一次性根管治疗在老年牙髓坏死并根尖周炎病人中的应用

目的:探讨一次性根管治疗在老年牙髓坏死并根尖周炎病人中应用效果。方法:138例老年牙髓坏死并根尖周炎病人随机分为观察组（n=71）和对照组（n=67），2组病人均采取机用Protaper镍钛锉联合超声冲洗进行根管预备，观察组采用一次性完成根管充填，对照组采取二次法根管治疗。分别于术前和术后7 d对病人疼痛情况进行评估，分别于术后7 d和6、12、24个月评估病人临床治疗效果。结果:观察组术后7 d总有效率91.55%，与对照组92.54%差异无统计学意义（P>0.05）；观察组病人术后牙齿疼痛发生率11.27%，与对照组的7.46%差异无统计学意义（P>0.05）；观察组病人术后6、12和24个月治疗成功率分别为74.19%、76.27%和79.63%，对照组分别为71.43%、72.41%和68.09%，2组术后各时间点的成功率差异均无统计学意义（P>0.05）。结论:一次性根管治疗老年牙髓坏死并根尖周炎临床效果与二次根管治疗相当，且有助于减少就诊次数及缩短治疗疗程，安全有效。

Effect of one-time root canal therapy in the treatment elderly pulp necrosis complicated with apical periodontitis

Objective: To investigate the effects of one-time root canal therapy in the treatment elderly pulp necrosis complicated with apical periodontitis.Methods: One hundred and thirty-eight elderly patients with pulp necrosis complicated with apical periodontitis were randomly divided into the observation group(n=71) and control group(n=67).Two groups were treated with machine Protaper NiTi files combined with ultrasonic washing the root canal.The observation group were treated with one-time root canal filling,and the control group were treated with secondary root canal filling.The pains in two groups were assessed before treatment and 7 d after operation,and the clinical effects in two groups were assessed 7 d,6 months,12 months and 24 months after operation.Results: The difference of the total effective rate between the observation group(91.55%) and control group(92.54%)7 d after operation was not statistically significant(P>0.05).The difference of the incidence rate of postoperative teeth pain between the observation group(11.27%) and control group(7.46%) was not statistically significant(P>0.05).The success rates in observation group 6 months,12 months and 24 months after operation were 74.19%,76.27% and 79.63%,respectively,and those in control group were 71.43%,72.41% and 68.09%,respectively.The differences of the success rates in postoperative different time-points between two groups were not statistically significant(P>0.05).Conclusions: The clinical effect of one-time root canal treatment in the treatment elderly pulp necrosis complicated with apical periodontitis is equivalent with the secondary root canal treatment,which can help to reduce the number of visits and shorten the course of treatment,and is safe and effective.