【摘要】 目的：比较根测仪下三个不同测量位点与解剖性根尖孔的关系，观察分析在慢性根尖周炎单根管患牙治疗中三组的根充效果。方法：实验一：收集内蒙古自治区人民医院口腔科2017年7月至2018年5月正畸需拔除前磨牙患者20例，至少52个根管作为研究对象。根据不同根尖止点将患牙分为3组。A组：根测仪显示“0”；B组:根测仪显示“0.5”;C组:根测仪显示“0”-0.5mm。测量三组工作长度及根管实际长度D，计算三组与实际长度差值L。对所得的数据结果进行统计分析。实验二：收集2018年1月至2019年1月于我科就诊的单根管根尖炎患者，筛选符合纳排标准的150例患牙作为研究对象。根据根测仪显示“0”、“0.5”“0”-0.5mm三个不同根尖止点分组，进行根管治疗。拍摄根尖片比较各组患牙工作长度与解剖性根尖孔的关系，并观察根充效果。结果： 1、根尖止点为“0”的一组工作长度与实际长度接近； 2、根管治疗后1周“0”-0.5㎜组的患牙疼痛发生率为4.00%，低于“0.5”组的16.00%及“0”组的10.00% ，但差异均无显著性（P＞0.05）；3、根充后1个月“0”-0.5㎜组的临床总有效率为92.00%，高于“0.5”组的68.00%及“0”组的74.00%，差异均有显著性（P＜0.025）。根充后3个月“0”-0.5㎜组的临床总有效率为98.00%，高于“0.5”组的70.00%及“0”组的82.00%，差异均有显著性（P＜0.01）。结论：1、根尖止点选择在根测仪显示“0”位点是稳定性最好且接近根管全长的位点；2、在单根管根尖炎患牙中，三种位点治疗效果中“0”-0.5mm位点组的临床总有效率最高，为临床根管治疗提供一定的指导。

Abstract: Objective To compare the relationship between the three different measuring sites under the elecronic apex locator and anatomical apical foramen, and to evaluate the clinical efficacy of the three groups in the treatment of chronic apical periodontitis with single canal. Methods Experiment 1. From July 2017 to May 2018, 20 patients with premolar extraction during orthodontic treatment were collected, and at least 52 root canals were selected as the research objects.The teeth were divided into three groups according to different measuring sites under the elecronic apex locator.Group A:The elecronic apex locator displays "0"; Group B:The elecronic apex locator displays "0.5"; Group C:The elecronic apex locator displays "0"-0.5mm. Measure the working length of the three groups and the actual length D of the root canal, and calculate the difference L between the three groups and the actual length.Statistical analysis was carried out on the data obtained. Experiment 2. From January 2018 to January 2019,the patients with chronic apical periodontitis,150 teeth of single canal in total,that met the inclusion and exclusion criteria,were selected as the research objects.According to three different measuring sites of "0", "0.5" and "0"-0.5mm displayed by the elecronic apex locator, root canal therapy was carried out.The relationship between working length of the teeth and anatomical apical foramen in each group was compared by taking periapical radiography, and the effective rate of the three groups was observed in three months. Results 1、The working length of group A with apical stop of "0" is close to the actual length.2. The incidence of pain after root canal therapy within one week in the "0" -0.5mm group was 4%, lower than 16.00% in the "0.5" group and 10.00% in the "0" group, but the difference was not significant（P＞0.05)；3. One month after root canal obturation,the total effective rate of "0"-0.5mm group was 92.00%, which was higher than that of "0.5" group 68.00% and "0" group 74.00%,with significant difference respectively(p < 0.025).The total effective rate of "0" -0.5mm group was 98.00%, three months after root canal obturation, which was higher than 70.00% of "0.5" group and 82.00% of "0" group, with significant difference respectively(p < 0.01).Conclusions 1. Selection of apical stop "0" on the elecronic apex locator is the site with the best stability and close to the full length of root canal. 2. Compared with the "0.5" group and the "0" group ,the "0"-0.5 mm group has a higher clinical effective rate after three months of root canal obturation, which provides some clinical guidance for the root canal therapy.

内蒙古自治区人民医院院内基金201704