镍钛机动器械联合不同超声冲洗液对慢性根尖周炎进行一次性根管治疗的临床研究

摘要

背景：临床一次性根管治疗中，超声冲洗可提高根管冲洗的质量，可通过超声的协同作用，让冲洗液达到根管预备器械所不能彻底清理的区域，如根尖狭部、侧支根管等，达到去除腐质清理消毒的目的。　　目的：探讨镍钛机动器械联合不同超声冲洗液进行一次性根管治疗的临床疗效。　　方法：选择460例慢性根尖周炎患者，共460颗患牙，随机分为3组，次氯酸钠组使用Mtwo镍钛机动器械联合2.5%次氯酸钠超声冲洗清理根管，银离子抗菌液组使用镍钛机动器械联合活性银离子抗菌液超声冲洗清理根管，对照组使用K锉双氧水+生理盐水注射器根管冲洗，在根管预备完成后即刻根充。术后24 h由患者采用目测类比量表进行疼痛程度自评；7 d复诊时评价3组术后急性反应；术后6，12个月复诊，临床检查结合X射线机根尖周指数进行疗效评价。　　结果与结论：次氯酸钠组、银离子抗菌液组术后疼痛程度、急性反应发生率低于对照组(P<0.05)，次氯酸钠组、银离子抗菌液组间疼痛程度与急性反应发生率无差异(P>0.05)；术后6个月，3组治愈率差异无显著性意义(P>0.05)，但12个月后对照组治愈率低于其他两组(P<0.05)。结果说明使用Mtwo镍钛机动器械联合超声冲洗对慢性根尖周炎患者一次性根管治疗，取得了可靠的近远期临床疗效。%BACKGROUND:For on-visit root canal therapy, ultrasound washing can improve the quality of root canal irrigation, and play a synergistic role with ultrasound so that the flushing fluid can reach the area that cannot be completely cleaned up by root canal preparation instruments, such as apical isthmus and col ateral root canal, for removal of the detritus, cleanup and disinfection. OBJECTIVE:To evaluate the clinical effect of one-visit root treatment with nickel-titanium rotary instruments and ultrasonic irrigation unit in treatment of chronic apical periodontitis. METHODS:A total of 460 patients with il ed 460 teeth were selected. Patients were randomly divided into three groups:Mtwo instrument and ultrasonic technique combined with sodium hypochlorite was utilized in group A;ultrasonic technique combined with active silver ion antibacterial solution was utilized in group B;stainless steel K files with saline and hydrogen peroxide solution were used as irrigations in group C. Twenty-four hours after root canal fil ing, the pain degree was self-assessed by patients with visual analogue scale, and subsequent visit was done 7 days after root canal fil ing. Six and twelve months after root canal fil ing, the therapeutic effect was determined with X-ray examination and clinical assessment. RESULTS AND CONCLUSION:The degree of pain and occurrence rate of acute reactions in groups A and B were significantly lower than those in group C (P<0.05), but there was no significant difference between groups A and B (P>0.05). Six months after root canal fil ing, the cure rate was not significantly different between three groups (P>0.05). But after 12 months, the cure rate in the group C was significantly lower than that in groups A and B (P<0.05). By using of nickel-titanium rotary instruments and ultrasonic irrigation unit in treatment of chronic apical periodontitis, the short-and long-term effects of one-visit root treatment have been achieved clinical y.