新型生物陶瓷iRoot SP联合单尖充填技术治疗慢性根尖周炎的临床效果

Clinical efficacy of novel bioceramic sealer iRoot SP combined with single-cone filling technique in the treatment of chronic periapical periodontitis

摘要:

目的 比较AH-Plus根管封闭剂结合热牙胶垂直加压充填技术与新型生物陶瓷iRoot SP联合单尖充填技术在慢性根尖周炎治疗中的临床效果。方法 选取2020年5月—2023年5月宝鸡市人民医院口腔科收治的慢性根尖周炎患者76例，按照随机数字表法分为对照组、观察组，各38例。对照组采用AH-Plus根管封闭剂结合热牙胶垂直加压充填技术，观察组采用新型生物陶瓷iRoot SP联合单尖充填技术。分别收集患者治疗前（T₀）、治疗3个月（T₁）、治疗6个月（T₂）的龈沟液检测炎症因子水平。统计并比较两组患者根管充填时间、治疗充填质量与疗效。采用视觉模拟评分法（VAS）评估患者治疗各时期疼痛情况。统计两组患者治疗各时期咀嚼功能、咬合功能，采用电测牙髓试验（EPT）评估牙髓活性。采用根尖周指数（PAI）对患者X射线检查进行病损评估。结果 对照组充填时间长于观察组（P <0.05），超填比例高于观察组（P <0.05），显效/有效占比低于观察组（P <0.05）。观察组与对照组T₁、T₂时VAS评分比较，结果 ①不同时间点VAS评分比较，差异有统计学意义（P <0.05）；②观察组与对照组VAS评分比较，差异有统计学意义（P <0.05）；③两组VAS评分变化趋势比较，差异无统计学意义（P >0.05）。观察组与对照组T₀，T₁、T₂时IL-1β、IL-6、IL-8、TNF-α水平比较，结果 ①不同时间点IL-1β、IL-6、IL-8、TNF-α水平比较，差异均有统计学意义（P <0.05）；②观察组与对照组IL-1β、IL-6、IL-8、TNF-α水平比较，差异均有统计学意义（P <0.05）；③两组IL-1β、IL-6、IL-8、TNF-α水平变化趋势比较，差异均有统计学意义（P <0.05）。观察组与对照组T₀、T₁、T₂时EPT、咀嚼功能、咬合功能评分比较，结果 ①不同时间点EPT、咀嚼功能、咬合功能评分比较，差异均有统计学意义（P <0.05）；②观察组与对照组EPT、咀嚼功能、咬合功能评分比较，差异均有统计学意义（P <0.05）；③两组EPT、咀嚼功能、咬合功能评分变化趋势比较，差异均有统计学意义（P <0.05）。观察组与对照组T₀、T₁、T₂时PAI评分比较，结果 ①不同时间点PAI评分比较，差异有统计学意义（P <0.05）；②观察组与对照组PAI评分比较，差异有统计学意义（P <0.05）；③两组PAI评分变化趋势比较，差异无统计学意义（P >0.05）。结论 iRoot SP联合单尖充填技术治疗慢性根尖周炎能够显著缩短治疗时间，有效控制治疗后疼痛，并在根尖区病损治疗及充填质量上展现出更佳的效果。

Abstract:

Objective To compare the clinical efficacy of AH-Plus root canal sealer combined with warm vertical gutta-percha compaction technique versus the novel bioceramic iRoot SP in conjunction with single-cone filling technique in the treatment of chronic periapical periodontitis.Methods Seventy-six patients with chronic periapical periodontitis, treated at the Department of Stomatology, Baoji People's Hospital from May 2020 to May 2023, were selected and divided into a control group (n = 38) and an observation group (n = 38) by the random number table method. The control group underwent root canal filling using AH-Plus sealer combined with warm vertical gutta-percha compaction, while the observation group was treated with the novel bioceramic iRoot SP and the single-cone filling technique. Gingival crevicular fluid was collected pre-treatment (T₀), and 3 months (T₁) and 6 months (T₂) post-treatment to measure inflammatory factor levels. The root canal filling time, quality of filling, and treatment outcomes were statistically analyzed and compared between the two groups. The Visual Analog Scale (VAS) was used to assess patients' pain during each treatment period. Masticatory and occlusal functions were evaluated at each treatment stage, and electric pulp testing (EPT) was employed to assess the pulp vitality. The periapical index (PAI) was used to assess the lesion severity on X-ray images.Results The filling time in the control group was longer (P < 0.05), the overfilling rate was higher (P < 0.05), and the rate of marked/effective outcomes was lower in the control group than in the observation group (P < 0.05). The VAS scores at T₁ and T₂ in the observation and control groups were compared, which revealed that the VAS scores were different across the time points (P < 0.05) and between the groups (P < 0.05), and that the change trend of VAS scores was not different between the two groups (P > 0.05). Comparison of IL-1β, IL-6, IL-8, and TNF-α levels at T₀, T₁, and T₂ between the observation and control groups showed that they were different among the time points (P < 0.05) and between the groups (P < 0.05), and that the change trends of them also differed significantly between the two groups (P < 0.05). The EPT values, masticatory function scores, and occlusal function scores at T₀, T₁, and T₂ in the observation and control groups were compared. The results demonstrated that they were all statistically significant among the time points (P < 0.05) and between the two groups (P < 0.05), and that the change trends of them were different between the two groups (P < 0.05). The PAI scores at T₀, T₁, and T₂ in the observation and control groups were also compared, which suggested that the PAI scores were different across the time points (P < 0.05) and between the two groups (P < 0.05), while the change trend of PAI scores was not different between the two groups (P > 0.05).Conclusion The novel bioceramic sealer iRoot SP, when used in combination with the single-cone filling technique for the treatment of chronic periapical periodontitis, significantly reduces treatment time, effectively alleviates post-treatment pain, and demonstrates superior outcomes in periapical lesion resolution and filling quality.