iRoot SP外溢对根管治疗结果的短期影响

Short-term impact of iRoot SP extrusion on the outcome of root canal treatment

摘要:

目的分析iRoot SP这种根管封闭材料外溢对根管治疗结果的短期影响，分析根管治疗结果的短期影响因素。 方法收集2022年6月—2023年9月上海交通大学医学院附属第九人民医院口腔第二门诊部就诊的84名患者（89颗根管治疗患牙）的资料。所有患牙均采用iRoot SP根管封闭材料联合单尖法完成根管充填。将患牙分为完全愈合组、愈合中组、未愈合组。比较iRoot SP外溢组和非iRoot SP外溢组的治疗结果，并使用Fisher精确检验和Logistic回归分析影响根管治疗结果的因素。 结果平均随访时间为370 d，所有患牙完全愈合与愈合中比例为95.5%，非iRoot外溢组完全愈合比例为86.4%，iRoot外溢组完全愈合比例为75.6%，二者之间差异没有统计学意义(P＞0.05)。Logistic回归提示年龄、牙齿类型、治疗前PAI指数、iRoot SP是否外溢对1年后根管治疗结果均没有影响，治疗前根尖阴影直径＞5 mm时根尖周组织完全愈合比例下降(P＜0.001)。 结论本研究提示iRoot SP外溢对短期内根管治疗结果的差异没有统计学意义(P>0.05)。根管封闭材料外溢可能来自根管过度预备，外溢的生物陶瓷材料会导致细胞坏死及炎症反应，临床操作中应尽量避免根管封闭材料外溢的产生，但当临床上出现iRoot SP外溢时，可采取相对乐观的态度进行观察随访。

Abstract:

ObjectiveTo analyze the short-term impact of iRoot SP extrusion on the outcome of root canal treatment, and the short-term influencing factors of the root canal treatment outcome. MethodsThe data of 84 patients and 89 teeth that underwent root canal treatment at the Second Dental Clinic of the Ninth Peoples Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from June 2022 to September 2023 were collected. All the teeth were filled with single-cone technique and iRoot SP material. The affected teeth were divided into 3 groups according to clinical outcome and radiographic examination： healed group, healing group and non-healing group. The treatment outcomes were compared between the iRoot SP extrusion group and the non-iRoot SP extrusion group. The Fishers exact test and Logistic regression were used to analyze factors affecting the results of root canal treatment. ResultsThe average follow-up time was 370 days, the proportion of healed and healing teeth was 95.5%. The proportion of healed teeth in the non-iRoot extrusion group and iRoot extrusion group was 86.4% and 75.6%, respectively; there was no statistical difference between the two groups(P＞0.05). Logistic regression showed that age, tooth type, pre-treatment PAI index, and iRoot SP extrusion had no impact on the results of root canal treatment. The success rate in the teeth with a pre-treatment periapical lesions ＞5 mm in diameter was significantly lower(P＜0.001). ConclusionIts suggested that iRoot SP extrusion has no statistical impact on the short-term results of root canal treatment. Since extrusion of root canal sealing material often results from over-preparation, extruded bioceramic materials can cause cell necrosis and inflammatory reactions, the occurrence of iRoot SP extrusion should be avoided as much as possible during clinical operations. Once it happens, a relatively optimistic attitude could be adopted for further observation.