米诺环素联合Vitapex糊剂治疗逆行性牙髓炎对缺氧诱导因子-1α水平与牙周指数的影响及其预测价值OA

AIM To explore the effect of minocycline combined with Vitapex paste in the treatment of retrograde pulpitis on the level of hypoxia-inducible factor-1α(HIF-1α)and periodontal indices,as well as its predictive value for prognosis.METHODS A total of 140 patients with retrograde pulpitis in our hospital from March 2024 to February 2025 were selected and divided into the observation group(n=70,treated with minocycline hydrochloride combined with Vitapex paste root canal filling)and the control group(n=70,treated with conventional root canal filling)based on the treatment methods.After 1∶1 propensity score matching,there were 51 patients in each group.Outcomes before and after treatment,gingival crevicular fluid inflammatory factors,and periodontal indices were compared,and repeated measures analysis of variance was performed.The visual analogue scale(VAS)score,Pittsburgh sleep quality index(PSQI)score,and short form 36 health survey(SF-36)score before and after treatment were compared.Logistic regression and receiver operating characteristic(ROC)curve analysis were used to evaluate the predictive value of inflammatory factors one month after treatment for prognosis.RESULTS Compared with the control group,the total effective rate of the observation group was significantly higher(P＜0.05).After treatment,the levels of inflammatory factors in gingival crevicular fluid,periodontal indices,PSQI and VAS scores in the observation group were significantly lower than those in the control group,and they were also significantly lower than those before treatment(P＜0.05).The SF-36 score was significantly higher than that of the control group,and it also showed a significant increase compared to the score before treatment(P＜0.05).There were significant differences in the levels of inflammatory factors of gingival crevicular fluid and the periodontal indices between the 2 groups regarding time,inter-group comparisons,and interaction effects(P＜0.001).The logistic multivariate regression analysis showed that one month after treatment,interleukin-1β(IL-1β),tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),high-sensitivity C-reactive protein(hs-CRP),and HIF-1α were risk factors for poor prognosis(P＜0.05).The ROC curve analysis indicated that the combined test had the highest predictive value for the prognosis.CONCLUSION The combination of minocycline hydrochloride and Vitapex paste can significantly reduce the levels of HIF-1α and other inflammatory factors in the gingival crevicular fluid of patients with retrograde pulpitis,and improve the periodontal indices and quality of life.Additionally,the level of HIF-1α in the gingival crevicular fluid one month after treatment has good predictive value for short-term prognosis.