中国实用口腔科杂志

中国实用口腔科杂志 ›› 2022, Vol. 15 ›› Issue (6): 694-698.DOI: 10.19538/j.kq.2022.06.011

• 论著 • 上一篇    下一篇

Er∶YAG激光激活荡洗辅助根管治疗对慢性根尖周炎临床效果及影响因素的回顾性研究

何新宇，李　珍，赵斯佳，张晓巍，张慧杰，吴　宣，赵继志   

  1. 中国医学科学院北京协和医学院，北京协和医院口腔科，北京 100730
  • 出版日期:2022-11-30 发布日期:2023-01-16
  • 基金资助:
    北京市自然科学基金面上项目（7212075）；中国医学科学院北京协和医院青年科学基金（PTI201912000）；北京协和医院中央高水平医院临床科研专项青年培优计划（2022-PUMCH-A-014）

  • Online:2022-11-30 Published:2023-01-16

摘要： 目的    研究Er∶YAG激光激活荡洗辅助根管治疗对慢性根尖周炎的临床效果及其影响因素。方法    收集2017—2020年在中国医学科学院北京协和医院口腔科接受Er∶YAG激光激活荡洗辅助根管治疗的47例慢性根尖周炎患者临床和影像学资料进行回顾性分析，共计患牙51颗。所有病例随访时间至少1年，根据临床和影像学检查结果，将患牙的转归分为已治愈、正在愈合和治疗失败3类，并对患者年龄、性别、牙位、颌位、随访时间、有无超充、治疗前根尖阴影大小及根尖周指数（PAI）8项可能影响临床效果的因素进行分析。结果    采用Er∶YAG激光激活荡洗辅助根管治疗的51颗慢性根尖周炎患牙已治愈43颗（84.3%），正在愈合5颗（9.8%），治疗失败3颗（5.9%）。分析其影响因素发现，治疗前PAI评价对患牙治疗效果具有明显影响（H = 10.722，P = 0.005），治疗前PAI评价为5级的患牙治疗效果较PAI评价为3、4级的患牙差（P < 0.05），而治疗前PAI评价为3、4级的患牙治疗效果差异无统计学意义（P > 0.05）。其他7项因素对患牙治疗效果无明显影响（均P > 0.05）。结论    采用Er∶YAG激光激活荡洗辅助根管治疗的慢性根尖周炎患者临床效果良好，但治疗前PAI评价为5级的患牙可能预后较差。

关键词: Er∶YAG激光, 回顾性研究, 根尖周炎, 激光激活荡洗

Abstract: Objective    To evaluate the clinical outcome and influencing factors of Er∶YAG laser activated irrigation assisting root canal treatment for chronic periapical periodontitis. Methods    Totally 51 teeth diagnosed with periapical periodontitis with a minimum of 1-year follow-up were involved in this retrospective study. All these teeth received root canal therapy with Er∶YAG laser activated irrigation in the hospital of Peking Union Medical College Hospital from 2017 to 2020. According to the clinical examination and radiographic examination at follow-up，the outcome of the treated teeth was classified as healed，healing and failure. Eight prognostic factors that could influence clinical outcome，including patients′   age，gender，tooth position，jaw position，follow-up time，extruding sealer，preoperative apical shadow and pre-operation PAI were evaluated in this study. Results    The number of healed teeth in our study was 43（84.3%），healing tooth was 5（9.8%），failed tooth was 3（5.9%）. Among all these prognostic factors，preoperative PAI score had significant influence on the treatment effect（H = 10.722，P = 0.005）. The patients with preoperative PAI score of 5 had worse prognosis compared with the patients with preoperative PAI score of 3 and 4（P < 0.05）. There was no statistical difference between the patients with preoperative PAI score of 3 and those of 4（P > 0.05）. Moreover，there was no significant difference found in other prognostic factors. Conclusion    Root canal therapy assisted by Er∶YAG laser activated irrigation has ideal effect on chronic periapical periodontitis. The prognosis of teeth with PAI score of 5 may be poor.

Key words: Er∶YAG laser, retrospective study, periapical periodontitis, laser activated irrigation