【摘要】：目的:觀察局部麻醉法和失活法在成人磨牙牙髓摘除術中的療效。方法:選擇280例成人磨牙慢性牙髓炎患者,按患牙部位隨機分為麻醉組和失活組,各組上下頜磨牙各70例。麻醉組上頜磨牙采用含1:100 000腎上腺素的2%利多卡因2ml,行上牙槽后神經(jīng)阻滯麻醉,下頜磨牙行下牙槽神經(jīng)阻滯麻醉,麻醉顯效后行開髓引流、牙髓摘除術。失活組取盡腐質露髓者,直接封多聚甲醛失活劑,12~14d天復診,未露髓者封三氧化二砷失活劑,行間接失活法,4d復診,封藥之前適當制備洞形,形成較好的固位形,復診時常規(guī)開髓,摘除牙髓,兩組患者在牙髓摘除術后行傳統(tǒng)的根管治療,觀察每位患者在牙髓摘除術中的鎮(zhèn)痛效果、開髓及牙髓摘除的時間、根管治療期間疼痛反應及根管治療術后1年進行臨床療效評價。結果:鎮(zhèn)痛效果:麻醉組成功率70%,失活組成功率93%,兩組差異有統(tǒng)計學意義(P0.05);開髓及牙髓摘除的平均時間:麻醉組平均(14±3.0)min,失活組平均(10±2.3)min,兩組差異有統(tǒng)計學意義(P0.05);根管治療期間麻醉組出現(xiàn)疼痛反應的發(fā)生率為15.71%,顯著高于失活組的8.57%(P0.05);臨床療效評價:失活組成功率95%,麻醉組成功率90%,兩組比較差異無統(tǒng)計學意義(P0.05)。結論:失活法在磨牙慢性牙髓炎牙髓摘除術中基本無疼痛、髓腔內無滲血、牙髓摘除效率高,根管治療期間疼痛反應輕微,整體效果優(yōu)于局部麻醉法。
[Abstract]:Objective: to observe the effect of local anesthesia and deactivation in adult molar pulp extraction. Methods: 280 adult patients with chronic pulpitis were randomly divided into anesthetic group and inactivated group. The maxillary molars in the anesthetized group were treated with 2% lidocaine with 1: 100 000 epinephrine. The maxillary molars were anesthetized by posterior alveolar nerve block, and mandibular molars were anesthetized by inferior alveolar nerve block. In the inactivated group, the decomposed pulp was taken, and the paraformaldehyde inactivating agent was directly sealed for 14 days, and the arsenic trioxide inactivating agent was sealed for 14 days. The indirect inactivation method was performed for 4 days. The cavity shape was properly prepared before the drug was sealed to form a better fixation form. The patients in the two groups were treated with traditional root canal therapy after pulpal extirpation. The analgesic effect of each patient, the time of pulp opening and pulp removal were observed. Pain response during root canal therapy and 1 year after root canal therapy were evaluated. Results: the analgesic effect: the success rate of anesthesia group was 70 and that of inactivated group was 933, the difference between the two groups was statistically significant (P0.05), the average time of pulp opening and pulp removal was (14 鹵3.0) min in anesthetic group and (10 鹵2.3) min in inactivated group, the difference between two groups was statistically significant (P0.05). The incidence of pain reaction in the anesthesia group was 15.71, which was significantly higher than that in the inactivated group (8.57%) (P0.05); the clinical efficacy evaluation: 95% success rate in the inactivated group and 90% in the anesthetic group, there was no significant difference between the two groups (P0.05). Conclusion: there is no pain, no bleeding in pulp cavity, high efficiency of pulp extirpation, slight pain response during root canal therapy, and the overall effect is better than that of local anesthesia.
【作者單位】： 清水縣人民醫(yī)院口腔科;清水縣人民醫(yī)院檢驗科;
【分類號】：R781.31

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