半导体激光及超声荡洗应用于慢性根尖周炎根管消毒中的疗效

Efficacy of semiconductor laser and ultrasonic irrigation in root canal disinfection for chronic apical periodontitis

摘要:

目的 探讨半导体激光及超声荡洗应用于慢性根尖周炎根管消毒中的临床效果。方法 选取2022年1月—2023年6月在阜阳市人民医院口腔科就诊的120例慢性根尖周炎患者为研究对象，按照随机数字表法分为对照组、超声组及激光组，每组40例。对照组进行常规根管预备及化学冲洗；超声组在常规治疗基础上使用超声荡洗进行消毒；激光组在常规治疗基础上使用半导体激光进行消毒。对比3组治疗前后根管内细菌数量、术后24 h记录3组患者舒适度评分、术后24及72 h随访根管约诊间疼痛（EIAP）发生率。术前及术后1周分别采用酶联免疫吸附试验检测患者血清C反应蛋白水平（CRP）。治疗前及治疗后6个月复诊评价患牙，摄片记录3组患者患牙根尖骨灰度值。治疗后12个月复诊评价患牙治疗效果。结果 超声组和激光组消毒前后根管内厌氧菌数量的差值均高于对照组（P <0.05）。超声组和激光组简化舒适状况量表评分均高于对照组（P <0.05），且激光组高于超声组（P <0.05）。3组患者术后24 h EIAP发生率比较，差异有统计学意义（P <0.05）。3组患者术后72 h EIAP发生率比较，差异无统计学意义（P >0.05）。超声组、激光组治疗前后CRP水平的差值均高于对照组（P <0.05）。超声组和激光组患牙治疗前及治疗后6个月根尖骨密度的差值均高于对照组（P <0.05）。3组术后12个月治疗有效率比较，差异无统计学意义（P >0.05）。结论 超声荡洗及半导体激光辅助根管消毒使用可降低根管内细菌含量，缓解术后疼痛，提高治疗有效率。

Abstract:

Objective To evaluate the clinical effects of semiconductor laser and ultrasonic irrigation in root canal disinfection for chronic apical periodontitis.Methods A total of 120 patients diagnosed with chronic apical periodontitis who visited the Department of Stomatology, Fuyang People's Hospital, between January 2022 and June 2023 were selected for the study and randomly divided into three groups: a control group, an ultrasonic group, and a laser group, with 40 patients in each group. Patients in the control group underwent standard root canal preparation and chemical irrigation. In the ultrasonic group, disinfection was performed using ultrasonic irrigation in addition to standard treatment, while in the laser group, semiconductor laser disinfection was used alongside standard treatment. The bacterial count in the root canal before and after treatment was compared among the three groups. Patient comfort scores were recorded 24 hours after treatment, and the incidence of endodontic interappointment pain (EIAP) was monitored at 24 and 72 hours postoperatively. Serum C-reactive protein (CRP) levels were assessed using ELISA one week before and after treatment. Apical bone density was evaluated via radiographs before treatment and six months post-treatment. Treatment outcomes were assessed 12 months after the procedures.Results The reduction in anaerobic bacterial count in the root canal was significantly higher in both the ultrasonic and laser groups compared to the control group (P <0.05). Both the ultrasonic and laser groups showed higher comfort scores compared to the control group (P <0.05), with the laser group scoring higher than the ultrasonic group (P <0.05). There was a significant difference in the incidence of EIAP among the three groups at 24 hours postoperatively (P <0.05), but no significant difference was observed at 72 hours (P >0.05). The reduction in CRP levels in the ultrasonic and laser groups was significantly greater than in the control group (P <0.05). The increase in apical bone density in the ultrasonic and laser groups from baseline to six months post-treatment was significantly greater than in the control group (P <0.05). There was no significant difference in treatment efficacy among the three groups at the 12-month follow-up (P >0.05).Conclusion Both ultrasonic irrigation and semiconductor laser disinfection are effective in reducing intracanal bacterial load, alleviating postoperative pain, and improving treatment outcomes in patients with chronic apical periodontitis.