iRoot BP Plus和MTA作为根尖倒充填材料在显微根尖手术应用中的近期临床疗效观察

王璐; 吴光远; 李午丽

doi:10.16766/j.cnki.issn.1674-4152.002936

iRoot BP Plus和MTA作为根尖倒充填材料在显微根尖手术应用中的近期临床疗效观察

doi: 10.16766/j.cnki.issn.1674-4152.002936

1.
安徽医科大学口腔医学院安徽医科大学附属口腔医院安徽省口腔疾病研究重点实验室, 安徽合肥 230032
2.
远见口腔门诊部, 安徽合肥 230032

基金项目:

安徽高校自然科学研究项目 KJ2020A0164

安徽医科大学口腔医学院学科建设后续推进研究项目 2020kqkyT05

详细信息

通讯作者:
李午丽，E-mail: hotspot2008@163.com

中图分类号: R781.341 R783.1
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出版历程
- 收稿日期: 2022-10-18
- 网络出版日期: 2023-05-31

Short-term clinical efficacy of iRoot BP Plus and MTA as root-end filling materials in endodontic microsurgery

WANG Lu¹,
WU Guangyuan²,
LI Wuli^{1
, ,}

1.
College & Hospital of Stomatology, Anhui Medical University, Key Lab. of Oral Diseases Research of Anhui Province, Hefei, Anhui 230032, China

摘要

摘要: 目的根尖倒充填是显微根尖手术的关键步骤之一，倒充填材料的选择影响手术的预后，本研究旨在评估新型生物陶瓷材料iRoot BP Plus作为根尖倒充填材料在显微根尖手术应用中的近期临床疗效并与三氧化物聚合物（MTA）相比较，以期为临床倒充填材料的选择提供参考。方法选取2018年12月—2020年12月在安徽省口腔医院牙体牙髓儿童牙病科诊断为慢性根尖周炎需要进行显微根尖手术的患者60例(81颗患牙)，在取得患者知情同意后, 按照随机数表分为2组，试验组为iRoot BP Plus组29例(39颗患牙), 对照组为MTA组31例（42颗患牙），由同一术者按标准化步骤对患者实施显微根尖手术。术后3个月、6个月、1年随访, 1年随访时获得的临床和X线评估资料作为疗效评定的主要依据, 对2组临床疗效进行评定, 并对2组成功率和预后影响因素进行统计学分析。结果 iRoot BP Plus组患者的成功率为92.3%，MTA组为90.5%，差异无统计学意义（P>0.05）；影响显微根尖手术疗效的相关因素分析结果显示患者性别、年龄以及牙位之间的比较差异无统计学意义（均P>0.05），尽管病变直径≤10 mm的1年随访成功率较病变直径>10 mm高（95.1% vs. 80.0%）, 但差异无统计学意义(χ²=2.639，P=0.104)。结论本研究初步证实了iRoot BP Plus和MTA作为根尖倒充填材料均能取得满意的效果，值得临床推广应用。
- 慢性根尖周炎 /
- 显微根尖手术 /
- 根尖倒充填材料 /
- iRoot BP Plus /
- 三氧化物聚合物
Abstract: Objective The root-end filling is one of the key steps of the endodontic microsurgery, and the selection of the root-end filling material affects the prognosis of the surgery. The purpose of this study is to evaluate the short-term clinical efficacy of the new bioceramic material iRoot BP Plus as the root-end filling material in the endodontic microsurgery and compare it with the trioxide polymer (MTA), so as to provide reference for clinical selection. Methods Sixty patients (81 teeth) diagnosed as chronic apical periodontitis with the need for endodontic microsurgery in the Department of Endodontics and Pediatric Dentistry of Anhui Stomatological Hospital from December 2018 to December 2020 were selected. After obtaining the informed consent of the patients, they were randomly divided into two groups through a table of random numbers, the test group was iRoot BP Plus group with 29 patients (39 teeth), and the control group was MTA group with 31 patients (42 teeth). A standardized surgical procedure was performed by a single operator. The patients were followed up at 3 months, 6 months, and 1-year. Clinical and radiographic evaluations acquired at the 1-year follow-up were taken as the primary outcome, and the success rate and prognostic factors of the two groups were statistically analyzed. Results The success rate in the iRoot BP Plus and MTA groups were 92.3% and 90.5%, respectively (P>0.05). The analysis of related factors affecting the curative effect of endodontic microsurgery showed that there was no significant difference in gender, age and tooth position (all P>0.05). Although the 1-year follow-up success rate of lesions with diameter ≤10 mm was higher than that of lesions with diameter>10 mm (95.1% vs. 80.0%), the difference was not statistically significant (χ²=2.639, P=0.104). Conclusion Both iRoot BP Plus and MTA can achieve satisfactory results as root-end filling materials, which are worthy of clinical promotion and application.
- Chronic apical periodontitis /
- Endodontic microsurgery /
- Root-end filling material /
- iRoot BP Plus /
- Mineral trioxide aggregate

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图 1 显微根尖手术过程

注：A为翻瓣后暴露术区；B为根尖切除后显微镜下观察根切断面(×15)；C为显微镜下超声根尖倒预备(×15)；D为观察倒预备洞型(×15)；E为生物材料根尖倒充填(×15)：F为显微镜下观察倒充填质量(×15)。

Figure 1. Process of microscopic apical surgery

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图 2 iRoot BP Plus组代表性图片(12、11患牙)

注：A为术前根尖片；B为术后即刻；C为术后3个月随访；D为术后6个月随访；E为术后1年随访。

Figure 2. Representative pictures of iRoot BP plus group(12, 11 teeth)

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图 3 MTA组代表性图片(21患牙)

注：A为术前片；B为根充及冠修复后；C为术后即刻；D为术后1年随访。

Figure 3. Representative pictures of MTA group(21 teeth)

下载: 全尺寸图片幻灯片

表 1 2组慢性根尖周炎患牙临床疗效对比[颗(%)]

Table 1. Comparison of clinical efficacy of chronic periapical inflammation between the two groups [n(%)

组别	患牙数(颗)	完全愈合	不完全愈合	不满意愈合	成功
iRootBP Plus	39	28(71.8)	8(20.5)	3(7.7)	36(92.3)
MTA	42	29(69.1)	9(21.4)	4(9.5)	38(90.5)
合计	81	57(70.4)	17(21.0)	7(8.6)	74(91.4)

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表 2 显微根尖手术疗效相关影响因素分析

Table 2. Analysis of related influencing factors on the curative effect in endodontic microsurgery

影响因素	患牙数[颗(%)]	成功牙数	χ²值	P值
性别				1.000^a
男性	36(44.4)	33(91.7)
女性	45(55.6)	41(91.1)
年龄			0.014	0.907
>45岁	16(19.8)	14(87.5)
≤45岁	65(80.2)	60(92.3)
牙位				0.693^a
上颌前牙	27(33.3)	26(96.3)
上颌前磨牙	16(19.8)	14(87.5)
下颌前牙	15(18.5)	13(86.7)
下颌前磨牙	22(27.2)	20(90.9)
下颌磨牙	1(1.2)	1(100.0)
病变直径			2.639	0.104
≤10 mm	61(75.3)	58(95.1)
>10 mm	20(24.7)	16(80.0)
注：^a为采用Fisher精确检验。

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