MTA、iRoot BP Plus在难治性前牙根尖周病患者根管治疗中的应用比较

The comparison of application of MTA and iRoot BP Plus in root canal therapy for refractory periapical disease of anterior teeth

摘要:

目的 对比无机三氧化物聚合物（MTA）、iRoot BP Plus在难治性前牙根尖周病患者根管治疗中的 应用效果。方法 选取2016年3月—2018年3月承德医学院附属医院口腔科收治的246例难治性前牙根尖周病患 者，均为单颗患病且实施根管倒充填治疗。其中82例患者采用MTA治疗（MTA组），84例患者采用iRoot BP Plus治 疗（iRoot BP Plus组），80例患者接受氢氧化钙糊剂治疗（对照组）。对比根充质量、治疗前和治疗1周后局部红肿、疼 痛评分，不同时刻旧根尖指数（O-PAI）变化及临床疗效。结果 iRoot BP Plus组适充率较MTA组和对照组高（P < 0.05）。MTA组治疗前和治疗1周后局部红肿、疼痛评分的差值较对照组高（P <0.05），iRoot BP Plus组最高（P < 0.05）。iRoot BP Plus组O-PAI评级较MTA组、对照组低（P <0.05），相对效果较好；MTA组治疗后较对照组低（P < 0.05），相对效果较好。iRoot BP Plus组临床总有效率最高（P <0.05）。结论 在难治性前牙根尖周病患者根管治疗 中MTA、iRoot BP Plus均优于氢氧化钙糊剂，且应用iRoot BP Plus可保证适充率，并有效减轻局部红肿、疼痛， 改善O-PAI，疗效理想，有望替代MTA推广应用。

Abstract:

: Objective To compare the effects of mineral trioxide aggregate (MTA) and iRoot BP Plus in root canal therapy of refractory periapical disease of anterior teeth. Methods The data of 246 patients with refractory periapical disease of anterior teeth admitted to the Department of Stomatology of the Affiliated Hospital of Chengde Medical College from March 2016 to March 2018 were retrospectively analyzed. All patients had a single affected tooth and all received retrograde filling therapy. Among them, eighty-two cases were treated with MTA (MTA group) and eighty-four cases were treated with iRoot BP Plus (iRoot BP Plus group). Besides, eighty cases in the control group were treated with calcium hydroxide paste. The quality of root canal filling, local swelling and pain scores before and 1 week after treatment, changes of old periapical indexes (O-PAI) at different time points and clinical efficacy were compared. Results The percentage of adequate root canal filling in the iRoot BP Plus group was greater than that in MTA group and control group (P < 0.05). The differences of local swelling and pain scores before and one week after treatment in MTA group were higher than those in control group, and those in iRoot BP Plus group were the highest (P < 0.05). The O-PAI grade of iRoot BP Plus was lower than that of MTA group and control group, which indicated relatively better therapeutic efficacy of iRoot BP Plus (P < 0.05), and the O-PAI grade of MTA group after treatment was lower than that of control group (P < 0.05). Besides, the overall effective rate of iRoot BP Plus group was the highest among the three groups (P < 0.05). Conclusion The iRoot BP Plus and MTA are better than calcium hydroxide paste in the treatment of refractory periapical disease of anterior teeth. Furthermore, the application of iRoot BP Plus is more likely to achieve adequate root canal filling, and can effectively alleviate local swelling and pain and improve O-PAI. Thus, iRoot BP Plus is promising to replace MTA for wider popularization and application.