Abstract:【Objective】To explore the curative effect of periodontal treatment at different time after root canal therapy in patients with combined periodontal and pulp lesions. 【Methods】A total of 120 patients with combined periodontal and pulp lesions from October 2018 to October 2019 were selected as the research object. Patients were randomly divided into the observation group and the control group with 60 cases in each group. Both groups received periodontal treatment after root canal treatment. Patients in the observation group received periodontal treatment in 1 week after root canal treatment and patients in the control group received periodontal treatment in 3 weeks after the root canal treatment . The clinical efficacy of the two groups were compared 5 weeks after treatment, and the differences of periodontal probing depth (PD), attachment loss level (AL), gingival retreat (RG) and plaque index (PLI) before and after treatment were compared between the two groups as well. In addition, interleukin-8 (IL-8), interleukin-6 (IL-6) and interleukin-1 β (IL-1β) levels in gingival crevicular fluid and serum were compared between the two groups before and after operation. 【Results】The total effective rate of observation group was 91.66%(55/60), and there was no statistical significance compared with 88.33%(53/60) of control group (P>0.05). The levels of PD, AL and PLI in the two groups were significantly decreased and the level of RG was significantly increased after treatment, and the differences were statistically significant (P<0.05). The levels of PD, AL and PLI in the observation group were significantly lower than those in the control group after treatment, and the differences were statistically significant (P<0.05). Compared to before operation, levels of IL-8, IL-1β and IL-6 in gingival crevicular fluid and serum in both groups decreased significantly after operation with statistical significance (P<0.05), while levels of IL-8, IL-1β and IL-6 in observation group were lower than those in control group after operation and the difference was statistically significant (P<0.05). 【Conclusion】Root canal therapy combined with early periodontal treatment can better improve the levels of PD, AL, PLI, IL-8, IL-1β and IL-6 in patients of combined periodontal and pulp lesions, which is worthy of clinicians' attention.
林兴伟, 王迎捷, 王博. 牙周牙髓联合病变患者根管治疗后不同时机进行牙周治疗的疗效观察[J]. 医学临床研究, 2021, 38(12): 1853-1856.
LIN Xing-wei, WANG Ying-jie, WANG Bo. Curative Observation of Different Time Periodontal Treatments after Root Canal Therapy in Patients with combined Periodontal and Pulp Disease. JOURNAL OF CLINICAL RESEARCH, 2021, 38(12): 1853-1856.
[1] 高竹英.盐酸米诺环素软膏与替硝唑片联合辅助根管治疗牙周—牙髓联合病变的临床效果[J].临床医学研究与实践, 2017,2(28):85-86.
[2] 邱勇棋.牙周源性牙周牙髓联合病变根管治疗后牙周治疗时机选择及效果观察[J].陕西医学杂志, 2018, 47(3):353-355.
[3] 王立彬. 探讨根管治疗联合牙周基础治疗对牙周牙髓联合病变的临床效果[J].世界最新医学信息文摘, 2018, 18(17):60-63.
[4] MARCO C, FABIO V, MASSIMO D S. Outcomes after 25 years of periodontal treatment and maintenance of a patient affected by generalized severe aggressive periodontitis[J].Int J Periodontics Restorative Dent,2018, 38(3):347-354.
[5] HIND A, ALMALIK A M, ALZAHRANI F F, et al. Successful management of teeth with different types of endodontic-periodontal lesions[J].Case Rep Dent,2018, 70(8):42-45.
[6] 郑亚南. 冷牙胶侧方加压与热牙胶垂直加压根管充填治疗牙周牙髓联合病变的效果[J].中国民康医学, 2020, 32(1):79-81.
[7] ZANCAN R F, HADIS M, BURGESS D, et al. A matched irrigation and obturation strategy for root canal therapy[J].Sci Rep,2021, 11(1):46-66.
[8] 赵翔青. 盐酸米诺环素软膏在牙周炎患者治疗中的应用及对患者治疗后PD、PLI、AL、SBI水平变化的影响[J].全科口腔医学电子杂志, 2018, 5(25):120-123.
[9] 金玥, 陈斌, 泥艳红,等. 牙周来源的牙周牙髓联合病变和牙周牙髓共存病变患牙牙周治疗时机的系统评价[J].华西口腔医学杂志, 2018, 36(2):57-63.
[10] 王斌, 吕锦, 孔敏,等. 盐酸米诺环素治疗牙周炎的临床效果[J].中国医药导报, 2019, 16(9):116-119.
[11] 莫志祥. 经根管途径用盐酸米诺环素治疗牙周牙髓综合征的效果分析[J].中国高等医学教育, 2020, 285(9):147-149.
[12] 杨扬, 李威, 王左敏,等. 牙周炎合并AECOPD患者血清IL-6,IL-8水平及相关性研究[J].安徽医科大学学报, 2018,53(6):964-966.
[13] 王春风, 李咏, 金玲,等. 吸烟对慢性牙周炎患者牙周指数及龈沟液MCP-1、IL-8表达的影响[J].实用口腔医学杂志, 2018, 34(6):75-78.