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目的:比较不同封闭性能的充填材料在根尖倒充填治疗中的临床疗效。方法:选择近2年因常规根管治疗无法治愈行根尖切除及根尖倒充填治疗的根尖周疾患病例69例;共72颗牙(其中上颌中切牙31颗、上颌侧切牙24颗、上颌尖牙17颗)根据选择的倒充填材料分为MTA治疗组(M组)、银汞合金治疗组(Y组)、银粉玻璃离子水门汀组(B组),每组24颗牙,三组均肉眼下进行根尖切除、倒预备及根尖倒充治疗。术后随访24月,通过临床体征及影像学评判术后疗效,统计分析术后6月、12月、24个月临床治愈率及术后短期(1周内)局部炎症反应发生率。结果:术后2年M组临床治愈率高于Y组和B组(P<0.05),差异有统计学意义;Y组与B组之间有效率无明显差异(P>0.05);术后6个月治愈率M组与Y组、M组与B组间差异有统计学意义(P<0.05),Y组与B组差异无统计学意义(P>0.05);术后1周内M组肿痛发生率略少于Y组与B组,但经统计学处理差异无统计学意义(P>0.05)。结论:以上三种不同根尖封闭性能的充填材料均能有效提高根尖倒充填治疗的临床效果,但MTA根尖封闭性能更好,根尖倒充填的临床治愈率更高。
OBJECTIVE: To compare the clinical efficacy of filling materials with different sealing properties in apical filling. Methods: A total of 69 cases of apical periodontal disease were selected which can not be cured by conventional root canal therapy in the recent 2 years. A total of 72 teeth (including 31 maxillary central incisors and 24 maxillary lateral incisors) , 17 maxillary canines) were divided into MTA treatment group, silver amalgam treatment group (Y group), silver ion glass cement group (B group), 24 teeth per group, Group were under the root apical resection, down preparation and apical refill treatment. The patients were followed up for 24 months. The postoperative curative effect was evaluated by clinical signs and imaging. The clinical cure rates at 6 months, 12 months and 24 months postoperatively and the postoperative short-term (1 week) incidence of local inflammatory reactions were statistically analyzed. Results: The cure rate of M group 2 years after operation was higher than that of Y group and B group (P <0.05), the difference was statistically significant. There was no significant difference between Y group and B group (P> 0.05) There were significant differences in the cure rates between M group and Y group at 6 months (P <0.05), but there was no significant difference between Y group and B group (P> 0.05) The incidence of group pain was slightly less than that of group Y and group B, but the difference was not statistically significant (P> 0.05). CONCLUSION: The three kinds of filling materials with different apical sealing performance can effectively improve the clinical effect of apical filling, but the apical appenication of MTA is better and the clinical cure rate of apical filling is higher.