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单次根管治疗与两次根管治疗:一项使用锥形束计算机断层扫描的初步随机临床研究

Single vs Two-session Root Canal Treatment: A Preliminary Randomized Clinical Study using Cone Beam Computed Tomography.

作者信息

de Castro Rizzi-Maia Claudia, Maia-Filho Etevaldo M, Nelson-Filho Paulo, Segato Raquel Ab, de Queiroz Alexandra M, Paula-Silva Francisco Wg, da Silva Pereira Sângela M, Borges Alvaro H, da Silva Léa Ab

机构信息

Department of Dentistry, School of Dentistry of Ribeirao Preto, University of Sao Paulo, Ribeirao Preto, Sao Paulo, Brazil.

Professor Department of Dentistry, CEUMA University, Sao Luis Maranhao, Brazil, Phone: +55(98)981803085, e-mail:

出版信息

J Contemp Dent Pract. 2016 Jul 1;17(7):515-21.

Abstract

AIMS

To compare root canal treatment of teeth with apical periodontitis (AP) in a single or two visits, using cone beam computed tomography (CBCT).

MATERIALS AND METHODS

Twenty-six pairs of teeth (13 patients) were assigned to two groups: Group single-session (GSS): Instrumentation and root canal filling in the same session; and group two-session (GTS): A calcium hydroxide intracanal medication (Calen(®) paste) was used for 14 days between two sessions. Cone beam computed tomography scans were obtained before and 12 months after treatment. The pre- and postoperative volume of the AP lesions was measured in mm(3). The percentages of volume reduction was compared using Student's t-test and the existence of significant difference between the groups for cases with ≤ 50% or > 50% lesion volume reduction was assessed by chi-squared test ratio likelihood test (α = 5%).

RESULTS

The volume reduction was greater in GTS (79.25%) than GSS (68.35%), though without significant difference (p > 0.05). After 12 months, complete repair was not observed in any specimen. Lesion volume reduction > 50% was significantly greater with the use of an intracanal medication (p < 0.05).

CONCLUSION

Twelve months posttreatment, CBCT did not show complete repair in any of the teeth, suggesting that this follow-up period is not sufficient for complete lesion regression. In both groups, similar AP lesion volume reduction was observed after 12 months, with a more advanced repair (> 50% volume reduction) in the teeth medicated with calcium hydroxide intracanal dressing.

CLINICAL SIGNIFICANCE

Calcium hydroxide intracanal dressing provided clinical evidence to indicate its use in teeth with apical periodontitis prior to definitive root canal filling.

摘要

目的

使用锥形束计算机断层扫描(CBCT)比较单次就诊和两次就诊对患有根尖周炎(AP)牙齿的根管治疗效果。

材料与方法

将26对牙齿(13名患者)分为两组:单次就诊组(GSS):在同一次就诊中进行根管预备和根管充填;两次就诊组(GTS):在两次就诊之间使用氢氧化钙根管内药物(Calen®糊剂)14天。在治疗前和治疗后12个月进行CBCT扫描。测量AP病变的术前和术后体积(以mm³为单位)。使用学生t检验比较体积减少的百分比,并通过卡方检验比值似然比检验评估病变体积减少≤50%或>50%的病例组间是否存在显著差异(α = 5%)。

结果

GTS组(79.25%)的体积减少大于GSS组(68.35%),但无显著差异(p > 0.05)。12个月后,任何标本均未观察到完全修复。使用根管内药物时,病变体积减少>50%的情况显著更多(p < 0.05)。

结论

治疗后12个月,CBCT显示任何牙齿均未完全修复,表明该随访期不足以使病变完全消退。两组在12个月后观察到类似的AP病变体积减少,根管内使用氢氧化钙敷料的牙齿修复更明显(体积减少>50%)。

临床意义

根管内使用氢氧化钙敷料提供了临床证据,表明其可用于在进行确定性根管充填之前患有根尖周炎的牙齿。

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