不同荡洗策略治疗有瘘型慢性根尖周炎的临床效果比较  

Comparison of clinical effects of different irrigant solutions combined with different agitation techniques in the treatment of chronic apical periodontitis with fistula

作　　者：刘慧楠 张富华 蒲灼光[1,2] LIU Hui-nan;ZHANG Fu-hua;PU Zhuo-guang(Hefei College of Stomatology,Anhui Medical University,Hefei 230001;The Fifth Clinical Medical College of Anhui Medical University,Hefei 230001;Department of Endodontics,Hefei Stomatological Hospital.Hefei 230001,Anhui Province,China)

机构地区：[1]安徽医科大学合肥口腔临床学院,安徽合肥230001 [2]安徽医科大学第五临床医学院,安徽合肥230001 [3]合肥市口腔医院牙体牙髓病科,安徽合肥230001

出　　处：《上海口腔医学》2023年第2期188-192,共5页Shanghai Journal of Stomatology

基　　金：2021年合肥市卫建委应用医学研究项目(Hwk2021zc005)。

摘　　要：目的:评价辅助冲洗技术和根管冲洗液联合治疗有瘘型慢性根尖周炎的效果,寻求一种更有效、更微创的临床治疗策略。方法:选择2021年1月—2022年1月在合肥市口腔医院治疗的有瘘型慢性根尖周炎患者150例,随机分为6组,每组25例。A组—0.5%次氯酸钠+超声荡洗;B组—1.0%次氯酸钠+超声荡洗;C组—2.0%氯己定+超声荡洗;D组—0.5%次氯酸钠+声波荡洗;E组—1.0%次氯酸钠+声波荡洗;F组—2.0%氯己定+声波荡洗。观察每组瘘管愈合时间、治疗效果以及术后疼痛情况。采用SPSS 20.0软件包对数据进行统计学分析。结果:瘘管愈合方面,E组和F组10天瘘管愈合率显著高于A组和D组(P<0.05),但E组与F组之间差异无统计学意义(P>0.05)。治疗效果方面,A组术后1个月有效率较低,差异有统计学意义(P<0.05)。术后疼痛方面,A组VAS评分在所有时间点均显著小于E组和F组(P<0.05)。结论:治疗有瘘型慢性根尖周炎时,使用1.0%次氯酸钠或2.0%氯己定联合声波荡洗或超声波荡洗,可获得短期较好的效果,其中声波荡洗组还可获得瘘管早期愈合,但是使用声波荡洗时,术后疼痛发生率较高。PURPOSE:To evaluate the effect of combination of auxiliary irrigation technology and root canal irrigation solution in the treatment of chronic apical periodontitis with fistula,and try to seek a more effective and minimally invasive therapeutic strategy.METHODS:One hundred and fifty patients with fistulous chronic apical periodontitis who were diagnosed in Hefei Stomatological Hospital from January 2021 to January 2022 were randomly divided into 6 groups,25 cases in each group.The 6 groups were as follows,group A:0.5%NaOCl+ultrasonically activated irrigation;Group B:1.0%NaOCl+ultrasonically activated irrigation;Group C:2.0%CHX+ultrasonically activated irrigation;Group D:0.5%NaOCl+sonic activation;Group E:1.0%NaOCl+sonic activation;Group F:2.0%CHX+sonic activation.The fistula healing time,treatment effect and postoperative pain were observed in each group.The data were analyzed with SPSS 20.0 software package.RESULTS:In terms of fistula healing,the 10-day fistula healing rate of group E and group F was higher than that of group A and group D,and the difference was statistically significant(P<0.05);but there was no significant difference between group E and group F(P>0.05).The effective rate at 1 month after operation in group A was lower,and the difference was significant(P<0.05).In terms of postoperative pain,the VAS score of group A was lower than that of group E and group F at all time points,and the difference was statistically significant(P<0.05).CONCLUSIONS:In the treatment of chronic apical periodontitis with fistula,1.0%NaOCl or 2.0%CHX combined with ultrasonically activated irrigation or sonic activation obtain a better short-term effect,of which the sonic activation group can also obtain early healing of the fistula,but the incidence of postoperative pain is higher when sonic activation is used.

关 键 词：次氯酸钠 氯己定 超声波荡洗 声波荡洗 慢性根尖周炎 

分 类 号：R781.34[医药卫生—口腔医学]