数字化根尖片联合锥形束CT对根管治疗疗效评价和预后评估的研究

Evaluation of curative effect and prognosis of root canal therapy by digital apical film combined with cone beam CT

    摘要
  • 摘要:
    目的 探究数字化根尖片联合锥形束CT（CBCT）对根管治疗（RCT）疗效评价和预后评估的作用。
    方法 回顾性分析2021年1至12月于沧州市人民医院行RCT的84例患者的临床资料，其中男性45例、女性39例，年龄（42.7±10.4）岁。采用随机数字表法将患者分为观察组（42例）和对照组（42例）。对照组采用数字化根尖片辅助行RCT，观察组采用数字化根尖片联合CBCT扫描辅助行RCT。对照组患者共54颗患牙，其中上颌第一、第二磨牙分别为11颗和12颗，下颌第一、第二磨牙分别为13颗和18颗；观察组患者共56颗患牙，其中上颌第一、第二磨牙分别为13颗、10颗，下颌第一、第二磨牙分别为14颗、19颗。采用χ2检验比较2组患者上颌和下颌第一磨牙、第二磨牙的恰填率、根管填充致密度合格率和治愈率。
    结果 对照组上颌第一磨牙、下颌第二磨牙的恰填率均低于观察组65.71%（23/35）对88.10%（37/42）、68.29%（28/41）对87.50%（42/48），且差异均有统计学意义（χ2=5.560、4.858，均P<0.05）。对照组上颌第二磨牙、下颌第一磨牙的恰填率均低于观察组71.43% （25/35） 对85.71% （24/28）、74.00% （37/50） 对86.27% （44/51），差异均无统计学意义（χ2=1.837、2.395，均P>0.05）。对照组患者根管填充致密度合格率低于观察组68.52%（37/54）对85.71%（48/56），且差异有统计学意义（χ2=4.630，P<0.05）。对照组3次复诊后的治愈率低于观察组76.19%（32/42）对92.86%（39/42），且差异有统计学意义（χ2=4.459，P<0.05）。
    结论 联合使用CBCT与数字化根尖片作为RCT疗效的评估手段，对RCT根管填充长度及严密程度的评价更为准确，可有效改善患者的预后。

     

    Abstract:
    Objective To explore the role of digital apical film combined with cone beam computed tomography (CBCT) in the evaluation of curative effect and prognosis of root canal therapy (RCT).
    Methods The clinical data of 84 patients who underwent RCT, including 45 males and 39 females, aged (42.7±10.4) years, in Cangzhou People's Hospital from January 2021 to December 2021 were analyzed retrospectively. The patients were divided into observation (n=42) and control (n=42) groups using the random number table method. Apical film was used to assist in the RCT of the control group, and apical film combined with CBCT scanning was used during the RCT of the observation group. A total of 54 teeth, including 11 maxillary first molars, and 12 maxillary second molars, 13 mandibular first molars, and 18 mandibular second molars were observed in the control group. A total of 56 teeth were detected in the observation group, exactly 13 maxillary first molars and 10 maxillary second molars were recorded, respectively, meanwhile, 14 and 19 mandibular first and second molars were identified, respectively. Proper filling rates and qualified rates of dense root canal filling of the maxillary first and second molars and mandibular first and second molars in two groups were compared by χ2 test.
    Results The control group showed lower proper filling rates of the maxillary first molars and mandibular second molars compared with the observation group (65.71%(23/35) vs. 88.10%(37/42), 68.29%(28/41) vs. 87.50%(42/48)), and the differences were statistically significant (χ2=5.560, 4.858; both P<0.05). The control group also presented lower proper filling rates of maxillary second molars and mandibular first molars than the observation group (71.43% (25/35) vs. 85.71% (24/28), 74.00% (37/50) vs. 86.27% (44/51)), but the differences showed no statistical significance (χ2=1.837, 2.395; both P>0.05). A lower qualified rate of dense root canal filling was observed in the control group than that in the observation group (68.52% (37/54) vs. 85.71% (48/56)), and the difference was statistically significant (χ2=4.630, P<0.05). The control group exhibited a lower cure rate after three revisits compared with the observation group (76.19% (32/42) vs. 92.86% (39/42)), and the difference was statistically significant (χ2=4.459, P<0.05).
    Conclusions CBCT combined with digital apical film as evaluation methods for the curative effect of RCT, the evaluation of the length and severity of root canal filling of RCT becomes more accurate and can effectively improve the prognosis of patients.

     

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