根管注入米诺环素联合现代根管治疗术对牙周牙髓综合征的疗效观察

目的:探讨根管注入米诺环素联合现代根管治疗术对牙周牙髓综合征病人牙周指数及细菌感染的影响.方法 :选择牙周牙髓综合征病人128例,随机分为观察组和对照组,各64例.对照组采用牙周袋内局部注射盐酸米诺环素联合现代根管治疗术,观察组采用根管注入米诺环素联合现代根管治疗术.比较2组病人的疗效、牙周指数、细菌感染情况及不良反应.结果 :观察组治疗总有效率为95.3%,明显优于对照组的78.1%(P<0.01).治疗前2组菌斑指数(PLI)、探诊后出血指数(BI)、牙周袋探诊深度(PD)和牙龈指数(GI)差异均无统计学意义(P>0.05);治疗结束时2组病人的牙周指数PLI、PD、BI和GI水平均明显下降,且观察组病人PLI、PD、BI和GI下降幅度均大于对照组(P<0.05~P<0.01);治疗后3个月,观察组PD下降幅度低于对照组,GI下降幅度高于对照组(P<0.05).治疗前2组细菌感染率差异无统计学意义(P>0.05),治疗后观察组细菌感染率显著低于对照组(P<0.01);2组治疗期间的耐药率差异无统计学意义(P>0.05).2组不良反应发生率差异无统计学意义(P>0.05).结论 :根管注入米诺环素联合现代根管治疗牙周牙髓综合征能改善病人牙周指数,降低细菌感染率,临床效果较好,值得推广应用.

Effect of minocycline injection via the root canal combined with modern root canal therapy on pulp-periodontal syndrome

Objective:To investigate the effects of minocycline injection via the root canal combined with modern root canal therapy on the periodontal index and bacterial infection in patients with pulp-periodontal syndrome. Methods:One hundred and twenty-eight patients with pulp-periodontal syndrome were randomly divided into the observation group and control group(64 cases each group). The control group was treated with periodontal pocket injection of minocycline hydrochloride combined with modern root canal therapy,and the observation group was treated with minocycline injection via root canal combined with modern root canal therapy. The curative effect,periodontal index,bacterial infection and adverse reaction between two groups were compared. Results:The total effective rate in observation group(95. 3%) was significantly better than that in control group(78. 1%)(P<0. 01). The differences of the plaque index ( PLI) ,bleeding index( BI) after probing,periodontal pocket depth( PD) and gingival index( GI) before treatment between two groups were not statistically significant(P>0. 05). At the end of treatment,the levels of the PLI,PD,BI and GI in two groups significantly decreased,and the decreasing degrees of PLI,PD,BI and GI in observation group were more than those in control group(P<0. 05 to P<0. 01). After 3 months of treatment,the decreasing degrees of PD and GI in observation group were lower and higher than those in control group,respectively(P <0. 05). The difference of the bacterial infection rate between two groups before treatment was not statistically significant(P>0. 05),and the bacterial infection rate in observation group after treatment was significantly lower than that in control group(P <0. 01). The difference of the drug resistance rate between two groups within treatment was not statistically significant(P>0. 05). The difference of the incidence rate of adverse reaction between two groups was not statistically significant(P>0. 05). Conclusions:The minocycline injection via root canal combined with modern root canal therapy treating pulp-periodontal syndrome can improve the periodontal index and clinical effect, decrease the bacterial infection rate of patients, which is worthy of popularizing.