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目的比较慢性根尖周炎患者采用一次性根管治疗、二次根管治疗的疗效和安全性。方法 200例慢性根尖周炎患者,100例行一次性根管治疗者为一次法组,100例采用二次根管治疗者为二次法组,2组均采用机用ProTaper和超声技术进行根管治疗。采用视觉模拟评分(visual analogue scale,VAS)评定治疗前及术后24h、7d、1a疼痛程度,比较2组术后24h、7d牙龈肿胀发生率;术后1a影像学检查评定2组治疗效果。结果 2组治疗前VAS评分比较差异无统计学意义(P>0.05);术后7d及1a,2组VAS评分均较治疗前明显降低(P<0.05);术后24h、7d、1a,一次法组VAS评分分别为1.61±1.25、0.78±0.47、0.52±0.19,二次法组分别为1.39±1.32、0.82±0.60、0.57±0.27,2组比较差异均无统计学意义(P>0.05);术后24h,一次法组牙龈肿胀发生率(17%)高于二次法组(7%)(P<0.05),但2组术后7d牙龈肿胀发生率(9%vs 5%)比较差异无统计学意义(P>0.05);一次法组治疗成功率(87%)与二次法组(89%)比较差异无统计学意义(P>0.05)。结论慢性根尖周炎采用一次性根管治疗可基本达到与二次根管治疗相同的疗效和安全性。
Objective To compare the efficacy and safety of one-time root canal therapy and secondary root canal therapy in patients with chronic periapical periodontitis. Methods One hundred patients with chronic periapical periodontitis were treated with one-time root canal therapy and one with 100 patients with secondary root canal therapy. Two groups were treated with ProTaper and ultrasound Root canal treatment. The visual analogue scale (VAS) was used to evaluate the pain degree before and 24 hours, 7 days and 1 day after operation. The incidence of gingival swelling was compared between the two groups at 24h and 7d. The postoperative radiography was used to evaluate the therapeutic effect of the two groups. Results There was no significant difference in VAS score between the two groups before treatment (P> 0.05). The VAS scores of the 7th and the 1st and 2nd groups were significantly lower than those before treatment (P <0.05) The VAS scores of the law group were 1.61 ± 1.25,0.78 ± 0.47 and 0.52 ± 0.19, respectively. There was no significant difference between the two groups (1.39 ± 1.32,0.82 ± 0.60,0.57 ± 0.27, P> 0.05) ; The incidence of gingival swelling in one group was higher than that in the second group (7%) at 24 hours after operation (P <0.05), but the incidence of gingival swelling was significantly lower at 7 days after operation (9% vs 5%) There was no significant difference between the two groups (P> 0.05). There was no significant difference between the two groups (87%) and the second group (89%) (P> 0.05). Conclusion One-time root canal treatment of chronic apical periodontitis can basically achieve the same curative effect and safety as secondary root canal therapy.