牙周牙髓联合病变牙周治疗时机选择研究

目的:探索牙周牙髓联合病变牙周治疗的时机。方法:收集2013年10月~2015年10月就诊于我院的138例牙周牙髓联合病变患牙,随机分为对照组(A组)和实验组(B组),A组于根管治疗完成后1周行全口龈下刮治及根面平整术,B组于根管治疗完成后4~6周行全口龈下刮治及根面平整术。分别记录2组患者在牙髓治疗前、牙周治疗前、牙周治疗后2个月、维护期3、6、12个月的SBI、PD、AL、PLI,TM并进行统计学分析。结果:牙髓治疗前,A组与B组各观察指标的组间比较,差异无统计学意义。牙周治疗前2组SBI、PD、TM值相比(P<0.05),差异有统计学意义。牙周治疗后2个月,2组分别与治疗前基线相比,各项指标比较差异有统计学意义。2组维护期3、6、12个月时各项指标与治疗后2个月相比差异无统计学意义。牙周治疗后各时间点,2组各项指标组间比较,差异无统计学意义。结论:对于牙周源性的牙周牙髓联合病变及"真正"的联合病变,根管治疗后1周即可行根面平整。

Research on the Periodontal Treatment Timing for Combined Periodontal-endodontic Lesions

Objective: To explore the periodontal treatment timing for combined periodontal-endodontic lesions. Methods: One hundred and thirty-eight patients with combined periodontal-endodontic lesions, from October 2013 to October 2015 in Nanjing Stomatological Hospital, were randomly divided into control group (group A) and the test group (group B). The involved teeth were treated with root canal therapy (RCT) and full mouth supragingival scaling, and then the subgingival scaling and root planning (SRP) were performed 1 week (group A) or 4-6 weeks (group B) later. SBI, PD, AL, PLI, and TM were recorded at baseline, 2 months, 3 months, 6 months and 12 months for statistical analysis. Results: All the indices observed were not significantly different between group A and group B at baseline before RCT. The differences of SBI, PD, TM were statistically significant between two groups before periodontal treatment (P<0.05). When compared with pre-treatment, the difference of the parameters of baseline and of 2 months after periodontal treatment was statistically significant in both groups. However, there were no statistically significant of the parameters at maintenance periods of 3 months, 6 months, and 12 months when compared to 2 months after treatment. There was no significant difference between two groups at any time point (P<0.05). Conclusion: SRP was suggested to perform 1 week after RCT.