中国实用口腔科杂志

中国实用口腔科杂志 ›› 2023, Vol. 16 ›› Issue (1): 82-86.DOI: 10.19538/j.kq.2023.01.014

• 论著 • 上一篇    下一篇

难治性根尖周炎形成的相关因素研究

马依热·阿布都赛麦提a，热孜亚·艾尼a，陈晓涛a，热夏提·克然木b   

  1. 新疆维吾尔自治区人民医院a口腔科，b颌面外科，新疆  乌鲁木齐  830001
  • 出版日期:2023-01-30 发布日期:2023-01-30
  • 基金资助:
    新疆维吾尔自治区自然科学基金（2020D01C125）

  • Online:2023-01-30 Published:2023-01-30

摘要： 目的    探讨难治性根尖周炎形成的相关因素，为指导临床完善治疗方案提供参考。方法    选取2020年1—12月于新疆维吾尔自治区人民医院口腔科行前牙根管再治疗失败的难治性根尖周炎患者30例作为观察组，选取同期行前牙根管再治疗成功的患者30例作为对照组。观察组患者行显微根尖外科手术，并用扫描电镜观察切除的根尖片段样本。收集所有患者临床和影像学资料，比较2组患者疾病相关资料的分布差异，再采用logistic回归模型分析形成难治性根尖周炎的相关因素。结果    观察组根尖片段样本根管内壁可见性状不同的细菌生物膜。2组患者首次根管治疗时长、根管形态、根管数目、根管工作长度、根管弯曲度、刷牙方式、刷牙时长、长期使用抗菌药物情况比较，差异均有统计学意义（均P < 0.05）；进一步行logistic回归模型分析显示，根管形态、根管数目、根管工作长度、根管弯曲度、长期使用抗菌药物均为形成难治性根尖周炎的独立影响因素（均P < 0.05）。结论    难治性根尖周炎患者根管内壁存在性状不同的细菌生物膜。难治性根尖周炎的形成原因可能与根管形态、根管数目、根管工作长度等多种因素有关，在临床治疗中需综合考虑相关因素，不断完善相关治疗方案。

关键词: 根管治疗, 难治性根尖周炎, 显微根尖外科手术, 生物膜

Abstract: Objective    To explore the related factors of refractory periapical inflammation，and to provide reference for clinical improvement of treatment plan. Methods    From January 2020 to December 2020，patients with refractory apical periodontitis who failed the root canal re-treatment of anterior teeth from in the Department of Stomatology，People′s Hospital of Xinjiang Uygur Autonomous Region were selected as the observation group，and 30 patients with successful re-treatment during the same period were selected as the control group. The observation group underwent microscopic apical surgery，and observe the excised specimen with scanning electron microscope. Disease and imaging data of all patients was collected，and the distribution differences in the related data between the two groups were compared. Logistic regression model was used to analyze the factors related to the formation of refractory periapical inflammation. Results    Bacterial biofilms could be seen in the inner wall of the root canal in most of the patients in the observation group. The difference in the first root canal treatment time，root canal morphology，root canal number，root canal working length，root canal curvature，tooth brushing method，tooth brushing time，and long-term use of antibacterial drugs between the two groups were statistically significant（P < 0.05）；Logistic regression model analysis showed that root canal morphology，number of root canals，working length of root canals，curvature of root canals and long-term use of antibiotics were independent influencing factors for the formation of refractory periapical inflammation（P < 0.05）. Conclusion    There are bacterial biofilms with different characters in the inner wall of root canal in patients with refractory periapical inflammation. Its causes are related to root canal morphology，number of root canals，working length of root canals and other factors. Clinical factors should be comprehensively considered in the clinical treatment in order to continuously improve related treatment programs.

Key words: root canal therapy, refractory periapical inflammation, microapical surgery, biofilm