龙军,龙刚,张红梅.盐酸米诺环素缓释剂联合Cortisomol糊剂根管充填治疗逆行性牙髓炎的中期临床评价[J].口腔材料器械杂志,2020,29(1):50-55.
盐酸米诺环素缓释剂联合Cortisomol糊剂根管充填治疗逆行性牙髓炎的中期临床评价
Mid-term clinical evaluation of minocycline hydrochloride sustained-release preparation combined with Cortisomol paste root canal filling for retrograde pulpitis
投稿时间:2018-11-19  修订日期:2019-03-22
DOI:10.11752/j.kqcl.2020.01.10
中文关键词:  慢性牙周炎  牙髓病变  Cortisomol糊剂  盐酸米诺环素缓释剂  IL-17  IL-8  TNF-α
英文关键词:Chronic periodontitis  Pulpal disease  Cortisomol paste  Minocycline hydrochloride sustained release preparation  IL-17  IL-8  TNF-α
基金项目:
作者单位E-mail
龙军 重庆市大足区妇幼保健院, 重庆 402360  
龙刚 重庆牙科医院, 重庆 400010 454048445@qq.com 
张红梅 重庆医科大学附属口腔医院, 重庆 401147  
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中文摘要:
      目的 探讨盐酸米诺环素缓释剂联合Cortisomol糊剂根管充填治疗逆行性牙髓炎的中期临床评价。方法 选取2015年1月至2017年1月在我院治疗的逆行性牙髓炎患者277例(277颗牙),随机数字表法分为实验组(n=139,139颗牙)和对照组(n=138,138颗牙)。对照组给予常规根管治疗,实验组给予Cortisomol糊剂根管充填治疗,并于牙周袋内注射盐酸米诺环素缓释剂,1次/周,连续治疗1个月。于治疗1个月后,统计两组的治疗效果、疼痛程度(VAS)、牙周情况[牙龈指数(GI)、牙周袋探诊深度(PD)、菌斑指数(PLI)、出血指数(BI)和牙周附着丧失(AL)]及血清炎症因子水平[白细胞介素-17(IL-17)、白细胞介素-4(IL-4)、肿瘤坏死因子-α(TNF-α)和白细胞介素-8(IL-8)]。治疗后随访6个月,统计两组生活质量(SF-36)。结果 (1)治疗1个月后,实验组治疗总有效率较对照组高(P<0.05);(2)与对照组比较,治疗1个月后实验组VAS评分较低(P<0.05);(3)与对照组比较,治疗1个月后实验组PLI、PD、BI、GI和AL水平较低(P<0.05);(4)与对照组比较,治疗1个月后实验组血清IL-4、IL-17、TNF-α和IL-8水平较低(P<0.05);(5)治疗后6个月两组SF-36评分较治疗前升高,且实验组较对照组高(P<0.05)。结论 牙周袋内注射盐酸米诺环素缓释剂联合Cortisomol糊剂根管充填治疗逆行性牙髓炎,在缓解患者疼痛、改善牙周症状、提高治疗效果及生活质量等方面具有重要价值,可能与IL-4、IL-17、TNF-α和IL-8水平降低有关。
英文摘要:
      Objective The aim of this study was to investigate the mid-term follow-up results of minocycline sustained-release preparation combined with Cortisomol paste root canal filling in the treatment of retrograde pulpitis. Methods From January 2015 to January 2017, 277 patients (277 teeth) with retrograde pulpitis in our hospital were randomly divided into the experimental group (n=139,139 teeth) and the control group (n=138,138 teeth). The control group was given the conventional root canal treatment. The experimental group was treated with Cortisomol paste root canal filling, and the minocycline hydrochloride sustained-release agent was injected into the periodontal bag once a week for 1 month. After 1 month of treatment, the treatment effect, the pain level (VAS), the periodontal status[gum index (GI), periodontal pocket probing depth (PD), plaque index (PLI), and bleeding index (BI), periodontal attachment loss (AL)] and the serum inflammatory factor levels[interleukin-17 (IL-17), interleukin-4 (IL-4), tumor necrosis factor-α (TNF-α), Interleukin-8 (IL-8)] were evaluated and compared between the two groups. Followed up for 6 months after treatment, the quality of life (SF-36) was calculated. Results (1) After 1 month of treatment, the total effective rate of the experimental group was higher than that of the control group (P<0.05). (2) Compared with the control group, the VAS score of the experimental group was lower after 1 month of treatment (P<0.05). (3) Compared with the control group, the levels of PLI, PD, BI, GI, and AL in the experimental group were lower after 1 month of treatment (P<0.05); (4) compared with the control group, the levels of IL-4, IL-17, TNF-α and IL-8 in the serum were lower after 1 month of treatment (P<0.05). (5) The SF-36 scores of the two groups at 6 months after treatment were higher than those before treatment, and the score of the experimental group was higher than that of the control group. (P<0.05). Conclusion Intra-periosteal injection of minocycline hydrochloride sustained-release preparation combined with Cortisomol paste root canal filling for patients with retrograde pulpitis is of great value in relieving pain, improving periodontal symptoms, improving treatment effect and quality of life. It may be associated with decreased levels of IL-4, IL-17, TNF-α, and IL-8.
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