口腔显微镜下生物陶瓷IRootBPPlus根尖屏障术治疗慢性根尖周炎根尖未闭合的临床疗效观察

蒋洁 罗婷苑 林臻 谭勇华

【摘要】 目的 探讨口腔显微镜下生物陶瓷IRoot BP Plus根尖屏障术治疗慢性根尖周炎根尖未闭合的临床疗效。

方法 选取2020年1～12月期间口腔科收治的90例慢性根尖周炎根尖未闭合患者作为研究对象，根据随机数字表分为A组、B组和C组各30例。A组采用常规处理，B组采用Vitapex治疗，C组采用生物陶瓷IRoot BP Plus根尖屏障术治疗。比较各组临床疗效、龈沟液炎性因子水平以及操作时间、术后持续疼痛时间。

结果 A组总有效为56.67%，B组总有效率为73.33%，C组总有效率为93.33%，C组高于其他两组（P<0.05）。三组治疗后的CRP、IL-6、TNF-α水平均低于治疗前，且C组低于其他两组（P<0.05）。C组术后持续疼痛时间少于其他两组（P<0.01）。

结论 口腔显微镜下生物陶瓷IRoot BP Plus根尖屏障术治疗慢性根尖周炎根尖未闭合的临床疗效确切，可减轻龈沟液炎性反应，术后疼痛持续时间短。

【关键词】 根尖未闭合;生物陶瓷IRoot BP Plus;Vitapex;炎性因子

中图分类号：R781.3   文献标志码：A   DOI：10.3969/j.issn.1003-1383.2021.12.003

【Abstract】 Objective To investigate the clinical efficacy of bioceramic IRoot BP Plus apical barrier under oral microscope in the treatment of chronic periapical periodontitis without apical closure. Methods A total of 90 patients with chronic periapical periodontitis without apical closure admitted to the department of stomatology from January to December 2020 were selected as research objects. They were divided into group A， group B and group C according to random number table， with 30 patients in each group. The Group A were given conventional treatment， the group B were treated with Vitapex， and the group C were treated with bioceramic IRoot BP Plus apical barrier. And then， clinical efficacy， gingival crevicular fluid inflammatory factor levels， operation time and duration of postoperative pain were compared among all groups.

Results The total effective rate was 56.67% in the group A， 73.33% in the group B and 93.33% in the group C， and that of the group C was higher than those of the other two groups （P<0.05）. The levels of CRP， IL-6 and TNF-α in the observation group after treatment were lower than those before treatment， and those of the group C were lower than those of the other two groups （P<0.05）. The duration of postoperative pain in the group C was shorter than the other two groups （P<0.01）.

Conclusion Bioceramic IRoot BP Plus apical barrier under oral microscope has definite clinical efficacy in the treatment of chronic periapical periodontitis without apical closure， which can alleviate the inflammatory response of gingival crevicular fluid with shorter postoperative pain duration.

【Key words】 apical unclosed; bioceramic IRoot BP Plus; Vitapex; inflammatory cytokines

慢性根尖周炎在臨床口腔科较为常见，具有较高的发生率，会严重影响患者的口腔健康，影响日常的生活、工作等，降低生存质量[1]。慢性根尖周炎患者根尖未闭合多因感染引起，尽管常规的根管治疗可以起到一定的效果，但是常规性的填充材料无法形成理想的致密封闭，导致无效或失败的风险较高[2]。Vitapex是临床使用较多的修复材料，应用效果良好，但是操作的难度较高，完成整个修复需要一定的时间[3]。生物陶瓷IRoot BP Plus根尖屏障术是一种新型的治疗根尖未闭合的术式，将生物陶瓷IRoot BP Plus作为填充材料，具有良好的封闭性，充填的成功率较高，能够有效保证填充效果[4]。……