目的:探讨超声冲洗联合洗必泰在牙髓炎根管治疗中的临床效果。
方法:将120例根管治疗牙髓炎患者随机分为研究组(60、72颗患牙)和对照组(60、70颗患牙)。在根管预备期间,研究组采用氯己定联合超声冲洗,对照组采用氯己定常规灌洗。比较两组根管预备前后根管内细菌计数和内毒素含量,以及牙髓性相互间疼痛(EIAP),侧支根管充填率,根管治疗后牙齿疼痛程度。随访1年,对治疗成功率进行统计学分析。采用SPSS19.0软件包进行统计学分析。
结果:根管预备后,与根管预备前相比,实验组和对照组菌落数明显减少(P<0.05),实验组菌落数明显低于对照组(P<0.05)。根管预备后,实验组和对照组的内毒素水平明显低于根管预备前(P<0.05),实验组水平明显低于对照组(P<0.05).研究组和对照组的侧支根管充填率分别为29.17%和11.43%,分别,组间差异有统计学意义(P<0.05)。EIAP的发生率分别为4.17%和14.29%,分别,两组比较差异有统计学意义(P<0.05)。手术后48小时,研究组和对照组的视觉模拟评分(VAS)分别为(2.74±0.61)和(3.29±0.68),分别,显著低于术前(P<0.05)。两组患者术后48hVAS评分比较,差异有统计学意义(P<0.05).手术后一周,研究组和对照组的VAS评分分别为(1.52±0.34)和(1.81±0.42),分别,术前、术后48h显著降低(P<0.05)。两组术后1周VAS评分比较差异有统计学意义(P<0.05).对照组治疗成功率为84.62%,研究组为95.71%,两组比较差异有统计学意义(P<0.05)。
结论:应用超声冲洗联合洗必泰治疗牙髓炎根管有助于降低根管预备后细菌和内毒素水平。减轻术后牙齿疼痛的程度,提高侧枝根管的充填率,具有优越的疗效。
OBJECTIVE: To explore the clinical effect of ultrasonic irrigation combined with chlorhexidine in root canal treatment of pulpitis.
METHODS: A total of 120 patients with pulpitis treated with root canal therapy were randomly divided into a study group (n=60, 72 affected teeth) and a control group (n=60, 70 affected teeth). During root canal preparation, the study group was treated with chlorhexidine combined with ultrasonic irrigation, while the control group was treated with chlorhexidine conventional irrigation. The bacterial count and endotoxin content in the root canal before and after root canal preparation were compared between the two groups, as well as the endodontic inter-appointment pain (EIAP), lateral branch root canal filling rate, and degree of tooth pain after root canal treatment. The success rate of treatment was statistically analyzed after one-year follow-up. Statistical analysis was performed with SPSS 19.0 software package.
RESULTS: After root canal preparation, the number of colonies in experimental group and control group was significantly decreased compared with that before root canal preparation(P<0.05), and the number of colonies in experimental group was significantly lower than that in control group(P<0.05). After root canal preparation, endotoxin levels in experimental group and control group were significantly lower than those before root canal preparation(P<0.05), and the level in experimental group was significantly lower than that in control group(P<0.05). The lateral branch root canal filling rate in the study group and the control group was 29.17% and 11.43%, respectively, with significant difference between the groups(P<0.05). The incidence of EIAP was 4.17% and 14.29%, respectively, with significant difference between the two groups(P<0.05). At 48 hours after surgery, the visual analogue score (VAS) of the study group and the control group was (2.74±0.61) and (3.29±0.68), respectively, which were significantly lower than at before surgery(P<0.05). There was a significant difference in VAS score between the two groups 48 hours after surgery(P<0.05). One week after surgery, the VAS score in the study group and the control group was (1.52±0.34) and (1.81±0.42), respectively, significantly lower than that before and 48 hours after surgery(P<0.05). There was a significant difference in VAS score between the two groups at one week after surgery (P<0.05). The successful rate of treatment in the control group was 84.62%, and 95.71% in the study group, with a significant difference between the two groups(P<0.05).
CONCLUSIONS: The application of ultrasonic irrigation combined with chlorhexidine in the treatment of pulpitis root canals can help reduce the level of bacteria and endotoxin after root canal preparation, alleviate the degree of postoperative tooth pain, and improve the filling rate of lateral branch root canals, with superior curative effects.