李雨轩 曾群玲 贺新兰 刘芳庆 裴佳 彭莎

*基金项目：吉安市科技计划指导性项目（20233-043591）

【摘要】 目的：探讨超声荡洗用于乳牙一次性根管治疗的临床效果。方法：选取2022年6月—2023年6月吉安市妇幼保健院收治的80例慢性牙髓炎、根尖周炎患儿作为研究对象，用随机数字表法将其分对照组和观察组，各40例，对照组接受机用镍钛器械与复方氯己定冲洗进行乳牙一次性治疗，观察组接受机用镍钛器械与复方氯己定+超声荡洗进行乳牙一次性治疗。比较两组治疗效果、治疗后1周疼痛率、牙周指标、龈沟液炎症因子指标、并发症发生情况等。结果：观察组治疗总有效率（97.50%）高于对照组（75.00%），差异有统计学意义（P<0.05）。观察组治疗后1周疼痛率相比对照组更低，差异有统计学意义（P<0.05）。治疗后，两组龈沟出血指数（SBI）、牙周袋深度（PD）、牙龈指数（GI）均低于治疗前，且观察组均低于对照组（P<0.05）。治疗后，两组C反应蛋白（CRP）、龈沟液白细胞介素-6（IL-6）、肿瘤坏死因子-α（TNF-α）均低于治疗前，且观察组均低于对照组，差异均有统计学意义（P<0.05）。观察组并发症发生率与对照组比较，差异无统计学意义（P>0.05）。结论：超声荡洗用于乳牙一次性根管治疗中，能显著降低治疗后1周疼痛率，缓解局部炎症反应，改善牙周状况，提升舒适性和短期总有效率。

【关键词】 一次性根管 乳牙 超声荡洗 镍钛器械 复方氯己定 疼痛 牙周

The Clinical Effect of Ultrasonic Cleaning for One-time Root Canal Treatment of Deciduous Teeth/LI Yuxuan， ZENG Qunling， HE Xinlan， LIU Fangqing， PEI Jia， PENG Sha. //Medical Innovation of China， 2024， 21（14）： 0-090

[Abstract] Objective： To explore the clinical effect of ultrasonic cleaning for one-time root canal treatment of deciduous teeth. Method： A total of 80 children with chronic pulpitis and periapical periodontitis admitted to the Matemity and Child Health Hospital of Jian from June 2022 to June 2023 were selected as the research subjects， and they were divided into control group and observation group by random number table method， with 40 children in each group. The control group was treated with NiTi instrument and Compound Chlorhexidine for one-time treatment of deciduous teeth， the observation group received one-time treatment of deciduous teeth using NiTi instruments and Compound Chlorhexidine + ultrasonic cleaning. The treatment effects， pain rate after 1 week of treatment， periodontal indicators， gingival crevicular fluid inflammatory factor indicators， and the incidence of complications between two groups were compared. Result： The treatment total effective rate of the observation group （97.50%） was higher than that of the control group （75.00%）， the difference was statistically significant （P<0.05）. After 1 week of treatment， the pain rate in the observation group was lower compared to the control group， the difference was statistically significant （P<0.05）. After treatment， gingival sulcus bleeding index （SBI）， periodontal pocket depth （PD） and gingival index （GI） in both groups were lower than those before treatment， and those in the observation group were lower than those in the control group （P<0.05）. After treatment， C reactive protein （CRP）， gingival crevicular fluid interleukin-6

（IL-6） and tumor necrosis factor-α （TNF-α） in two groups were lower than those before treatment， and those in the observation group were lower than those in the control group， the differences were statistically significant （P<0.05）. There was no significant difference in the incidence of complications between the observation group and the control group （P>0.05）. Conclusion： Ultrasonic cleaning used in one-time root canal treatment of deciduous teet can significantly reduce the pain rate after 1 week of treatment， alleviate local inflammatory reaction， improve periodontal condition， improve comfort and short-term total effective rate.

[Key words] One-time root canal Deciduous teeth Ultrasonic cleaning NiTi instruments Compound Chlorhexidine Pain Periodontium

First-author's address： Department of Stomatology， the Matemity and Child Health Hospital of Jian， Jian 343000， China

doi：10.3969/j.issn.1674-4985.2024.14.021

慢性牙髓炎、根尖周炎为近年临床牙科中发病率较高的一种疾病，病症主要表现为周围血管炎症、剧烈疼痛等[1]。目前认为病因与免疫反应、化学刺激、物理刺激、细菌感染等有关，且细菌感染为诱发龋病的主要病因，牙髓组织长时间遭受刺激，进而诱发牙髓炎。根管治疗为近年临床常用疗法，涉及根管清除、消毒、填充等环节[2]。一次性根管治疗主要包含三个步骤，即预备根管、消毒处理、填充，可降低反复感染率。因乳牙根管壁薄，根管系统较为复杂，一次性根管填充中根管预备的主要环节则为根管冲洗[3]，以往多用化学方法清除根管内感染物，即药物清除和消毒。……