两种不同根管充填方法的临床效果比较(1)
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[摘要] 目的：比较根管充填中分别采用冷牙胶侧方加压与热牙胶垂直加压的临床效果。方法：选择同期急性牙髓炎患者70例，经患者同意后随机均分为A组和B组，每组各35例。A组采用冷牙胶侧方加压进行根管充填，B组采用热牙胶垂直加压进行根管充填，比较两组患者治疗8周后充填质量和临床疗效。结果：治疗8周后，两组患者根管充填满意率分别为82.9%和97.1%，组间比较差异有统计学意义(χ2=3.968，P=0.046)；两组患者临床治疗满意率分别为77.1%和94.3%，组间比较差异有统计学意义(χ2=4.200，P=0.040)。结论：根管充填治疗急性牙髓炎时，应首选热牙胶垂直加压充填的方式，可显著提高临床疗效。
[关键词] 冷牙胶侧方加压；热牙胶垂直加压；根管充填；充填质量；临床疗效
[中图分类号] R781 [文献标识码] B [文章编号] 1673-7210(2011)12(a)-188-02
Comparison of clinical effect in two different methods of root canal filling
SHI Hanping, CHEN Zhou
Department of Dental, Fujian Medical University Affiliated United Hospital, Fujian Province, Fuzhou 350001, China
[Abstract] Objective: To compare the clinical effect of cold gutta-percha lateral condensation and hot gutta-percha vertical condensation in the teeth root canal filling. Methods: 70 patients with the acute pulpitis were divided into group A and group B. Group A were treated by the cold gutta-percha lateral condensation, group B were treated by the hot gutta-percha vertical condensation, then the filling quality and the clinical effect 8 weeks after treatment of the two groups were compared. Results: After 8 weeks, two groups′ filling quality were 82.9% and 97.1%, and there was a statistical significant between the two groups (χ2=3.968, P=0.046); two groups′ clinical effect were 77.1% and 94.3%, and there was a statistical significant between the two groups (χ2=4.200, P=0.040). Conclusion: We should use hot gutta-percha vertical condensation in the teeth root canal filling first, and it can significantly improve the clinical effect.
[Key words] Cold gutta-percha lateral condensation; Hot gutta-percha vertical condensation; Teeth root canal filling; Filling quality; Clinical effect
根管充填是根管治疗急性牙髓炎过程中的重要步骤，其治疗的目的是严密封闭根管系统，隔绝根尖周组织与根管的交通途径，防止感染的复发[1]。根管系统由一个或多个主根管与较多的侧副根管构成，包括了根管交通支、根尖分支等，由于该结构复杂，所以能否对根管系统进行满意的三维封闭，是决定根管治疗是否成功的关键步骤[2]。目前临床上通常采用冷牙胶侧方加压与热牙胶垂直加压的方法进行根管充填，冷牙胶侧方加压具有所需设备简单、易于操作的特点，被广泛采用；热牙胶垂直加压充填被证实能够达到理想的三维封闭的效果[3]。笔者比较了根管充填中分别采用冷牙胶侧方加压与热牙胶垂直加压的临床效果，旨在探讨最佳根管充填的方法，现报道如下：
1 资料与方法
1.1 一般资料
选择2010年3月~2011年5月期间，在我科门诊治疗的70例急性牙髓炎患者，上述入选患者均符合急性牙髓炎的临床诊断标准，每位患者病变牙齿均为1颗，且患牙根尖畅通，发育正常且无畸形；上述入选患者就诊时X线检查提示患牙牙根及周围组织无吸收破坏，根尖阴影<2 mm，且患者为并发其他基础性疾病或慢性感染性疾病，能够耐受根尖治疗，无治疗禁忌证。经患者同意，将以上入选患者随机均分为A组和B组 ......
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