标题：MTAD与洗必泰联合超声荡洗根管治疗难治性根尖周炎的效果比较

      作者：邹林洪，张琳林，邵春婷，陈新    重庆医科大学附属永川医院口腔科，重庆 402160

      卷次： 2021年32卷5期

      【摘要】 目的 比较MTAD与洗必泰(CHX)联合超声荡洗根管在难治性根尖周炎感染治疗中的应用效果。方法 选取2017年1月至2018年 12月在重庆医科大学附属永川医院口腔科治疗的难治性根尖周炎患者60例(患牙60颗)用以研究，按随机数表法分为MTAD组(n=30)和CHX组(n=30)，MTAD组采用MTAD加NaClO进行超声荡洗，CHX组采用CHX加NaClO超声荡洗，所有的治疗操作均由同一名医生完成，治疗后 6个月和1年复诊，比较两组患牙的治疗效果及患牙冲洗前后的主观感觉评分。结果 MTAD组和CHX组患牙治疗后 6个月的成功率分别为 90.0%和 86.7%，差异无统计学意义(P>0.05)；治疗后 1年，MTAD组患牙的成功率为 86.7%，高于 CHX组的63.3%，差异有统计学意义(P<0.05)；MTAD组和CHX组患牙冲洗前患者的疼痛主观感觉评分分别为(78.13±8.25)分和(77.27±5.63)分，差异无统计学意义(P>0.05)，冲洗后MTAD组和CHX组患者的主观感觉评分分别为(12.18±2.17)分和(36.52±4.85)分，MTAD组明显低于CHX组，差异有统计学意义(P<0.05)。结论 在难治性根尖周炎感染治疗中，MTAD和CHX联合超声荡洗均具有较好的清洁能力和抗菌效果，达到良好的根管治疗效果，但相对而言MTAD冲洗抑菌效果比CHX更稳定持续。
      【关键词】 MTAD；洗必泰；超声荡洗；难治性根尖周炎；根管治疗
      【中图分类号】 R781.34+1 【文献标识码】 A 【文章编号】 1003—6350（2021）05—0639—03

Antibacterial effect between MTAD, chlorhexidine combined with ultrasonic washing of root canal in thetreatment of refractory periapical periodontitis.
ZOU Lin-hong, ZHANG Lin-lin, SHAO Chun-ting, CHEN Xin.Department of Stomatology, Yongchuan Hospital of Chongqing Medical University, Chongqing 402160, CHINA
【Abstract】 Objective To compare the efficacy of MTAD, chlorhexidine (CHX) combined with ultrasonicwashing in the treatment of refractory periapical periodontitis. Methods A total of 60 patients (60 teeth) with refractoryperiapical periodontitis treated in Yongchuan Hospital of Chongqing Medical University were selected for study. Theywere randomly divided into MTAD group (n=30) and CHX group (n=30). In the MTAD group, MTAD+NaClO wereused for ultrasonic washing, and in CHX group, CHX+NaClO was used for ultrasonic washing. All the treatment opera-tions were completed by the same doctor. Six months and one year after treatment, the treatment effect of the two groupsof affected teeth was compared and the subjective feelings were scored in the two groups before and after irrigation. Re-sults The success rate of MTAD group and CHX group after six months of treatment was 90.0% and 86.7%, respective-ly, and the difference was not statistically significant (P>0.05). The success rate at 1 year after treatment was 86.7% inMTAD group, significantly higher than 63.3% in CHX group (P<0.05). The subjective sensory scores of patients inMTAD group and CHX group before irrigation were 78.13±8.25 and 77.27±5.63, respectively, with no statistically signif-icant difference (P>0.05); after irrigation, the subjective sensory scores of MTAD group was 12.18±2.17, significantlylower than 36.52 ± 4.85 in CHX group (P<0.05). Conclusion In the treatment of refractory periapical periodontitis,MTAD and CHX combined with ultrasonic washing has a good cleaning ability and antibacterial effect, achieving agood root canal treatment effect, but MTAD washing antibacterial effect is more stable and continuous than CHX.
      【Key words】 MTAD; Chlorhexidine; Ultrasonic washing; Refractory periapical periodontitis; Root canal treat-ment·短篇论著·doi:10.3969/j.issn.1003-6350.2021.05.028基金项目：重庆永川区2018年公益科技计划项目(编号：Ycstc 2018nb0203)