根管治疗期间急症的影响因素及防治研究

目的 研究根管治疗期间急症(endodontic interappointment emergencies,EIAE)的影响因素及防治方法.方法 慢性根尖周炎患牙368颗随机分为4组,每组92颗: A组(对照组)初诊行根管预备,封甲酚甲醛(FC);B组初诊行根管预备,封氢氧化钙糊剂;C组髓室封FC棉球,1周后行根管预备;D组初诊行根管预备,开放引流2～3d后封FC.记录相关因素,比较各组EIAE发生率.结果 A组18.48%的患牙发生EIAE;EIAE 发生率后牙高于前牙,在根管预备超出根尖孔的患牙高于根管预备长度欠和恰的患牙,无瘘管的患牙高于有瘘管者,差异有统计学意义(P＜0.05).患者的年龄与性别与EIAE 发生率,差异无统计学意义(P＞0.05).B、C、D组较A组EIAE 发生率低,差异有统计学意义(P＜0.05).结论 预备长度、牙位及有无瘘管与EIAE 发作有显著关系,预备前消毒、根管内封氢氧化钙及根管预备后开放引流等措施,可能减少EIAE 发作.

A study of related factors and prevention measures of endodontic interappointment emergencies

Objective To study the related factors and prevention measures of endodontic interappointment emergencies(EIAE).Methods The 368 teeth with chronic periapical disease were divided into four groups at random.Group A,root canals were prepared at the first visit and sterilized with formocresol(FC).Group B,root canals were prepared at the first visit and sterilized with Ca(OH)2.Group C,pulp chambers had been sterilized with FC for 1 week before root canal preparation.Group D,root canals were prepared at the first visit and were left open for 2d or 3d.The related factors were recorded.The incidences of EIAE were statistically analyzed.Results The EIAE incidence of group A was 18.48 %.The EIAE incidence of posterior teeth,the over instrumented teeth and teeth without fistula were significantly higher than those of other teeth(P<0.05).EIAE were not significantly related to the age and gender(P>0.05).The EIAE incidences of group B,C and D were significantly lower than that of group A(P<0.05).Conclusion The occurrence of EIAE was significantly related to overinstrumentation,tooth location and fistula.Sterilization before preparation,Ca(OH)2 and drainage may relieve EIE.