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盐酸米诺环素软膏联合Vitapex糊剂治疗中老年牙周牙髓联合病变疗效显著。

Minocycline hydrochloride ointment combined with Vitapex paste is effective for middle-aged and elderly patients with combined periodontal-endodontic lesions.

作者信息

Zeng Zhimei, Zeng Zijun, Wu Guangyu

机构信息

Department of Stomatology, The First Affiliated Hospital of Gannan Medical University Ganzhou 341000, Jiangxi, China.

Anesthesia Surgery Center, The First Affiliated Hospital of Gannan Medical University Ganzhou 341000, Jiangxi, China.

出版信息

Am J Transl Res. 2024 Jan 15;16(1):314-322. doi: 10.62347/NLWG5751. eCollection 2024.

Abstract

OBJECTIVE

This study was designed to determine the efficacy of minocycline hydrochloride ointment (MHO) combined with Vitapex paste on middle-aged and elderly patients with combined periodontal-endodontic lesions (CPELs) and its effect on the inflammatory factors.

METHODS

The data of 88 elderly patients with CPELs treated in the First Affiliated Hospital of Gannan Medical University from March 2020 to March 2022 were analyzed retrospectively. Among them, the patients treated with MHO and iodoform zinc oxide clove oil paste were assigned into the control group (n = 42) and the rest of the patients treated by MHO and Vitapex paste were assigned to the study group (n = 46). The inflammatory factors, periodontal indexes and efficacy were determined and compared between the two groups. The MOS 36-Item Short-Form Health Survey (SF-36) was adopted to evaluate the quality of life (QoL) of patients before and after treatment. Additionally, the adverse reactions of the two groups during treatment were analyzed and compared. The prognosis of the two groups of patients was analysed, and factors impacting their prognosis was analysed through the Logistic regression analysis.

RESULTS

Before treatment, the levels of interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α) and interleukin-1β (IL-1β) were not significantly different between the two groups (all P > 0.05), while after treatment, these levels in both groups decreased significantly, with notably lower levels in the study group than those in the control group (all P < 0.05). Before treatment, the gingival index (GI), plaque index (PLI), probing depth (PD) and bleeding index (BD) of the two groups were similar (all P > 0.05); however, after treatment, the levels of GI, PD, PLI and BI of both groups decreased significantly (all P < 0.05), with more notable decreases in the study group than those in the control group (all P < 0.05). The study group showed a significantly higher overall response rate than the control group (P < 0.05). Before treatment, the SF-36 scores of the two groups were not significantly different (P > 0.05), while after treatment, both groups had significantly increased SF-36 scores, and the score in study group was significantly higher than the control group (P < 0.05). In addition, the incidence of adverse reactions was not notably different between the two groups (P > 0.05). According to univariate analysis, age, dental lesion grade, course of disease, and persistent dull pain were the risk factors affecting the prognosis of patients. According to multivariate analysis, dental lesion grade was the independent risk factor affecting the prognosis.

CONCLUSION

MHO combined with Vitapex paste is effective for middle-aged and elderly patients with CPELs, which can effectively inhibit the patients' inflammatory reaction and improve their periodontal condition and QoL, with a low adverse reaction rate, so it is worthy of clinical promotion.

摘要

目的

本研究旨在探讨盐酸米诺环素软膏(MHO)联合Vitapex糊剂治疗中老年牙周牙髓联合病变(CPELs)的疗效及其对炎症因子的影响。

方法

回顾性分析2020年3月至2022年3月在赣南医学院第一附属医院治疗的88例老年CPELs患者的资料。其中,采用MHO和碘仿氧化锌丁香油糊剂治疗的患者被分配到对照组(n = 42),其余采用MHO和Vitapex糊剂治疗的患者被分配到研究组(n = 46)。测定并比较两组患者的炎症因子、牙周指标及疗效。采用MOS 36项简短健康调查(SF - 36)评估患者治疗前后的生活质量(QoL)。此外,分析并比较两组治疗期间的不良反应。分析两组患者的预后情况,并通过Logistic回归分析影响其预后的因素。

结果

治疗前,两组患者白细胞介素 - 6(IL - 6)、肿瘤坏死因子 - α(TNF - α)和白细胞介素 - 1β(IL - 1β)水平差异无统计学意义(均P > 0.05);治疗后,两组这些水平均显著降低,且研究组低于对照组(均P < 0.05)。治疗前,两组患者的牙龈指数(GI)、菌斑指数(PLI)、探诊深度(PD)和出血指数(BD)相似(均P > 0.05);治疗后,两组GI、PD、PLI和BI水平均显著降低(均P < 0.05),且研究组降低更显著(均P < 0.05)。研究组的总有效率显著高于对照组(P < 0.05)。治疗前,两组SF - 36评分差异无统计学意义(P > 0.05);治疗后,两组SF - 36评分均显著升高,且研究组评分高于对照组(P < 0.05)。此外,两组不良反应发生率差异无统计学意义(P > 0.05)。单因素分析显示,年龄、牙病变分级、病程和持续性钝痛是影响患者预后的危险因素。多因素分析显示,牙病变分级是影响预后的独立危险因素。

结论

MHO联合Vitapex糊剂治疗中老年CPELs患者疗效显著,能有效抑制患者炎症反应,改善牙周状况和QoL,不良反应发生率低,值得临床推广。

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