不同根管内消毒方案联合生物陶瓷材料iRoot SP糊剂填充治疗急性根尖周炎的效果OA
Efficacy of different intracanal disinfection protocols combined with bioceramic material iRoot SP paste for obturation in treating acute apical periodontitis
目的 对比观察不同根管内消毒方案联合生物陶瓷材料iRoot SP糊剂填充根管治疗急性根尖周炎的效果.方法 收集急性根尖周炎患者的临床资料并进行回顾性研究.根据根管内消毒方案的不同,将这些患者分为氢氧化钙组与三联抗生素糊剂(triple antibiotic paste,TAP)组.为消除选择偏倚,确保两组基线可比,采用倾向评分匹配法按1∶1进行匹配,匹配变量包括年龄、性别、患牙位置.匹配后,两组各成功纳入119例患者,其中氢氧化钙组采用iRoot SP糊剂根管填充联合氢氧化钙糊剂根管内消毒,TAP组采用iRoot SP糊剂根管填充联合TAP根管内消毒.比较两组的治疗效果,以及术前术后的疼痛程度[视觉模拟评分(visual analogue scale,VAS)、咀嚼功能评分],龈沟液炎性因子[C反应蛋白(C-reactive protein,CRP)、白细胞介素-8(interleukin-8,IL-8)、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)]和牙周指标[牙周袋深度(periodontal pocket depth,PD)、牙龈沟出血指数(sulcus bleeding index,SBI)、牙龈指数(gingival index,GI)],并统计不良反应的发生情况.结果 TAP组总有效率高于氢氧化钙组(96.64％vs.84.87％,P＜0.05).术后1周、术后3个月,TAP组VAS评分低于氢氧化钙组,咀嚼功能评分高于氢氧化钙组,其龈沟液CRP、IL-8、TNF-α水平及PD、SBI、GI均低于氢氧化钙组(均P＜0.05).TAP组不良反应总发生率(3.36％)与氢氧化钙组(7.56％)相比,差异无统计学意义(P＞0.05).结论 相较于氢氧化钙,采用TAP根管消毒联合iRoot SP根管填充治疗急性根尖周炎,在短期内能更有效地控制炎症,同时改善临床症状.
Objective To compare and observe the efficacy of different intracanal disinfection protocols combined with bioceramic material iRoot SP paste for root canal obturation in the treatment of acute apical periodontitis.Methods Clinical data of patients with acute apical periodontitis were collected for a retrospective study.According to different intracanal disinfection protocols,these patients were divided into a calcium hydroxide group and a triple antibiotic paste(TAP)group.To eliminate selection bias and ensure baseline comparability between the two groups,propensity score matching method was performed at a 1∶1 ratio,with matching variables including age,sex,and affected tooth position.After matching,119 patients were successfully included in each group.In the calcium hydroxide group,root canal filling with iRoot SP paste combined with intracanal disinfection using calcium hydroxide paste was applied,while in the TAP group,root canal filling with iRoot SP paste combined with intracanal disinfection using TAP was applied.Therapeutic effects,as well as preoperative and postoperative pain degrees[visual analogue scale(VAS)and masticatory function score],gingival crevicular fluid inflammatory factors[C-reactive protein(CRP),interleukin-8(IL-8)and tumor necrosis factor-α(TNF-α)],and periodontal indicators[periodontal pocket depth(PD),sulcus bleeding index(SBI)and gingival index(GI)]were compared between the two groups.The incidence of adverse reactions was also recorded.Results The total effective rate in the TAP group was higher than that in the calcium hydroxide group(96.64％vs.84.87％,P＜0.05).At 1 week and 3 months postoperatively,the TAP group showed lower VAS scores,higher masticatory function scores,and lower levels of CRP,IL-8 and TNF-α in gingival crevicular fluid,as well as lower PD,SBI and GI compared with the calcium hydroxide group(all P＜0.05).There was no statistically significant difference in the total incidence of adverse reactions between the TAP group(3.36％)and the calcium hydroxide group(7.56％,P＞0.05).Conclusion Compared with calcium hydroxide,the use of TAP for intracanal disinfection combined with iRoot SP for obturation in the treatment of acute apical periodontitis proves to be more effective in controlling inflammatory and improving clinical symptoms in the short term.
闫胜男;李冬;徐娟娟;闫利辉
450000 河南郑州,郑州大学附属郑州中心医院口腔科450000 河南郑州,郑州大学附属郑州中心医院口腔科450000 河南郑州,郑州大学附属郑州中心医院口腔科450000 河南郑州,郑州大学附属郑州中心医院口腔科
医药卫生
急性根尖周炎抗生素糊剂疼痛牙周指标不良反应
acute periapical periodontitisantibiotic pastepainperiodontal indicatoradverse reaction
《实用心电与临床诊疗》 2026 (3)
400-406,7
河南省医学教育研究项目(WJLX2024106)
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