蔡雪莲 王月 干春凤 李玉增

[摘要]目的：評价半导体激光治疗窦道型慢性根尖周炎的临床效果。方法：选取2019年6月-2020年12月笔者医院收治的80例窦道型慢性根尖周炎患者，按照随机数字表法分为对照组与观察组，每组40例。对照组采用常规根管预备及氢氧化钙封药，观察组在常规根管预备的基础上采用半导体激光根管内照射后再用氢氧化钙封药。比较两组的疗效、根管治疗约诊间疼痛（EIAP）发生率、牙周情况指标[探诊深度（PD）、牙龈出血指数（GBI）、菌斑指数（PLI）、牙周附着水平（CAL）]及龈沟液中炎症因子[白细胞介素-6（IL-6）、白细胞介素-1β（IL-1β）、肿瘤坏死因子-α（TNF-α）]。结果：观察组的总有效率（95.00% vs 80.00%）明显高于对照组，观察组EIAP发生率（10.00% vs 27.50%）明显低于对照组，差异均有统计学意义（P<0.05）;治疗后1个月，观察组的PD、GBI、PLI及龈沟液中IL-6、IL-1β及TNF-α水平均明显低于对照组，差异均有统计学意义（P<0.05）。结论：半导体激光治疗窦道型慢性根尖周炎的临床效果显著，能够缓解患者疼痛，改善牙周状态，降低牙龈炎症反应。

[关键词]慢性根尖周炎;窦道型;半导体激光;疼痛;龈沟液;炎症因子

[中图分类号]R781.4+2    [文献标志码]A    [文章编号]1008-6455（2022）06-0153-03

Clinical Evaluation of Semiconductor Laser in the Treatment of Patients with Sinus Chronic Periapical Periodontitis

CAI Xuelian， WANG Yue， GAN Chunfeng， LI Yuzeng

（Department of Stomatology， Daxing Teaching Hospital， Capital Medical University， Beijing 102600，China）

Abstract： Objective  To discuss the clinical effect of semiconductor laser in the treatment of patients with sinus chronic periapical periodontitis. Methods  A total of 80 patients with sinus chronic periapical periodontitis who were successively included in our hospital from June 2019 to December 2020. Those patients were divided into control group and observation group according to random number table method， with 40 cases in each group. The control group was treated with routine root canal preparation and calcium hydroxide sealant， while the observation group was treated with semiconductor laser root canal irradiation on the basis of routine root canal preparation and  calcium hydroxide sealant. The efficacy， incidence rate of endodontic interappointment pain（EIAP）， periodontal condition indicators[probing depth（PD）， gingival bleeding index（GBI）， plaque index（PLI）， clinical attachment level（CAL）]， inflammatory factors in gingival creval fluid[interleukin-6（IL-6）， interleukin-1β（IL-1β） and tumor necrosis factor-α （TNF-α） were compared between the two groups. Results  The total effective rate in observation group （95.00% vs 80.00%） was significantly higher than that in control group. The incidence rate of EIAP（10.00% vs 27.50%） in observation group was significantly better than that of the control group，the differences were statistically significant（P<0.05）.At 1 month after treatment， the PD， GBI，PLI，CAL and levels of IL-6，IL-1β，TNF-α in gingival creval fluid in observation group was significantly lower than that of the control group，the differences were statistically significant（P<0.05）. Conclusion The clinical effect was remarkable of semiconductor laser in the treatment of sinus chronic periapical periodontitis， it could relieve the pain of patients， improve the periodontal condition， and reduce the inflammatory response of gingiva.

Key words： chronic periapical periodontitis; sinus; semiconductor laser; pain; gingival creval fluid; inflammatory factors

竇道型慢性根尖周炎治疗难度大，其窦道是由于根尖部脓液逐渐穿通骨壁和软组织进行不彻底的引流而形成的，并有内衬上皮细胞，窦道如迁延不愈则可经常由窦道分泌脓性物影响患者健康[1-2]。因此，迫切需要寻找一种合适的根管消毒方法，既能有效杀灭根管内感染细菌，有利于根尖周炎症的消退，同时又能促进根尖周组织的愈合。……