生物陶瓷充填材料和AH-plus糊剂对成人慢性根尖周炎根管治疗疗效及血清骨保护素RANKL的影响

doi:10.3969/j.issn.1006-6233.2025.01.016

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摘要 目的: 探究生物陶瓷充填材料(iRoot SP)和AH-plus糊剂对成人慢性根尖周炎(CAP)根管治疗疗效及血清骨保护素(OPG)、核因子-κB受体活化因子配体(RANKL)的影响。方法: 选取2021年1月至2023年12月期间在本院行根管治疗的135例成人CAP患者作为研究对象,采用电脑随机数字摇号法将其分为iRoot SP组(iRoot SP 行单尖充填,n=68)和AH-plus组(AH-plus热压胶充填,n=67)。比较iRoot SP组和AH-plus组治疗即刻填充情况,治疗7d(T1)疼痛分级,T1、3个月(T2)、6个月(T3)疗效,治疗前(T0)、T1、T2、T3旧根尖周指数(old-periapical index,O-PAI)、血清OPG、RANKL及RANKL/OPG。结果: iRoot SP组适充率为98.53%,高于AH-plus组的89.55%,差异有统计学意义(P<0.05);iRoot SP组疼痛率下降幅度大于AH-plus组疼痛率下降幅度,差异有统计学意义(P<0.05);iRoot SP组T1、T2、T3时间点有效率分别为98.53%、95.59%、91.18%,均高于AH-plus组的89.55%、85.07%、79.10%,差异均有统计学意义(P<0.05);O-PAI、OPG、RANKL、RANKL/OPG组间效应、时间效应、交互效应均有差异统计学意义(P<0.05),且iRoot SP组O-PAI下降幅度、血清OPG上升幅度、RANKL与RANKL/OPG下降幅度均大于AH-plus组,差异均有统计学意义(P<0.05)。结论: 相较于AH-plus糊剂作为填充物行根管治疗,iRoot SP作为填充物行根管治疗成人CAP效果更佳,可显著下调患者疼痛分级、RANKL表达及RANKL/OPG值,提高适充率和血清OPG表达,优化牙周病损。

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关键词 ：生物陶瓷充填材料, AH-plus糊剂, 慢性根尖周炎, 骨保护素, 核因子-κB受体活化因子配体

Abstract：Objective: To investigate the influence of root repair material SP (iRoot SP) and AH-plus paste on the efficacy of root canal therapy and serum osteoprotegerin (OPG) and receptor activator of nuclear factor-κB ligand (RANKL) levels in adult patients with chronic apical periodontitis (CAP). Methods: A total of 135adult CAP patients who received root canal therapy in our hospital from January 2021 to December 2023 were selected as the study objects. They were randomly divided into the iRoot SP group (root SP root canal occluders as fillers for root canal therapy, n=68) and AH-plus group (AH-plus paste as a filling material for root canal therapy, n=67) by computer random number method. The filling status immediately after the treatment, pain grading at 7 days of treatment (T1), efficacy at T1, 3 months of treatment (T2) and 6 months of treatment (T3), old-periapical index (O-PAI), and serum OPG, RANKL and RANKL/OPG before treatment (T0) and at T1, T2 and T3 were compared between the iRoot SP group and the AH-plus group. Results: Compared with the AH-plus group, the appropriate filling rate in the iRoot SP group was significantly higher (98.53% vs.89.55%) (P<0.05). The decrease in the pain rate was significantly greater in the iRoot SP group than that of theAH-plus group (P<0.05). The effective rate at T1 (98.53% vs. 89.55%), T2 (95.59% vs. 85.07%) and T3 (91.18% vs. 79.10%) in the iRoot SP group was significantly higher in the iRoot SP group than the AH-plus group (P<0.05). There were significant differences in O-PAI, OPG, RANKL and RANKL/OPG from the aspects of intragroup effect, time-point effect and interaction effect (P<0.05), and the decreases in the O-PAI, RANKL and RANKL/OPG, and the increase in serum OPG were significantly greater in the iRoot SP group than those of the AH-plus group (P<0.05). Conclusion: Compared with AH-plus paste, iRoot SP as a filling material for root canal therapy of adult CAP is more effective, and the latter one can more significantly relieve the pain grading, serum RANKL expression and RANKL/OPG value, enhance the appropriate filling rate and serum OPG, and optimize the periodontal lesions.

Key words： Root repair material SP AH-plus paste Chronic apical periodontitis Osteoprotegerin Receptor activator of nuclear factor-κB ligand

基金资助:安徽省自然科学基础研究计划项目,(编号,2020JM-394)

引用本文:

陈珍珍, 刘刚, 朱坤鹍. 生物陶瓷充填材料和AH-plus糊剂对成人慢性根尖周炎根管治疗疗效及血清骨保护素RANKL的影响[J]. 河北医学, 2025, 31(1): 91-96.
CHEN Zhenzhen, LIU Gang, ZHU Kunkun. Influence of Root Repair Material SP and AH-plus Paste on the Efficacy of Root Canal therapy and Serum Osteoprotegerin and RANKL Levels in Adult Patients with Chronic Apical Periodontitis. HeBei Med, 2025, 31(1): 91-96.

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http://www.hbyxzzs.cn/CN/10.3969/j.issn.1006-6233.2025.01.016 或 http://www.hbyxzzs.cn/CN/Y2025/V31/I1/91

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