iRoot SP与MTA修复成人根尖孔未闭合患牙的疗效比较

摘要

目的 探讨iRoot SP治疗成人根尖孔未闭合患牙的可行性及其临床疗效.方法 选择2014年1月-2015年10月在锦州医科大学附属第二医院显微根管治疗中心因慢性根尖周炎就诊并伴根尖孔未闭合的成年患牙50颗.按照随机数字表法分为2组,iRoot SP组25颗,MTA组25颗.iRoot SP组(实验组)用iRoot SP糊剂充填至根尖(厚约4 mm),MTA组(对照组)用MTA糊剂充填至根尖(厚约4 mm),热牙胶垂直加压法充填根管中上段;术后拍摄X射线片.患者6、12个月进行常规复诊,整理数据,评价其临床疗效.结果 所有患牙在治疗后均无自发痛、咬合痛;临床检查无叩痛、触痛等阳性体征;原有窦道消失,牙龈恢复正常.术后12个月实验组X射线显示15颗患牙根尖暗影完全消失,8颗患牙根尖暗影减小,2颗患牙根尖暗影无变化,总有效率为92.0％;MTA组X射线显示17颗患牙根尖暗影完全消失,8颗患牙根尖暗影减小,总有效率为100.0％.结论 iRoot SP可用于成人根尖孔未闭合患牙的治疗,短期疗效可观,长期临床效果有待于更进一步观察.%Objective To study the feasibility and clinical efficacy of iRoot SP in the treatment of adult teeth with apical open. Methods Fifty adult teeth with both chronic apical periodontitis and apical open were selected in the Microscopic Root Canal Treatment Center of Stomatology Hospital in Jinzhou Medical University from January 2014 to October 2015. The teeth were randomly divided into 2 groups by the random number table: iRoot SP group with 25 cases, MTA group with 25 cases. The teeth in the iRoot SP group (experimental group) were filled with iRoot SP to the apex (4 mm thick), the teeth in the MTA group (control group) were filled with MTA to the apex (4 mm thick), the upper section of the root canal was filled by hot gutta-percha vertical condensation. The patients had routine follow-up in 6 and 12 months and X-rays were taken to observe the clinical efficacy. Results After treatment, all teeth did not have spontaneous pain or occlusion pain; there was no percussion pain or tenderness in clinical examination. The sinus disappeared, the gums turned to be normal. After 12 months the X-ray of the experimental group showed the apical shadow of 15 teeth disappeared, that of 8 teeth was reduced significantly,the shadow of 2 teeth did not change, the total effective rate was 92.0％. In the control group, X-ray showed the apical shadow of 17 teeth disappeared completely, that of 8 teeth significantly reduced, the total effective rate was 100.0％. Conclusions Through observation of the clinical efficacy of 43 patients, iRoot SP can be used for the adult tooth with the apical open, its short-term clinical efficacy is substantial, but the long-term clinical efficacy should be further observed.