本文選題：一次法　切入點(diǎn)：根管治療　出處：《大連醫(yī)科大學(xué)》2014年碩士論文　論文類型：學(xué)位論文

【摘要】：目的：對需進(jìn)行牙髓治療的患牙采用一次法根管治療，探討嚴(yán)重感染根管根管治療術(shù)后疼痛情況，為臨床應(yīng)用一次法根管治療提供依據(jù)。 方法：根據(jù)臨床檢查、術(shù)前拍攝X片并結(jié)合患者的癥狀做出明確診斷后，，收集符合納入標(biāo)準(zhǔn)的患者（其中活髓和死髓患牙病例各10例）。常規(guī)麻醉，上橡皮障，開髓，揭去髓頂，去除冠髓，探查根管，建立髓腔根管直線通路，根管長度電測儀測定根管工作長度，使用K3（0.06錐度）機(jī)用鎳鈦器械配合Crown-down（冠向下）技術(shù)進(jìn)行根管預(yù)備、成形，根管預(yù)備過程中，每次更換器械均使用5ml2.5%次氯酸鈉（SodiumHypochlorite，NaOCl）溶液沖洗根管，并用17%乙二胺四乙酸（EthyleneDiamine Tetraacetic Acid， EDTA）溶液完成最后根管沖洗。使用美松糊劑和相應(yīng)錐度牙膠尖，采用側(cè)方加壓方法完成嚴(yán)密的根管充填，最后進(jìn)行牙冠部的充填。 術(shù)后指導(dǎo)患者使用數(shù)字評分法（Numeric nating Scale, NRS）評估術(shù)后當(dāng)天至術(shù)后一周內(nèi)每天的疼痛情況并記錄于疼痛回訪表，在一周后復(fù)診時(shí)回收回訪表，對術(shù)后一周內(nèi)的疼痛情況進(jìn)行統(tǒng)計(jì)學(xué)分析。 結(jié)果： 1.一次法根管治療術(shù)后第1天的疼痛強(qiáng)度最大（P0.05），有統(tǒng)計(jì)學(xué)意義，疼痛在一周內(nèi)呈現(xiàn)逐漸降低并消失的趨勢。 2.一次法根管治療術(shù)后7天內(nèi)，死髓患牙組與活髓患牙組的疼痛發(fā)生率無顯著性差異，P0.05。 3.一次法根管治療術(shù)后7天內(nèi)，死髓患牙組與活髓患牙組的疼痛強(qiáng)度無顯著性差異，P0.05。 結(jié)論：死髓患牙和活髓患牙經(jīng)一次法根管治療后，術(shù)后一周之內(nèi)疼痛率和疼痛強(qiáng)度無明顯差異。臨床上為減少患者就診次數(shù)，嚴(yán)重感染根管的患牙可以選用一次法根管治療，但要排除術(shù)前嚴(yán)重的腫痛、根管內(nèi)活動(dòng)性滲出和根尖牙槽骨嚴(yán)重破壞的癥狀。
[Abstract]:Objective: to study the pain after root canal therapy in patients with severe infection, and to provide the basis for clinical application of single root canal therapy. Methods: according to clinical examination, X ray was taken before operation and definite diagnosis was made in combination with the symptoms of the patients. The patients who met the inclusion criteria were collected (including 10 cases of live pulp and 10 cases of dead pulp teeth), routine anesthesia, rubber barrier, pulp opening. Removing the top of the pulp, removing the crown pulp, exploring the root canal, establishing the straight passage of the root canal, measuring the working length of the root canal with the electric measuring instrument of the root canal length, using the K3A0.06 taper) machine to prepare the root canal with the nickel-titanium instrument and Crown-down (down) technique. During the root canal preparation, the root canal was washed with 5 ml 2.5% sodium hypochlorite sodium hypochlorite solution and 17% ethyleneDiamine Tetraacetic acid (EDTAT) solution. The method of lateral compression was used to complete the strict root canal filling, and finally the crown was filled. Numeric nating scale (NRS) was used to evaluate the daily pain status from the day of operation to one week after operation and recorded in the pain return form. The pain was statistically analyzed one week after operation. Results:. 1. The pain intensity was the highest on the first day after the treatment, which was statistically significant, and the pain gradually decreased and disappeared within one week. 2. There was no significant difference in the incidence of pain between the dead pulp teeth group and the living pulp tooth group within 7 days after a single root canal therapy (P 0.05). 3. There was no significant difference in pain intensity between the dead pulp teeth group and the living pulp tooth group within 7 days after a single root canal therapy (P 0.05). Conclusion: there is no significant difference in pain rate and pain intensity between dead and living pulp teeth after one treatment. In order to reduce the number of visits to patients, the teeth with severe infection can be treated with root canal only once. However, the symptoms of severe preoperative swelling and pain, active exudation in the root canal and severe destruction of the apical alveolar bone should be excluded.
【學(xué)位授予單位】：大連醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2014
【分類號】：R781.05

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相關(guān)期刊論文 前3條

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