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目的通过对根管治疗期间疼痛急性发作的病因进行分析,为缩短疗程和减少失败病例提供参考。方法对2003年4月-2007年6月间来院就诊的530例患者进行追踪随访,对其中546颗行根管治疗的牙齿术间发生EIP进行统计,结合治疗前牙位、牙髓状况以及根尖周骨质破坏等情况,分析发生EIP的原因。结果546颗行根管治疗的牙齿术间发生EIP88颗,发生率为16.12%。牙髓坏死组发生率为26.28%(82/312),牙髓炎组为2.56%(6/234)。两组间有显著差异(P<0.01)。牙髓坏死组中有59颗牙X片显示根尖有阴影,35颗根尖周有漏管。从牙位上看,前磨牙和磨牙均高于前牙,两者间有显著差异(P<0.01)。结论根尖周慢性病变的存在是EIP发生的最大因素之一。
Objective To analyze the etiology of acute exacerbation of pain during root canal therapy and provide references for shortening the course of treatment and reducing the number of failed patients. Methods A total of 530 patients who visited the hospital from April 2003 to June 2007 were followed up. EIP statistics of 546 patients undergoing root canal operation were analyzed. Combined with the treatment of anterior teeth, endodontic conditions and root Periapical bone destruction and other circumstances, analysis of the reasons for the occurrence of EIP. Results 546 teeth underwent root canal treatment of EIP 88, the incidence was 16.12%. The incidence of dental pulp necrosis was 26.28% (82/312) and that of pulpitis was 2.56% (6/234). There was a significant difference between the two groups (P <0.01). In the pulp necrosis group 59 teeth X-ray showed apical shadow, 35 periapical leak tube. From the point of view of teeth, premolar and molars were higher than the anterior teeth, there was a significant difference between the two (P <0.01). Conclusion The existence of chronic apical periodontal disease is one of the most important factors of EIP.