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中华口腔医学研究杂志(电子版)

中华口腔医学研究杂志(电子版) ›› 2019, Vol. 13 ›› Issue (06) : 349 -354. doi: 10.3877/cma.j.issn.1674-1366.2019.06.005

所属专题： 文献；

临床研究

牙周牙髓联合病变的综合治疗效果观察
李璟1, 刘娟2, 梁菁1, 谭凤清1, 徐婷1, 曾雄群2,†()   
  1. 1. 广州市海珠区口腔医院　510310
    2. 南方医科大学口腔医院，广州　510280
  • 收稿日期:2019-08-06 出版日期:2019-12-01
  • 通信作者: 曾雄群

Observation on the comprehensive therapeutic effect of periodontal-endodontic combined lesions

Jing Li1, Juan Liu2, Jing Liang1, Fengqing Tan1, Ting Xu1, Xiongqun Zeng2,†()   

  1. 1. Guangzhou Haizhuqu District Stomatological Hospital, Guangzhou 510310, China
    2. The Stomatological Hospital, Southern Medical University, Guangzhou 510280, China
  • Received:2019-08-06 Published:2019-12-01
  • Corresponding author: Xiongqun Zeng
  • About author:
    Corresponding author: Zeng Xiongqun, Email:
  • Supported by:
    Guangzhou Haizhu District Science and Technology Plan(2017-43)
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引用本文：

李璟, 刘娟, 梁菁, 谭凤清, 徐婷, 曾雄群. 牙周牙髓联合病变的综合治疗效果观察[J]. 中华口腔医学研究杂志(电子版), 2019, 13(06): 349-354.

Jing Li, Juan Liu, Jing Liang, Fengqing Tan, Ting Xu, Xiongqun Zeng. Observation on the comprehensive therapeutic effect of periodontal-endodontic combined lesions[J]. Chinese Journal of Stomatological Research(Electronic Edition), 2019, 13(06): 349-354.

目的

研究牙周牙髓综合治疗对下前牙牙周牙髓联合病变的疗效，以期为临床治疗提供依据。

方法

收集2017年1月至2018年2月至广州市海珠区口腔医院就诊的31例下颌重度牙周炎伴牙髓病变前牙，给予牙周治疗（龈上洁治、龈下刮治及根面平整术），根管治疗和松牙固定的综合治疗。记录患者基线、治疗后3个月、6个月、12个月的牙石指数（CI）、龈沟出血指数（SBI）、探诊深度（PD）、附着水平（AL）值，采用单因素重复测量资料方差分析统计数据（检验水准α = 0.05），比较患牙治疗前、后差异，评价临床疗效。

结果

31例患牙中，牙周牙髓联合治疗有效率为96.8%。患牙在术后3、6、12个月较基线相比，其CI、SBI、PD、AL值均显著下降，差异均有统计学意义（P<0.001）。术后6个月与3个月相比，PD、AL值继续下降，差异有统计学意义（FPD = 112.51，PPD<0.001；FAL = 117.64，PAL<0.001）；术后12个月较6个月仍持续降低，但差异无统计学意义（FPD = 0.04，PPD = 0.815；FAL = 0.09，PAL = 0.786）。

结论

对于下前牙牙周牙髓联合病变，综合治疗效果显著。

关键词: 牙周牙髓联合病变, 牙周治疗, 根管治疗, 牙周夹板, 下颌前牙
Objective

To study the effect of comprehensive treatment on mandibular anterior teeth with combined periodontal-endodontic lesions, and provide evidence for clinical treatment.

Methods

A total of 31 mandibular anterior teeth with severe periodontitis combined endodontic lesions from January 2017 to February 2018 in Guangzhou Haizhu District Stomatological Hospital were randomly selected. The comprehensive treatment (supragingival scaling, subgingival scaling, rootplanning and root canal treatment) of disease including splinting were performed. The calculus index (CI) , sulcus bleeding index (SBI) , probing depth (PD) , and loss of attachment level (AL) were recorded at baseline, 3 months, 6 months, and 12 months after treatment. ANOVA of single factor repeated measurement data were used to compare the differences before and after treatment and evaluate the clinical efficacy (Test level α = 0.05) .

Results

Compared the baseline with 3, 6, and 12 months after treatment, the CI, SBI, PD, and AL values of the teeth were significantly decreased, and the differences were statistically significant (P<0.001) . PD and AL values at 6 months continued to decrease compared with 3 months, PD (F = 112.51, P<0.001) , AL (F = 117.64, P<0.001) , and at 12 months, which were still lower than at 6 months, but the differences were not statistically significant: PD (F = 0.04, P = 0.815) , AL (F = 0.09, P = 0.786) . In 31 cases, the effective rate of combined periodontal and endodontic treatment was 96.8%.

Conclusion

The comprehensive treatment is significantly effective for the mandibular anterior teeth with combined periodontal-endodontic lesions.

Key words: Combined periodontal-endodontic lesions, Periodontal treatment, Root canal treatment, Periodontal splint, Mandibular anterior teeth
图1 31例牙周牙髓综合病变患者治疗1年牙周指数变化趋势图CI为牙石指数；SBI为龈沟出血指数；PD为探诊深度；AL为附着水平
表1 31例牙周牙髓综合病变患者治疗1年牙周指数的变化（ ± s）
牙周指数 基线 治疗后3个月 治疗后6个月 治疗后12个月
CI 2.87 ± 0.34 1.81 ± 0.40 1.74 ± 0.51 1.87 ± 0.50
SBI 3.09 ± 0.18 1.85 ± 0.45 1.70 ± 0.56 1.63 ± 0.50
PD(mm) 4.71 ± 1.26 3.52 ± 0.91 3.06 ± 0.76 3.02 ± 0.67
AL(mm) 6.02 ± 1.51 4.96 ± 1.19 4.57 ± 1.13 4.54 ± 1.03
图4 患牙41治疗前、后根尖X线片　4A：治疗前；4B：治疗后3个月；4C：治疗后6个月；4D：治疗后12个月
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