局部麻醉法和失活法在磨牙牙髓摘除术中的临床应用体会

发布时间：2018-08-23 15:54

【摘要】：目的:观察局部麻醉法和失活法在成人磨牙牙髓摘除术中的疗效。方法:选择280例成人磨牙慢性牙髓炎患者,按患牙部位随机分为麻醉组和失活组,各组上下颌磨牙各70例。麻醉组上颌磨牙采用含1:100 000肾上腺素的2%利多卡因2ml,行上牙槽后神经阻滞麻醉,下颌磨牙行下牙槽神经阻滞麻醉,麻醉显效后行开髓引流、牙髓摘除术。失活组取尽腐质露髓者,直接封多聚甲醛失活剂,12~14d天复诊,未露髓者封三氧化二砷失活剂,行间接失活法,4d复诊,封药之前适当制备洞形,形成较好的固位形,复诊时常规开髓,摘除牙髓,两组患者在牙髓摘除术后行传统的根管治疗,观察每位患者在牙髓摘除术中的镇痛效果、开髓及牙髓摘除的时间、根管治疗期间疼痛反应及根管治疗术后1年进行临床疗效评价。结果:镇痛效果:麻醉组成功率70%,失活组成功率93%,两组差异有统计学意义(P0.05);开髓及牙髓摘除的平均时间:麻醉组平均(14±3.0)min,失活组平均(10±2.3)min,两组差异有统计学意义(P0.05);根管治疗期间麻醉组出现疼痛反应的发生率为15.71%,显著高于失活组的8.57%(P0.05);临床疗效评价:失活组成功率95%,麻醉组成功率90%,两组比较差异无统计学意义(P0.05)。结论:失活法在磨牙慢性牙髓炎牙髓摘除术中基本无疼痛、髓腔内无渗血、牙髓摘除效率高,根管治疗期间疼痛反应轻微,整体效果优于局部麻醉法。
[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 卤3.0) min in anesthetic group and (10 卤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.
【作者单位】：清水县人民医院口腔科;清水县人民医院检验科;
【分类号】：R781.31

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