单次根管疏通填充对牙体牙髓病患者填充效果、龈沟液IL-1β、IL-17A、IL-35水平的影响

doi:10.20223/j.cnki.1000-8535.2025.08.008

摘要/Abstract

摘要： 目的探讨单次根管疏通填充对牙体牙髓病患者的填充效果及龈沟液炎症指标的影响。方法选择2023年8月—2024年2月天津市人民医院接收的牙体牙髓病患者84例进行研究,采用随机数字表法分为两组,各42例。对照组采取多次根管疏通填充,观察组采取单次根管疏通填充,比较2组填充效果、治疗效果、龈沟液炎症指标、口腔健康和功能指标、并发症情况。结果观察组欠填、恰填、超填比例与对照组比较无统计学意义（χ²分别为0.262、1.615、0.512,P分别为0.608、0.203、0.474）。观察组的总有效率为97.62%,高于对照组80.95%（χ²=6.098,P=0.014）。治疗后,观察组龈沟液白细胞介素IL-1β、IL-17A、IL-35、肿瘤坏死因子-α水平低于对照组（t分别为3.271、3.028、2.699、2.968,P分别为0.002、0.003、0.008、0.004）。治疗后,观察组龈沟出血指数、牙龈指数低于对照组,咬合力、咀嚼效率高于对照组（t分别为2.311、2.686、2.262、2.776,P分别为0.023、0.009、0.026、0.007）。观察组并发症发生率4.76%低于对照组21.43%（χ²=5.126,P=0.024）。结论牙体牙髓病采取单次根管疏通填充治疗可保证恰当的填充效果,取得良好的治疗效果,而且减轻龈沟液炎症反应,促进口腔健康和功能改善,并发症较少,安全性高,值得推广。

关键词: 牙体牙髓病, 单次根管疏通填充, 填充效果, 龈沟液, 并发症

Abstract: Objective To explore the effects of one-time root canal dredging and filling on the filling effect and gingival crevicular fluid inflammation indexes in patients with endodontic disease．Methods A total of 84 cases of endodontic patients admitted to the Tianjin People's Hospital from August 2023 to February 2024 were chosen and separated into the control group（n=42,multiple-time root canal dredging and filling）and the observation group（n=42,one-time root canal dredging and filling）by random number table method．The filling effect,therapeutic effect,gingival creval fluid inflammation indicators,oral health and function indicators,and complications were compared．Results The underfilling,accurate filling and overfilling showed no significant difference between the two groups（χ²=0.262,1.615,0.512,P=0.608,0.203,0.474）．The total effective rate of observation group was 97.62%,higher than that of control group 80.95%（χ²=6.098,P=0.014）．After treatment,levels of interleukin（IL）-1β,IL-17A,IL-35 and tumor necrosis factor-α in gingival crevicular fluid of observation group were lower（t=3.271、3.028、2.699、2.968,P=0.002、0.003、0.008、0.004）．After treatment,the sulcus bleeding index and gingival index of the observation group were lower,and the biting force and mastication efficiency were higher（t=2.311、2.686、2.262、2.776,P=0.023、0.009、0.026、0.007）．The complication rate in the observation group was 4.76%,lower than that in the control group 21.43%（χ²=5.126,P=0.024）．Conclusions A one-time root canal dredging and filling treatment for endodontic diseases can ensure proper filling effect,achieve good therapeutic effect,reduce gingival crevicular fluid inflammation,promote oral health and function improvement,with fewer complications,high safety,which is worthy of promotion．

Key words: endodontic disease, one-time root canal dredging and filling, filling effect, gingival crevicular fluid, complication

于昕琦, 潘裕兴, 鲁译暄. 单次根管疏通填充对牙体牙髓病患者填充效果、龈沟液IL-1β、IL-17A、IL-35水平的影响[J]. 广州医药, 2025, 56(8): 1069-1073.

YU Xinqi, PAN Yuxing, LU Yixuan. Effects of one-time root canal dredging and filling on filling effect and levels of IL-1β,IL-17A and IL-35 in gingival crevicular fluid in patients with endodontic disease[J]. Guangzhou Medical Journal, 2025, 56(8): 1069-1073.

参考文献

[1] 潘丹丽. 单次与重复多次根管疏通填充治疗对牙体牙髓病效果观察[J].中国现代药物应用,2019,13(1):72-73.
[2] 赵云,李海燕,黄婷.Nd∶YAG和Er∶YAG双激光辅助治疗老年牙周合并牙髓病变患者的疗效及对牙周状态,炎性因子的影响[J].四川生理科学杂志,2023,45(12):2365-2369.
[3] 王贺,张婷婷,周群.单次与重复多次根管疏通填充治疗对牙体牙髓病患者的临床效果分析[J].中国实用医药,2022,17(6):89-9.
[4] 黄伟坚,曹凯华.单次与重复多次根管疏通填充治疗对牙体牙髓病患者的影响[J].中国医药科学,2020,10(2):269-271.
[5] 余道信,程梦.单次与重复多次根管疏通填充用于牙体牙髓病治疗的对比研究[J].中国美容医学,2019,28(1):142-144.
[6] 周学东,李继遥.牙体牙髓科诊疗与操作常规[M].北京:人民卫生出版社,2018.
[7] 刘佳瑞. 多次法根管治疗与一次性根管治疗对牙体牙髓病疗效的影响对比[J].当代医药论丛,2023,21(15):78-81.
[8] 杨燕子,梁涛.龈沟液IL-1β、ICAM-1水平与慢性牙周炎患者米诺环素治疗疗效的相关性[J].四川生理科学杂志,2023,44(3):540-542.
[9] 柯云艳,陈学鹏,张立港,等.慢性根尖周炎患者根管感染病原学与危险因素及miR-146a-5p、IL-1β、IL-34 的预测价值[J].中华医院感染学杂志,20,33(23):3620-3624.
[10] 贾敏. 一次性根管治疗与常规根管治疗对急性牙髓炎患者的影响比较[J].实用中西医结合临床,2023,23(16):95-97,109.
[11] 许霞,陈宝勇.自锁托槽矫正和传统托槽矫正对儿童口腔微生态环境的影响[J].现代诊断与治疗,2021,32(10):1629-1631.
[12] 朱承章,张丽云.单次根管疏通填充对牙体牙髓病治疗效果、龈沟液及血清炎症因子水平的影响[J].中外医学研究,2023,21(24):10-14.
[13] ARAÚJO L P,GOBBO L B,SILVA T A D,et al.Photodynamic therapy in the root canal treatment of primary teeth:A systematic review of clinical trials[J].Int J Paediatr Dent,2024,34(2):114-124.
[14] DUARTE M L,PIRES P M,FERREIRA D M,et al.Is there evidence for the use of lesion sterilization and tissue repair therapy in the endodontic treatment of primary teeth? A systematic review and meta-analyses[J].Clin Oral Investig,2020,24(9):2959-297.
[15] CHOUCHENE F,OUESLATI A,MASMOUDI F,et al.Efficacy of non-instrumental Endodontic treatment in primary teeth:A systematic review of clinical randomized trials[J].Syst Rev,2024,13(1):11.
[16] 马丽芳,邝容,王丹,等.根管治疗术改善牙髓炎患者外周血炎性细胞因子水平及焦虑抑郁状态的研究[J].口腔疾病防治,2023,31(8):580-585.
[17] 张乐琪,谭蕾,孙聪,等.单次与重复多次根管疏通填充对牙体牙髓病患者疼痛程度、咀嚼功能及炎性因子水平的影响[J].现代生物医学进展,2020,20(23):4497-4500.
[18] 薛睿. iRoot BP Plus和氢氧化钙用于年轻恒前牙活髓切断术的疗效对比[J].广州医药,2023,54(8):92-95.
[19] 邱庆发,陈春兰.一次性根管及多次根管治疗急性牙髓炎的疗效分析[J].中国现代药物应用,2022,16(9):58-61.
[20] 滕敏. 一次性与分次根管治疗对牙髓根尖周病患者的临床疗效及对生活质量的影响[J].国际医药卫生导报,2020,26(9):1264-1266.