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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) ›› 2020, Vol. 14 ›› Issue (06) : 353 -360. doi: 10.3877/cma.j.issn.1674-1366.2020.06.003

所属专题： 总编推荐； 文献；

临床研究

iRoot SP单尖法充填技术对根管治疗临床效果影响的回顾性研究
陈柳池1, 黎晶1, 曾椿媚1, 刘奕雯1, 蒋宏伟1,†()   
  1. 1. 中山大学附属口腔医院，光华口腔医学院，广东省口腔医学重点实验室，广州　510055
  • 收稿日期:2020-04-26 出版日期:2020-12-01
  • 通信作者: 蒋宏伟

Clinical outcome of using single-cone obturation technique with bioceramic sealer iRoot SP in root canal treatment: a retrospective analysis

Liuchi Chen1, Jing Li1, Chunmei Zeng1, Yiwen Liu1, Hongwei Jiang1,†()   

  1. 1. Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University, Guangdong Provincal Key Laboratory of Stomatology, Guangzhou 510055, China
  • Received:2020-04-26 Published:2020-12-01
  • Corresponding author: Hongwei Jiang
  • About author:
    Corresponding author: Jiang Hongwei, Email:
  • Supported by:
    Natural Science Foundation of Guangdong Province(2017A030313713)
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引用本文：

陈柳池, 黎晶, 曾椿媚, 刘奕雯, 蒋宏伟. iRoot SP单尖法充填技术对根管治疗临床效果影响的回顾性研究[J]. 中华口腔医学研究杂志(电子版), 2020, 14(06): 353-360.

Liuchi Chen, Jing Li, Chunmei Zeng, Yiwen Liu, Hongwei Jiang. Clinical outcome of using single-cone obturation technique with bioceramic sealer iRoot SP in root canal treatment: a retrospective analysis[J]. Chinese Journal of Stomatological Research(Electronic Edition), 2020, 14(06): 353-360.

目的

通过回顾性分析，研究iRoot SP辅助单尖充填法及多种预后因素对根管治疗临床效果的影响。

方法

从2014—2018年于中山大学附属口腔医院接受根管治疗且能追踪复查的患者中，选择使用iRoot SP辅助单尖充填后且复诊时间为1年以上患者的110颗患牙纳入分析。根据每颗患牙复诊时临床和影像学检查结果，将患牙的预后分为成功和失败两组。使用连续性修正卡方检验和Fisher精确检验，对术前是否存在根尖阴影、术前根尖阴影的直径大小和有无封闭剂超充等8项可能影响iRoot SP单尖充填临床效果的预后因素进行统计分析。

结果

110颗接受iRoot SP单尖充填治疗的患牙总体成功率为95.5%。其中，83颗术前有根尖阴影患牙的治疗成功率为96.4%，68.7%为已愈合；27颗术前无根尖阴影患牙的治疗成功率为92.6%。术前有根尖阴影和无根尖阴影患牙的治疗成功率差异无统计学意义（χ2 = 0.084，P = 0.772）。术前根尖阴影直径小于或等于5 mm的患牙共53颗，治疗成功率为98.1%；而阴影直径大于5 mm的患牙共30颗，治疗成功率为93.3%。两组患牙治疗成功率的差异无统计学意义（χ2 = 0.259，P = 0.611）。44颗封闭剂超充患牙的治疗成功率为97.7%，患牙有无iRoot SP超充的治疗成功率差异也无统计学意义（χ2 = 0.218，P = 0.640）。

结论

iRoot SP单尖充填法是可行的根管充填技术。

关键词: 根管充填, 治疗结果, 单尖充填法, iRoot SP
Objective

This retrospective study aims to evaluate the clinical outcome of root canal treatment filling with single-cone technique and iRoot SP sealer and to identify factors associated with success or failure.

Methods

There are 110 teeth with a minimum of 1-year recall included in this retrospective study, which received root canal therapy and were filled with single-cone technique and iRoot SP sealer in the hospital of Stomatology affliated to Sun Yat-sen University from 2014 to 2018. According to the clinical examination and radiographic examination at recall, the outcome of the treated teeth was classified as success and failure. For statistical analysis, chi-square test with Yate′s correction and Fisher′s exact test were used to identify which prognostic factors would influence the clinical outcome of the treated teeth. Eight prognostic factors such as the presence of periapical lesion, size of periapical lesion and extruding sealer were evaluated in this study.

Results

The overall success rate of the 110 treated teeth included in our study was 95.5%. The success rate of 83 treated teeth with periapical lesions was 96.4%, and 68.7% were healed. The success rate of 27 treated teeth without periapical lesions was 92.6%. There was no significant difference found in success between teeth with and without periapical lesions (χ2 = 0.084, P = 0.772) . The successful rate of the 53 treated teeth with periapical lesions less than or equal to 5 mm in diameter, was 98.1%. There were 30 teeth with periapical lesions lager than 5 mm in diameter and the success rate was 93.3%. No statistical difference was noted between the two groups (χ2 = 0.259, P = 0.611) . Besides, Forty-four treated teeth exhibited postoperative sealer extrusion, the success rate of which was 97.7%. No significant difference was found in success between the presence or absence of postoperative sealer extrusion (χ2 = 0.218, P = 0.640) .

Conclusion

Single-cone obturation with iRoot SP sealer is a viable root canal filling technique.

Key words: Root canal obturation, Treatment outcome, Single-cone obturation, iRoot SP
图3 iRoot SP单尖充填治疗后，26未愈合　3A：术前根尖X线片，显示26根尖周无阴影；3B：术后即刻根尖X线片；3C：术后4年复查根尖X线片，显示26根尖周出现阴影
表1 预后因素对iRoot SP单尖充填110颗患牙临床疗效的影响[例（%）]
影响因素 例数 已愈合 正在愈合 成功 失败 χ2值 P值
年龄（岁）           0 1.000
  <40 83 58（69.9） 21（25.3） 79（95.2） 4（4.8）    
  40 ~ 70 27 24（88.9） 2（7.4） 26（96.3） 1（3.7）    
性别           0 1.000
  男 21 15（71.4） 5（23.8） 20（95.2） 1（4.8）    
  女 89 67（75.3） 18（20.2） 85（95.5） 4（4.5）    
牙位           1.072 0.300
  前牙 34 21（61.8） 13（38.2） 34（100.0） 0（0.0）    
  后牙 76 61（80.3） 10（13.1） 71（93.4） 5（6.6）    
颌位           0.044 0.835
  上颌 60 45（75.0） 13（21.7） 58（96.7） 2（3.3）    
  下颌 50 37（74.0） 10（20.0） 47（94.0） 3（6.0）    
复查时间（年）           5.004a 0.066a
  1~2 52 36（69.2） 15（28.9） 51（98.1） 1（1.9）    
  2~4 39 34（87.2） 4（10.2） 38（97.4） 1（2.6）    
  >4 19 12（63.2） 4（21.0） 16（84.2） 3（15.8）    
术前根尖阴影           0.084 0.772
  无 27 25（92.6） 0（0.0） 25（92.6） 2（7.4）    
  有 83 57（68.7） 23（27.7） 80（96.4） 3（3.6）    
术前根尖阴影大小（mm）           0.259 0.611
  ≤5 53 42（79.2） 10（18.9） 52（98.1） 1（1.9）    
  >5 30 15（50.0） 13（43.3） 28（93.3） 2（6.7）    
超充           0.218 0.640
  无 66 52（78.8） 10（15.1） 62（93.9） 4（6.1）    
  有 44 30（68.2） 13（29.5） 43（97.7） 1（2.3）    
图6 21 iRoot SP单尖充填术后19个月复查　6A：根尖X线片，显示21、22根尖周阴影消失；6B：口内照片
图11 46 iRoot SP单尖充填术后2年复查　11A：全颌曲面断层片，显示根尖周无阴影；11B：口内照片
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