一次法与多次法根管治疗不可复性牙髓炎的术后疼痛和放射学疗效比较

目的比较一次法根管充填术与多次法根管充填术治疗不可复性牙髓炎的临床疗效，以评价一次法根管治疗的临床可行性。方法选择临床明确诊断为不可复性牙髓炎患牙135颗，随机分成2组，实验组73颗患牙于就诊当天局麻下开髓、拔髓，预备根管后根管消毒、充填一次完成，对照组62颗患牙采用传统根管治疗术分次（2次或多次以上）完成根管治疗术，术后1周进行复诊检查，比较2种治疗方法的术后疼痛情况。术后6个月、12个月随访复诊检查患牙的治疗情况并拍摄X线片对照2组治疗方法的远期治疗效果，比较其成功率。观察2组术后近期疼痛的发生率和1年后临床反应及放射学疗效。结果治疗结束1周内，实验组与对照组急性反应发生率分别为12．32％和19．35％，差异无统计学意义（P〉0．05）。术后12个月复查，实验组和对照组成功率分别为92．31％和93．10％，差异也无统计学意义（P〉0．05）。一次法根管治疗组术后疼痛发生的例数少于多次法根管治疗组，术后6个月和12个月X线片比较治疗效果无临床意义。结论根管治疗术一次法治疗急、慢性牙髓炎临床疗效明确，近期疼痛发生率低于多次法，远期疗效与常规根管治疗术两者之间的差异没有显著性的意义，治疗中只要掌握好适应证，可以避免治疗后疼痛的发生，临床可以推广使用。

Postoperative pain and radiographic evaluation of single-visit and multi-visit root canal therapy of teeth with irreversible pulpitis

Objective To compare the clinical efficacy of single-visit and muhi-visit root canal therapy of teeth with irre- versible pulpitis, and to evaluate the clinical feasibility of single-visit root canal therapy. Methods A total of 135 teeth with irreversible pulpitis requiring root canal treatment were included preoperatively. The teeth were assigned into two groups at random and treated according to standardized protocol. The teeth in control group（n = 62） were treated by multi- visit root canal therapy while those in experimental group （ n = 73 ） were treated by one-visit root canal therapy. Patients were recalled at intervals of one week,6 and 12 months postoperatively to compare the pain remission rate and radiograph- ic investigation between the two groups. Results There was no statistically significant difference between the two groups in the incidence and severity of postoperative pain at the end of one week（ 12.32% and 19.35% ,P 〉 0.05）. Radiograph- ic investigation at the end of 6 and 12 months also showed no significant difference. Conclusion On strict adherence to biological principles and proper case selection, no significant difference existed in the success, postoperative pain when treated with either single-visit or multiple-visit therapy.