率低于AH Plus组,差异有统计学意义(P<0.0167);三组关于血清TNF-α、IL-6水平的时间点效应、组间效应及组间与时间点交互作用均差异有统计学意义(P<0.05),三组治疗后均低于治疗前(P<0.05),其中Gutta Flow组和iRoot SP组均低于AH Plus组,均差异有统计学意义(P<0.0167);AH Plus组、Gutta Flow组和iRoot SP组术后6个月后的有效率分别为81.67%、90.00%和96.67%,三组疗效等级情况和有效率对比差异有统计学意义(P<0.05),其中iRoot SP组的有效率高于AH Plus组,差异有统计学意义(P<0.0167)。结论:选择iRoot SP和Gutta Flow作为根管封闭剂结合热牙胶垂直加压技术治疗牙髓病的根尖封闭性能优于AH Plus,能缩短充填时间和减轻术后疼痛情况,改善炎症反应,但iRoot SP的长期根尖封闭疗效优于Gutta Flow。Objective:To investigate the efficacy of three root canal sealants(AH Plus,Gutta Flow,iRoot SP)combined with hot gutta-percha vertical compression technique in the treatment of dental pulp disease.Methods:One hundred and eighty patients(180 affected teeth)with dental pulp disease were selected and randomly divided into AH Plus group,Gutta Flow group and iRoot SP group by the random number grouping method,with 60 cases in each group.The three groups selected AH Plus,Gutta Flow and iRoot SP as root canal sealants respectively,and then they were combined with hot gutta-percha vertical compression technique for root canal filling treatment.The quality of root canal filling,filling time,filling area ratio,pain occurrence(Mohd score standard)after surgery,serum inflammatory factors levels[serum interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α)]one week before and after surgery and efficacy at 6 months after surgery were compared among the three groups.Results:The accurate filling rates of AH Plus group,Gutta Flow group and iRoot SP group were 96.67%,98.33%and 98.33%respectively.There was no statistical significance in filling quality among the three groups(P>0.05).The filling time of Gutta Flow group and iRoot SP group was shorter than that of AH Plus group the differences has statiscal sighificance(P<0.0167).The pain rates of AH Plus group,Gutta Flow group and iRoot SP group at 1 week after surgery were 16.67%,5.00%and 3.33%respectively,and there were statistical differences in pain grading and pain rate among the three groups(P<0.05),the pain rate was lower in Gutta Flow group and iRoot SP group than that in AH Plus group the differences has statisthcal sigificance(P<0.0167).The time-point effect,between-group effect and interaction effect of between-group and time-point of serum TNF-αand IL-6 revealed statistical differences among the three groups(P<0.05),the two levels of the three groups after treatment were lower than those before treatment(P<0.05),and the levels were lower in Gutta Flow group and iRoot SP

关 键 词：根管封闭剂 根尖封闭 热牙胶垂直加压技术 牙髓病 

分 类 号：R781.3[医药卫生—口腔医学]