慢性根尖周炎一次性根管治疗的临床疗效观察

目的：评价慢性根尖周炎一次性根管治疗的临床效果和可靠性。方法：选择患有慢性根尖周炎的直根管患牙200例，采用改良双敞技术和平衡力法预备根管，0．5％次氯酸钠及17％EDTA冲洗，随机均分为两组：一次性根管治疗组在上述操作完成后立即行牙胶尖加树脂类封闭剂AHplus侧方加压术充填根管；多次性根管治疗组根管内封入氢氧化钙糊剂复诊，待无症状后再行根充。治疗结束后1d、7d、30d随访记录患者的疼痛反应。1年后进行临床及X线复查，计算每组根管治疗的成功及失败率，并进行统计学检验。结果：有94例患者回访，一次性根管治疗组43例，多次根管治疗51例。根管治疗术后1d疼痛发生率一次性治疗组高于多次性组，且有统计学差异，7d、30d的疼痛发生率两组间无明显差异。1年后复查两组的成功率无统计学差异。一次性根管治疗组的前牙与后牙治疗成功率间无统计学差异。结论：慢性根尖周炎一次性根管治疗术后疼痛发生率较多次法高，但远期疗效等同于多次法者。

Clinical Study on Chronic Apical Periodontitis with Single-visit Root Canal Treatment

Objective: To investigate the effect of single-visit root canal treatment (RCT) on teeth with chronic apical periodontitis using contemporary technique of canal cleaning, shaping and obturation. Methods: Two hundred teeth with chronic apical periododntitis were randomly divided into two groups: single-visit RCT group and multiple-visit RCT group. The canals were instrumented with modified double-flared technique in conjunction with balance force technique, irrigated with 0.5% sodium hypochlorite and EDTA and obturated by means of cold lateral condensation technique. Calcium hydroxide paste was used as an intracanal medication remained at least one week in multiple-visit group. 1 day, 7days and 30 days after root canal obturation, patients were reviewed for pain experience, 1 year follow-up was performed using clinical and radiographic examinations. The results were analyzed statistically. Results: The incidence of post-obturation pain after 1 day in single-visit group was significantly higher than that in multiple-visit group. The pain occurrence happened 7 or 30 days, canal filling were no difference between two groups. No statistical difference was observed in success rate of RCT between two groups. Conclusions: Single-visit RCT may be also an effective method for chronic apical periodontitis although the occurrence ofrpost-obturation pain was higher to some degree.