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显微根尖手术联合引导骨再生技术治疗难治性根尖炎的临床疗效
Clinical effect of apical microsurgery combined with guided bone regeneration on refractory apical periodontitis
- 局解手术学杂志 2024年33卷第2期 页码：125-128
- 作者机构：
内蒙古自治区人民医院口腔科，内蒙古 呼和浩特 010017
- 作者简介：
陈丽春，E-mail：176522078@qq.com
- 基金信息：内蒙古口腔医学会临床科研基金项目(IMSA-2022-C2);内蒙古自治区人民医院院内基金项目(2021YN07)
DOI：10.11659/jjssx.01E023092
中图分类号： 781.34纸质出版日期：2024-02-25，
收稿日期：2023-01-30，
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王宾,王俊艳,苗伟等.显微根尖手术联合引导骨再生技术治疗难治性根尖炎的临床疗效[J].局解手术学杂志,2024,33(02):125-128.
WANG Bin,WANG Jun-yan,MIAO Wei,et al.Clinical effect of apical microsurgery combined with guided bone regeneration on refractory apical periodontitis[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2024,33(02):125-128.
王宾,王俊艳,苗伟等.显微根尖手术联合引导骨再生技术治疗难治性根尖炎的临床疗效[J].局解手术学杂志,2024,33(02):125-128. DOI： 10.11659/jjssx.01E023092.
WANG Bin,WANG Jun-yan,MIAO Wei,et al.Clinical effect of apical microsurgery combined with guided bone regeneration on refractory apical periodontitis[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2024,33(02):125-128. DOI： 10.11659/jjssx.01E023092.
摘要
目的
2
探讨显微根尖手术联合引导骨再生技术（GBR）治疗难治性根尖炎的临床疗效及对咀嚼功能的影响。
方法
2
选取2019年6月至2021年9月本院收治的难治性根尖炎患者82例作为研究对象，按照随机数字表法分为对照组和联合组，每组41例。对照组采用显微根尖手术治疗，联合组采用显微根尖手术联合GBR治疗。对比2组患者的临床疗效、咀嚼功能和骨吸收标志物[Wnt3a、骨保护素（OPG）、核因子-κB受体活化因子配体（RANKL）]水平。
结果
2
联合组总有效率（100%）高于对照组（85.37%），差异有统计学意义（
P
<
0.05）。术后3、6、12个月，2组患者的咀嚼效率提高，咬合力逐渐增强（
P
<
0.05），且联合组上标指标均优于对照组（
P
<
0.05）；术后3、6、12个月，2组患者的牙齿松动度均逐渐降低，且联合组患者术后3、6个月牙齿松动度低于对照组（
P
<
0.05）。术后1周，2组患者的Wnt3a和OPG水平均升高，且联合组高于对照组（
P
>
0.05）；2组患者的龈沟液RANKL水平均降低，且联合组低于对照组（
P
>
0.05）。
结论
2
采用显微根尖手术联合GBR治疗难治性根尖炎效果显著，能有效抑制骨吸收，改善咀嚼功能。
Abstract
Objective
2
To investigate the clinical effect of apical microsurgery combined with guided bone regeneration （GBR） on refractory apical periodontitis and masticatory function.
Methods
2
A total of 82 patients with refractory apical periodontitis admitted to our hospital from June 2019 to September 2021 were selected as the study subjects，and they were divided into the control group and the combined group according to the random number table，with 41 cases in each group. The control group was treated with apical microsurgery，and the combined group was treated with apical microsurgery combined with GBR. The clinical efficacy，masticatory function and the levels of bone absorption markers ［Wnt3a，osteoprotegerin （OPG），receptor activator of nuclear factor-κB ligand （RANKL）］ of patients in the two groups were compared.
Results
2
The total effective rate of the combined group（100%） was higher than that of the control group （85.37%），the difference was statistically significant （
P
<
0.05）.The masticatory efficiency and bite force of patients in both groups increased gradually 3，6 and 12 months after operation（
P
<
0.05），which were higher in the combined group compared with the control group （
P
<
0.05）. The tooth mobility of patients in both groups decreased gradually 3，6 and 12 months after operation，and the tooth mobility of patients 3 and 6 months after operation in the combined group were lower than those in the control group （
P
<
0.05）. The levels of Wnt3a and OPG of patients 1 week after operation in both groups increased，which were higher in the combined group compared with the control group （
P
<
0.05）. The RANKL level of gingival crevicular fluid of patients 1 week after operation in both groups decreased，and which was lower in the combined group compared with the control group （
P
<
0.05）.
Conclusion
2
The microapical surgery combined with GBR is effective for refractory apical periodontitis，which can effectively inhibit bone resorption， and improve masticatory function.
关键词
显微根尖手术引导骨再生技术根尖炎咀嚼功能临床疗效
Keywords
apical microsurgeryguided bone regenerationapical periodontitismasticatory functionclinical efficacy
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