神经生长因子局部注射联合替硝唑辅助根管治疗术对牙周-牙髓联合病变的疗效分析

Analysis of the therapeutic efficacy of local nerve growth factor injection combined with tinidazole-assisted root canal treatment for periodontal-endodontic combined lesions

摘要:

目的 评估神经生长因子局部注射联合替硝唑辅助根管治疗术对牙周-牙髓联合病变患者临床疗效的影响。方法 选取2021年10月—2023年10月在榆林市第一医院口腔科接受治疗的102例牙周-牙髓联合病变患者作为研究对象。采用随机数字表法将其分为对照组（替硝唑辅助根管充填治疗）与联合组（在对照组基础上联合神经生长因子局部注射治疗），每组51例。比较两组患者治疗前后疼痛程度、牙周状态、炎症指标、患牙状况及不良反应发生情况。结果 联合组患者的疼痛总发生率（7.84%）低于对照组（25.49%）（P <0.05）。联合组患者治疗前后牙周探诊深度、探诊出血指数、临床附着水平、菌斑指数的差值均高于对照组（P <0.05）。联合组患者治疗前后高敏C-反应蛋白、白细胞介素-17、白三烯B4的差值均高于对照组（P <0.05）。联合组患者治疗前后肿胀程度、松动度、叩痛评分、口臭程度的差值均高于对照组（P <0.05）。两组在治疗过程中的不良反应发生率比较，差异无统计学意义（P >0.05）。结论 神经生长因子局部注射联合替硝唑辅助根管充填治疗能有效改善牙周-牙髓联合病变患者的临床症状，促进牙周组织愈合及牙髓状态恢复，降低炎症水平，且具有良好的安全性，可成为治疗该类疾病的选择方案。

Abstract:

Objective To evaluate the effect of local nerve growth factor injection combined with tinidazole-assisted root canal treatment on clinical efficacy in patients with periodontal-endodontic combined lesions.Methods A total of 102 patients with periodontal-endodontic combined lesions treated from October 2021 to October 2023 were divided into control group (tinidazole-assisted root canal filling, n = 51) and combination group (additional local nerve growth factor injection, n = 51) using random number table. Pain degree, periodontal status, inflammatory indexes, affected tooth conditions, and adverse reactions were compared before and after treatment.Results The total pain incidence in combination group (7.84%) was significantly lower than in control group (25.49%) (P < 0.05). For periodontal status, the treatment-to-baseline differences in probing depth (PD), periodontal bleeding index (PBI), clinical attachment loss (CAL), and plaque index (PLI) were significantly greater in combination group versus control group (P < 0.05). For inflammatory indexes, the treatment-to-baseline differences in high-sensitivity C-reactive protein (hs-CRP), interleukin-17 (IL-17), and leukotriene B4 (LTB4) were significantly greater in combination group versus control group (P < 0.05). For tooth conditions, the treatment-to-baseline differences in swelling degree, tooth mobility, percussion pain score, and halitosis degree were significantly greater in combination group versus control group (P < 0.05). No significant difference existed in adverse reaction incidence between groups (P > 0.05).Conclusion Local nerve growth factor injection combined with tinidazole-assisted root canal treatment effectively improves clinical symptoms, promotes periodontal tissue healing and pulp status recovery, reduces inflammation levels, and demonstrates good safety for periodontal-endodontic combined lesions.