根尖孔入路囊腔改良减压及根尖屏障治疗根尖周囊肿样病损的临床效果分析OA

Objective:To evaluate the clinical efficacy and influencing factors of modified decompression through the apical foramen approach combined with iRoot BP plus apical barrier technology in the treatment of periapical cystic lesions(CPLs).Methods:Forty-two patients with CPLs(46 affected teeth)with lesion diameter≥8 mm were included.All affected teeth underwent modified decompression surgery through the apical foramen approach(using a modified apical negative pres-sure irrigation system,ANPI)and iRoot BP plus apical barrier technique.Bone density(BD%),defect volume,healing grade and complications were evaluated by clinical examination and cone beam CT(CBCT)at 3,6 and 12 months postoperatively.Results:Overall efficacy:the 12-month success rate was 90.48%(38/42),and bone density increased from preoperative(21.35±5.67)%to(88.42±10.53)%(P<0.001).Age factor:the healing rate at 6 months after surgery in the<30-year-old group was 90.48%,significantly higher than the 30～45 age group(66.67%)and>45-year-old group(33.33%)(P<0.05),and the bone density of<30-year-old group[(94.25±5.35)%]was significantly higher than the 30～45 age group[(85.60±9.85)%]and>45-year-old group[(75.35±12.30)%](P<0.05).Cortical bone defect:complete closure time in the non defect group[(4.15±0.95)months]was shorter than unilateral[(6.05±1.25)months]and bilateral[(8.25±1.85)months]defect group(P<0.001).Complications:the total incidence rate was 14.29%(6/42),mainly characterized by iRoot BP plus overfilling(4.76%)and postoperative pain(4.76%).Conclusion:The combination of modified decom-pression through the apical foramen approach and iRoot BP plus apical barrier technique can significantly promote bone re-generation in CPLs,with a success rate of 90.48%.Patients under the age of 30 without cortical bone defects have better therapeutic effects.