上海口腔医学

上海口腔医学 ›› 2019, Vol. 28 ›› Issue (6): 636-639.doi: 10.19439/j.sjos.2019.06.016

• 论著 • 上一篇    下一篇

牙周治疗在牙周-牙髓联合病变中的应用效果评价

仇成豪1, 余优成2, 徐培成3   

  1. 1.上海市（复旦大学附属）公共卫生临床中心 口腔科,上海 200083;
    2.复旦大学附属中山医院 口腔科,上海 200032;
    3.上海市徐汇区牙病防治所,上海 200032
  • 收稿日期:2019-04-01 出版日期:2019-12-25 发布日期:2020-01-14
  • 通讯作者: 余优成,E-mail：Yu.youcheng@zs-hospital.sh.cn
  • 作者简介:仇成豪 （1972-）,男,硕士,主治医师,E-mail：den.doctor@163.com

Treatment of combined periodontal-pulpal lesions with periodontal therapy

QIU Cheng-hao1, YU You-cheng2, XU Pei-cheng3   

  1. 1.Department of Stomatology, Clinical Center of Public Health, Fudan University. Shanghai 200083;
    2. Department of Stomatology, Zhongshan Hospital, Fudan University. Shanghai 200032;
    3. Shanghai Xuhui District Dental Disease Prevention and Control Institute. Shanghai 200032, China
  • Received:2019-04-01 Online:2019-12-25 Published:2020-01-14

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摘要： 目的 评价牙周治疗在牙周-牙髓联合病变中的疗效。方法 选择109例牙周-牙髓病变患者（120颗患牙）,所有患牙均经完善的根管治疗,分为A、B 2组。A组为牙周治疗组（60颗患牙）,根管治疗完成2周后行牙周基础治疗;6周后仍有5 mm以上牙周袋且探诊后出血者,进行翻瓣术治疗。B组为非牙周治疗组（60颗患牙）,单纯行根管治疗和龈上洁治术。术后3、6、12、24个月进行随访,观察2组患者牙周探诊深度（PD）、牙槽骨吸收程度、牙松动度（TM）等的变化。采用SPSS 22.0软件包对数据进行统计学分析。结果 A组术前、术后2年PD分别为（5.966±1.877）mm、（5.133±1.935)mm,牙周探诊深度减轻,有统计学差异。B组术前、术后2年PD分别为（5.533±1.856）mm、( 6.167±1.927)mm,牙周探诊深度显著增加。2组术前TM无统计学差异（P>0.05）。术后2年,A组TM显著低于B组（P<0.05）。X线表现,A组术后2年牙槽骨吸收较术前无显著变化（P>0.05）;B组术后2年,牙槽骨吸收较术前显著减轻（P<0.05）。结论 根管治疗结合牙周治疗用于牙周-牙髓联合病变能取得较好的疗效,值得推广应用。

关键词: 牙周-牙髓联合病变, 牙周治疗, 根管治疗术

Abstract: PURPOSE: To evaluate the clinical effects of periodontal therapy for combined periodontal-pulpal lesions. METHODS: One hundred and nine patients with periodontal-pulpal lesions were included in this study, with total 120 teeth. All the teeth were treated by perfect root canal therapy, and than divided into group A and B. Group A was treated with periodontal therapy (60 teeth). After 2 weeks of root canal therapy, basic periodontal therapy was performed. After 6 weeks, patients with more than 5 mm periodontal pockets and bleeding after probe were treated with valvuloplasty. Group B underwent non-periodontal treatment (60 teeth), root canal therapy and supragingival scaling alone. The patients were followed up for 3, 6, 12 and 24 months after operation. SPSS 22.0 software package was used to analyze the indexes at initial diagnosis and 24 months after operation. RESULTS: In group A, the depth of periodontal pockets was significantly reduced before and after PD, from(5.966±1.877) mm to(5.133±1.935) mm. The periodontal pocket depth of group B was significantly increased before and after operation, from(5.533±1.856) mm to (6.167±1.927) mm. The degree of tooth mobility (TM) before operation was similar between the two groups (P>0.05). Two years after operation, the degree of TM in group A was significantly lower than that in group B (P<0.05). There was no significant change in alveolar bone resorption before and after operation in group A (P>0.05). The alveolar bone resorption in group B changed significantly before and after operation (P<0.05). CONCLUSIONS: Root canal therapy combined with periodontal therapy for combined periodontal-pulpal lesions can achieve good results. It can be widely used in clinic.

Key words: Combined periodontal-endodontic lesions, Periodontal therapy, Root canal therapy

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