甲硝唑联合Vitapex辅助治疗皮肤窦道型根尖周炎的临床效果

目的探讨甲硝唑联合Vitapex辅助治疗皮肤窦道型慢性根尖周炎的临床效果。方法皮肤窦道型慢性根尖周炎患者30例,患牙30颗,根管预备后,0.5%甲硝唑注射液冲洗根管至窦道口流出,Vitapex糊剂根管充填,1个月内每2周复诊1次,若窦道未愈合给予窦道刮治术。治疗后1～3个月复诊,进行临床检查,拍根尖X线片,对根尖周暗影缩小或消失、无临床症状、窦道已完全消失的患牙,完成根管充填,牙体充填修复或全冠修复。结果 30例患者中28例经1～3次辅助治疗后皮肤窦道愈合,患牙无松动或叩痛。2例治疗后仍有窦道行窦道刮治术后愈合,患牙无松动或叩痛。治疗后1～3个月复查,无临床症状,X线片上未见根尖暗影扩大,完成根管侧压充填,牙体充填修复或全冠修复。随访6～12个月,3例复发,2例行根尖切除及窦道刮治术后愈合,1例患牙松动无功能而拔除。结论甲硝唑联合Vitapex辅助治疗皮肤窦道型慢性根尖周炎效果良好,能减少手术治疗的创伤和痛苦。

Treatment of Periapical Periodontitis with Cutaneous Fistula By Using Metronidazole and Vitapex

Objective To investigate the effect of treatment for periapical periodontitis with cutaneous fistula using metronidazole and Vitapex.Methods Thirty cases with periapical periodontitis with cutaneous fistula and treated by using metronidazole and Vitapex were reviewed.The lesions of apical periodontitis and cutaneous fistula as well as the function of the teeth were recorded.Results Cutaneous fistula of 28 cases healed up and the function of the teeth recovered after 1 to 3 times interviews.Two cases were treated by periapical surgery and scaling of fistula after using metronidazole and Vitapex and the results were good.Three cases recrudesced after 6 months to 1 years.Two cases were treated by periapical surgery and scaling of fistula.One case was treated by extraction of the teeth.Conclusion Periapical periodontitis with cutaneous fistula can obtain good prognosis using metronidazole and Vitapex.