目的 探讨3种根管冲洗剂应用于根管治疗急性牙髓炎患者的效果。方法 按照计算机分组法将我院2020年12月—2022年7月期间收治的121例急性牙髓炎患者分为3组,3组均采用一次性根管治疗,A组40例在超声引导下采用3%过氧化氢（H₂O₂）溶液荡洗,B组40例在超声引导下采用1%聚维酮碘溶液荡洗,C组41例在超声引导下采用0.5%次氯酸钠（NaClO）溶液荡洗,观察两组临床疗效、致病菌检出量以及不良反应发生率。结果 3组总有效率对比差异无统计学意义（P>0.05）;3组粪肠球菌、具核梭杆菌、牙髓卟啉单胞菌均降低,A组、B组对比差异无统计学意义（P>0.05）,C组均较A、B组低（P<0.05）;3组不良反应发生率对比差异无统计学意义（P>0.05）。结论 3% H₂O₂、0.5% NaClO与1%聚维酮碘均具有良好的治疗效果,且安全性较好,但相较而言,0.5% NaClO在降低患者术后致病菌检出量方面效果更佳。

目的 研究牙周牙髓联合治疗对重度牙周炎的手术效果,以及手术预后评价。方法 研究对象选取我院2016年12月—2018年3月间收治的重度牙周炎患者60例(患齿共60颗),将其随机分为观察组(30例)和对照组(30例),分别接受牙周牙髓联合治疗和单纯牙周治疗。比较两组患者的治疗总有效率以及复发率和患者的美观满意度,同时比较治疗前后的各项临床指标水平。结果 观察组患者的治疗总有效率(93.33%)以及复发率(3.33%)均与对照组[(80.00%)、(10.00%)]无差异[(P=0.13,χ²=2.31)、(P=0.30,χ²=1.07)],美观满意度(96.67%)高于对照组(73.33%)(P=0.01,χ²=6.41);治疗一个月后,观察组患者的PD、AL、松动度水平与对照组无差异(P>0.05),龈沟出血指数(SBI)低于对照组(P<0.05);治疗三个月后,观察组的AL、SBI、松动度均低于对照组(P<0.05),PD水平与对照组无差异(P>0.05)。结论 牙周牙髓联合治疗可有效治疗重度牙周炎患者,改善患者临床症状,提高患者美观满意度,值得临床借鉴。

Objective To study the surgical effect of periodontal pulp combined therapy on severe periodontitis and the prognosis of surgery. Methods The study subjects selected 60 patients with severe periodontitis admitted to our hospital from December 2016 to March 2018 (60 teeth), and were randomly divided into observation group (30 cases) and control group (30 cases). The observation group received periodontal treatment with periodontal pulp and the control group received periodontal treatment alone. The total effective rate of treatment and the recurrence rate and the aesthetic satisfaction of the patients were compared between the two groups, and the clinical indicators before and after treatment were compared. Results The total effective rate (93.33%) and recurrence rate (3.33%) of the observation group were not different from the control group [(80.00%), (10.00%)] [(P=0.13, χ²=2.31), (P =0.30, χ²=1.07)], aesthetic satisfaction (96.67%) was higher than the control group (73.33) (P=0.01,χ2=6.41); after one month of treatment, in the PD, AL, looseness of the observation group, there was no difference between the level and the control group (P>0.05), and the sulcus bleeding index (SBI) was lower than that of the control group (P<0.05). After three months of treatment, the AL, SBI and looseness of the observation group were lower than those of the control group (P<0.05). P<0.05), the PD level was not different from the control groups (P>0.05). Conclusion The combined of periodontal and endodontic treatment may be effective to patients with severe periodontitis, improve the clinical symptoms of patients, and increase the aesthetic satisfaction of patients, which is worthy of clinical promotion.

目的 研究分析牙髓血管再生术治疗年轻恒牙的临床应用疗效。方法 选取本院2012年1月—2013年12月间年轻恒牙牙髓血管再生治疗的60例患者为研究对象,按随机数方式分成两组,每组30例。对照组患者应用根尖诱导成形手术治疗,观察组患者应用牙髓血管再生术进行治疗,统计比较两组患者术后VAS评分及临床疗效。结果 观察组患者治疗总有效率为93.3%,相较于对照组患者的90.0%差异无统计学意义(P＞0.05);治疗前,两组患者VAS疼痛等级评分差异无统计学意义(P＞0.05);治疗后,患者VAS评分降低明显,且观察组显著低于对照组,差异有统计学意义(P＜0.05)。结论 临床中应用内封氢氧化钙糊剂血管再生术在年轻恒牙治疗中具有较好的应用效果,提高有效率,减轻疼痛,值得临床中应用与推广。

       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（χ ² 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%（χ ² =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%（χ ² =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。

       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（χ ² =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%（χ ² =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%（χ ² =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．