Abbaszadegan Abbas, Nabavizadeh Mohammadreza, Hoseini Yekani Ameneh, Khayat Akbar
Department of Endodontics, Dental School, Shiraz University of Medical Sciences, Shiraz, IR Iran.
Iran Endod J. 2013 Fall;8(4):171-6. Epub 2013 Oct 7.
The aim of this clinical trial was to evaluate and compare the endodontic treatment results of teeth with apical periodontitis after thirty-month recall with two different irrigation regimen: normal saline followed by Iodine Potassium Iodide (IKI) or sodium hypochlorite (NaOCl) irrigation alone.
Twenty seven patients (30 teeth) who had been included in the first part of our antimicrobial survey were recalled. In previous stage, root canal treatments were performed using either normal saline with IKI final rinse (n = 15) or NaOCl (n = 15) as irrigating solutions. Bacterial samples were taken before and after instrumentation. In this stage, three patients (6 teeth) were excluded from the follow-up schedule since they did not respond to the recall requests. The remaining 24 subjects (12 teeth in each NaOCl and IKI group) were examined clinically and radiologically. Post-operative and follow-up images were coded, blindly evaluated and given a periapical score according to PAI scoring system. The outcome was assessed in two ways; first, the changes in PAI score from base line to the follow-up evaluation in each group were assessed by wilcoxon signed rank test. In addition, Mann-Whitney U test was used to compare the differences between the post-operative and follow-up images of treatment groups. Second, the dichotomous variables as "healed" or "not healed" were compared.
The Median (Min, Max) PAI scores for NaOCl group and IKI group were both 5 (3, 5) for immediate post-operative radiographs and declined to 1 (1, 2) and 2 (1, 2), respectively. A statistically significant decrease in PAI score from the base line to the follow-up evaluation was seen in both groups (P = 0.002). The decrease in NaOCl group was higher significantly in comparison to IKI group (P = 0.036). One hundred percent of the teeth were healed in both groups (PAI ≤ 2) and no teeth showed any abnormal clinical findings.
Root canal irrigation with NaOCl resulted in a significant higher decrease in PAI scores in comparison to irrigation with normal saline followed by IKI final rinse. Although, according to results of 30-months recall, complete bone formation was observed in all samples in both groups and no teeth showed any abnormal clinical findings. These findings depict the weight of all important clinical and biological factors which together impact the results of a successful endodontic treatment.
本临床试验的目的是评估和比较采用两种不同冲洗方案对根尖周炎牙齿进行根管治疗30个月后的疗效：先用生理盐水冲洗，再用碘化钾碘溶液（IKI）冲洗，或仅用次氯酸钠（NaOCl）冲洗。
召回了我们抗菌药物调查第一部分纳入的27例患者（30颗牙齿）。在前一阶段，根管治疗采用生理盐水加IKI终末冲洗（n = 15）或NaOCl（n = 15）作为冲洗液。在器械操作前后采集细菌样本。在本阶段，3例患者（6颗牙齿）因未回应召回请求而被排除在随访计划之外。对其余24名受试者（NaOCl组和IKI组各12颗牙齿）进行临床和影像学检查。对术后和随访图像进行编码，盲法评估，并根据PAI评分系统给出根尖周评分。结果通过两种方式评估；第一，通过Wilcoxon符号秩检验评估每组从基线到随访评估时PAI评分的变化。此外，使用Mann-Whitney U检验比较治疗组术后和随访图像之间的差异。第二，比较“愈合”或“未愈合”的二分变量。
NaOCl组和IKI组术后即刻根尖片的PAI评分中位数（最小值，最大值）均为5（3，5），随访时分别降至1（1，2）和2（1，2）。两组从基线到随访评估时PAI评分均有统计学意义的下降（P = 0.002）。与IKI组相比，NaOCl组的下降幅度显著更高（P = 0.036）。两组中100%的牙齿均愈合（PAI≤2），且无牙齿出现任何异常临床症状。
与先用生理盐水冲洗再用IKI终末冲洗相比，用NaOCl进行根管冲洗导致PAI评分显著降低。尽管根据30个月的随访结果，两组所有样本均观察到完全的骨形成，且无牙齿出现任何异常临床症状。这些发现描述了所有重要临床和生物学因素的权重，这些因素共同影响根管治疗成功的结果。
