【摘要】 目的 评价使用双波长激光辅助一次性根管治疗磨牙慢性根尖周炎的临床疗效。方法 将240例磨牙慢性根尖周炎患者随机均分为双波长激光辅助治疗组和超声辅助治疗组，双波长激光辅助治疗组行双波长激光辅助一次性根管治疗、超声辅助治疗组行超声辅助一次性根管治疗；对比两组治疗前及根管荡洗消毒完成即刻的根管内细菌数量，于治疗前及术后1周时采用视觉模拟评分法(VAS)对两组患者术后疼痛反应进行评价；采用根尖周指数(PAI)评价患牙根尖周组织结构，判定其临床疗效；于治疗前及术后1周时采用酶联免疫吸附试验法(ELISA)检测患者白细胞介素-8(IL-8)、白细胞介素-17(IL-17)、肿瘤坏死因子α(TNF-α)及C反应蛋白(CRP)水平；于治疗前及术后半年随访时拍摄根尖X线片，采用平均灰度值(MGV)检测患者骨密度情况。结果 两组在进行根管预备，荡洗消毒后，细菌计数均显著降低(P<0.01),双波长激光治疗组细菌计数低于超声辅助治疗组(P<0.05);双波长激光治疗组术后1周时疼痛程度及疼痛发生率低于超声辅助治疗组(P<0.05);半年随访复查评估，双波长激光治疗组治疗有效率高于超声辅助治疗组(P<0.05);治疗后双波长激光治疗组IL-8、IL-17、CRP、TNF-α炎症因子水平显著低于超声辅助治疗组治疗组、MGV值显著高于超声辅助治疗组(P<0.001)。结论 双波长激光辅助一次性根管治疗磨牙慢性根尖周炎较超声辅助一次性根管治疗的术后疼痛反应更小，成功率更高，临床疗效更好。更多还原

【Abstract】 Objective To assess the clinical outcomes of dual-wavelength laser-assisted versus ultrasonic-assisted single-visit root canal treatments in molars with chronic apical periodontitis（CAP）. Methods Two hundred and forty molars diagnosed with CAP were equally randomized into either a dual-wavelength laser-assisted or ultrasonic-assisted treatment group. The study compared bacterial counts in the root canal immediately after disinfection, post-treatment pain using the Visual Analogue Scale（VAS） at one week, and clinical efficacy through the Periapical Index（PAI）. Levels of interleukin-8（IL-8）, interleukin-17（IL-17）, tumor necrosis factor alpha（TNF-α）, and C-reactive protein（CRP） were measured using enzyme-linked immunosorbent assay（ELISA） before and one week post-treatment. Bone density was evaluated via periapical X-rays and mean gray value（MGV） analysis both before treatment and at a six-month follow-up. Results Both groups exhibited significant reductions in bacterial counts post-disinfection（P<0.01）, with the dual-wavelength laser group showing significantly lower levels than the ultrasonic group（P<0.05）. The laser group reported lower pain levels and incidence one week post-treatment（P<0.05）. At the six^th month, the laser-assisted group demonstrated a higher rate of treatment success（P<0.05）. Post-treatment inflammatory markers IL-8, IL-17, CRP, and TNF-α were lower, and the MGV indicating bone density was higher in the laser group compared to the ultrasonic group（P<0.05）. Conclusion Dual-wavelength laser-assisted root canal treatment reduces post-treatment pain, has a higher success rate for molars with CAP, and offers superior clinical efficacy to compare to ultrasonic-assisted treatments.更多还原