牙髓血运重建术对慢性根尖周炎趋化因子CCL21、干扰素γ诱导蛋白10水平的影响

目的： 探讨牙髓血运重建术对慢性根尖周炎的趋化因子CCL21、干扰素γ诱导蛋白10（IP-10）水平的影响。方法： 选取2018年9月—2019年5月就诊于武汉市中医医院口腔科的慢性根尖周炎患者100例作为研究对象,使用随机数表法平均分为2组,治疗前拍摄锥形束CT（CBCT）存档。实验组使用牙髓血运重建术治疗,对照组以根尖诱导成形术治疗,分别于治疗前,治疗后1、2、3、4周检测趋化因子CCL21、IP-10水平,统计2组患者手术效果,治疗前、后患牙冠根比和根管壁厚度。采用SPSS 25.0软件包对数据进行统计学分析。结果： 2组患者在1~3周的治疗过程中,CCL21、IP-10水平呈现上升趋势,但治疗4周后较之前下降;CCL21水平在治疗2周、3周和4周时相比具有显著差异（P<0.05）,1周时无显著差异（P>0.05）。2组患者IP-10水平在治疗1周、2周和3周时相比均无显著差异（P>0.05）,治疗4周时有显著差异（P<0.05）。实验组成功率为90%,对照组50%,2组相比差异显著（P<0.05）。2组患者术前患牙冠根比和根管壁厚度相比无显著差异（P<0.05）,术后则有显著差异（P<0.05）。结论： 慢性根尖周炎采用牙髓血运重建术、根尖诱导成形术治疗,治疗前期可促进趋化因子CCL21、IP-10分泌,CCL21水平在治疗前期变化较大、IP-10则在后期差异显著。

Effect of pulp revascularization on CCL21, IFN-γ-inducible protein 10 in chronic periapical periodontitis

PURPOSE: To investigate the effect of pulp revascularization on the levels of CCL21 and IFN-γ-inducible protein 10（IP-10）in chronic periapical periodontitis. METHODS: One hundred patients with chronic periapical periodontitis treated from September 2018 to May 2019 were selected as the research subjects. They were divided into two groups by using random number table method. The patients in both groups were taken cone-beam CT(CBCT) film for filing before operation. Patients in the experimental group were treated by pulp revascularization, while patients in the control group were treated by apexification. The level of CCL21 and IP-10 was measured within 4 weeks. The results of operation, the ratio of crown to root and the thickness of root canal wall were analyzed. Statistical analysis of the data was conducted with SPSS 25.0 software package. RESULTS: CCL21 and IP-10 levels of the two groups increased in the course of 1-3 weeks, but decreased after 4 weeks. CCL21 levels were significantly different at 2 weeks, 3 weeks and 4 weeks(P<0.05), but there was no significant difference at one week(P<0.05). There was no significant difference in IP-10 level between the two groups at 1, 2 and 3 weeks of treatment(P<0.05), but there was significant difference at 4 weeks of treatment (P<0.05). The success rate of the experimental group was 90% and that of the control group was 50%,there was a significant difference between the two groups(P<0.05). There was no significant difference in the ratio of crown to root and the thickness of root canal wall between the two groups(P<0.05). CONCLUSIONS: For chronic periapical diseases, pulp revascularization, apical induction can promote the secretion of chemokines CCL21 and IP-10 in the early stage of treatment, the level of CCL21 changes greatly in the early stage of treatment, while changes of IP-10 can be seen in the later stage.