摘要
目的探讨并分析显微镜联合超声、三氧化矿物凝聚体(MTA)根尖外科手术在难治性慢性根尖周病治疗中的疗效。方法选取自2018年6月至2021年6月在解放军总医院海南医院确诊的144例难治性慢性根尖周病患者(144颗患牙)为研究对象。采用随机数字表法将患者分为观察组(n=72,72颗患牙)与常规组(n=72,72颗患牙)。常规组采用常规外科根尖手术联合银汞合金充填手术,观察组采用显微镜根尖手术联合MTA倒充填手术。于术后3个月进行随访,评估两组患者的临床疗效。于手术前后,比较两组患者的根尖周指数(PAI)、根尖区平均灰度值(MGV)变化情况、疼痛程度及肿痛程度。记录并比较两组患者术后并发症发生情况。结果观察组治疗总有效率为94.4%(68/72),显著高于常规组的83.3%(60/72),差异有统计学意义(P<0.05)。观察组术后24 h、术后即刻的视觉模拟评分法评分均低于常规组,差异均有统计学意义(P<0.05)。术后7 d,观察组Negm分级1级患者比例高于常规组,Negm分级2、3、4级患者比例低于常规组,差异有统计学意义(P<0.05)。术后3个月,观察组患者MGV显著高于常规组,PAI显著低于常规组,差异均有统计学意义(P<0.05)。两组患者并发症发生率比较,差异无统计学意义(P>0.05)。结论显微镜联合超声、MTA根尖手术治疗难治性慢性根尖周病的疗效确切,可缓解患者疼痛和肿胀程度,有利于促进骨组织的快速修复。
Objective To investigate and analyze the clinical effect of apical surgery with microscopy combined with ultrasound and mineral trioxide aggregate(MTA)in the treatment of refractory chronic periapical disease.Methods A total of 144 patients(144 teeth)with refractory chronic periapical disease diagnosed in Hainan Hospital of PLA General Hospital from June 2018 to June 2021 were selected as the research objects.Patients were divided into observation group(n=72,72 teeth)and conventional group(n=72,72 teeth)by random number table method.The conventional group was treated with conventional apical surgery combined with silver amalgam filling surgery,while the observation group was treated with microscope apical surgery combined with MTA backfilling surgery.The patients were followed up 3 months after operation to evaluate the clinical efficacy of the two groups.Before and after operation,the periapical index(PAI),mean gray value(MGV)of apical area,pain degree and swelling degree were compared between the two groups.The incidence of postoperative complications was recorded and compared between the two groups.Results The total effective rate of the observation group was 94.4%(68/72),which was significantly higher than that of the conventional group(83.3%,60/72),and the difference was statistically significant(P<0.05).The scores of visual analogue scale at 24 hours and immediately after operation in the observation group were lower than those in the conventional group,and the differences were statistically significant(P<0.05).On postoperative day 7,the proportion of patients with Negm grade 1 in the observation group was higher than that in the conventional group,and the proportion of patients with Negm grade 2,3 and 4 in the observation group was lower than that in the conventional group,and the differences were statistically significant(P<0.05).At 3 months after operation,MGV of the observation group was significantly higher than that of the conventional group,PAI was significantly lower than that of the conventional group,and the differences were statistically significant(P<0.05).There was no significant difference in the incidence of complications between the two groups(P>0.05).Conclusion Microscope combined with ultrasound and MTA is effective in the treatment of refractory chronic periapical disease,which can relieve the pain and swelling of patients and promote the rapid repair of bone tissue.
作者
邱瑾
刘成龙
朱思怡
文照取
QIU Jin;LIU Cheng-long;ZHU Si-yi;WEN Zhao-qu(Department of Stomatology,Hainan Hospital of PLA General Hospital,Sanya 572000,China)
出处
《临床军医杂志》
CAS
2022年第12期1237-1241,共5页
Clinical Journal of Medical Officers
基金
海南省科技项目资助(ZDYF2020123)
关键词
显微镜根尖手术
超声
三氧化矿物凝聚体
难治性慢性根尖周病
疗效
Microscopic apical surgery
Ultrasound
Mineral trioxide aggregates
Refractory chronic periapical disease
Curative effect
作者简介
第一作者:邱瑾(1987-),女,广东人,主治医师;通信作者:文照取,E-mail:wenzhaoqu@163.com
