摘要
目的探讨牙髓血管再生术治疗年轻恒牙牙髓坏死伴根尖周炎的效果及对龈沟液血管内皮生长因子(VEGF)和碱性成纤维细胞生长因子(bFGF)含量的影响。方法选取海阳市人民医院2021年1—8月收治的年轻恒牙牙髓坏死伴根尖周炎患者72例进行病例对照研究,按照手术方法不同分为研究组35例、对照组37例。对照组采用常规根尖诱导成形术治疗,研究组采用牙髓血管再生术治疗。比较两组临床疗效及手术前后龈沟液VEGF、bFGF的变化,观察两组相关临床指标及不良反应发生情况。结果研究组总有效率为94.3%(33/35),高于对照组的70.3%(26/37),差异有统计学意义(χ^(2)=7.01,P<0.05)。术前两组龈沟液VEGF、bFGF、牙根长度、牙根管壁厚度差异均无统计学意义(均P>0.05);术后研究组VEGF、bFGF、牙根长度、牙根管壁厚度分别为(43.25±4.87)ng/L、(40.72±4.83)ng/L、(8.95±0.27)mm、(3.08±0.24)mm,对照组分别为(39.90±4.80)ng/L、(36.05±4.66)ng/L、(8.55±0.18)mm、(2.90±0.20)mm,两组差异均有统计学意义(t=2.96、4.18、5.67、2.88,均P<0.05);术后研究组根尖炎症、牙根发育、视觉模拟评分法(VAS)评分均高于对照组(t=7.61、4.83、9.47,均P<0.001)。研究组不良反应发生率为2.9%(1/35),显著低于对照组的21.6%(8/37)(χ^(2)=5.79,P<0.05)。结论牙髓血管再生术治疗年轻恒牙牙髓坏死伴根尖周炎的效果优于根尖诱导成形术,在缓解患者疼痛的同时可改善牙齿功能,不良反应少,具有较高的临床价值。
Objective To investigate the efficacy of pulp revascularization in the treatment of pulp necrosis with periapical periodontitis in young permanent teeth and its effect on the levels of vascular endothelial growth factor(VEGF)and basic fibroblast growth factor(bFGF)in gingival crevicular fluid.Methods From January 2021 to August 2021,72 young patients with permanent teeth exhibiting pulp necrosis and apical periodontitis who were treated at Haiyang People's Hospital were included in this study.These patients were subsequently divided into a study group(n=35)and a control group(n=37),depending on their respective treatment methods.The control group underwent conventional apical angioplasty,whereas the study group underwent pulp revascularization.A comparative analysis was conducted to assess the clinical efficacy of both treatments.Additionally,levels of VEGF and bFGF in gingival crevicular fluid were measured before and after surgery,and these values were compared between the two groups.Relevant clinical indicators and the incidence of adverse reactions were also compared between the study and control groups.Results The overall response rate in the study group was 94.3%(33/35),which was significantly higher than 70.3%(26/37)in the control group(χ^(2)=7.01,P<0.05).Prior to surgery,there were no notable differences in VEGF level,bFGF level,root length,or root canal thickness between the two groups(all P>0.05).However,after surgery,VEGF level,bFGF level,root length,and root canal thickness in the study group were(43.25±4.87)ng/L,(40.72±4.83)ng/L,(8.95±0.27)mm,and(3.08±0.24)mm,respectively.These values were(39.90±4.80)ng/L,(36.05±4.66)ng/L,(8.55±0.18)mm,and(2.90±0.20)mm,respectively,in the control group.There were significant differences in VEGF level,bFGF level,root length,and root canal thickness between the two groups(t=2.96,4.18,5.67,2.88,all P<0.05).After surgery,the scores for apical inflammation,root development,and Visual Analogue Scale(VAS)in the study group were significantly higher than those in the control group(t=7.61,4.83,9.47,all P<0.001).The incidence of adverse reactions in the study group was 2.9%(1/35),which was significantly lower than 21.6%(8/37)in the control group(χ^(2)=5.79,P<0.05).Conclusion Pulp revascularization exhibits superior curative effects compared with conventional apical angioplasty for the treatment of pulp necrosis and apical periodontitis in young permanent teeth.This treatment effectively alleviates pain,markedly improves tooth function,and has a low incidence of adverse reactions,highlighting its clinical value as a therapeutic option.
作者
杨杰
刘楠
Yang Jie;Liu Nan(Department of Stomatology,Haiyang People's Hospital,Haiyang 265100,Shandong Province,China)
出处
《中国基层医药》
CAS
2024年第4期492-496,共5页
Chinese Journal of Primary Medicine and Pharmacy
关键词
牙列
恒
牙髓坏死
根尖周炎
根尖诱导成形术
血管内皮生长因子类
成纤维细胞生长因子
疗效比较研究
Dentition,permanent
Dental pulp necrosis
Periapical periodontitis
Apexification
Vascular endothelial growth factors
Fibroblast growth factor
Comparative effectiveness research
