不同根管治疗对老年患者慢性根尖周炎的 影响因素的探讨

Influencing Factors of Different Root Canal Treatments on Chronic Periapical Periodontitis in Elderly Patients

摘要: 临床治疗根尖周炎的方法常采用根管治疗术，也分为单次或多次根管治疗法，但两者间疗效存在较大争议。尽管目前以多次根管治疗方式居多，但由于单次根管治疗对于老年患者而言，具有较短的治疗周期和较高的患者依从性的特点，或许能够提高根管治疗的质量和舒适度。基于此目的，本综述通过评估单次根管治疗在慢性根尖周炎中的临床效果，分析单次根管治疗的治疗过程、成功率、复发率以及术后疼痛等关键指标，探讨影响治疗效果的多种因素。研究表明，单次根管治疗复杂病例或感染较重的慢性根尖周炎，其疗效与多次治疗并无明显差异，且降低了经济和出行负担。此外，根管系统的解剖结构、感染的严重程度、治疗过程中的消毒及最后的充填材料等因素也对最终的治疗疗效产生重要影响。综合来看，临床医师可根据病情程度、患者需求及治疗技术的情况，提高单次根管治疗的应用率。未来的研究应进一步探讨新的治疗材料、技术以及治疗方案的优化，以提高单次治疗老年患者慢性根尖周炎的治疗效果，优化根管治疗的方式。

Abstract: Root canal therapy is a commonly used clinical method for the treatment of periapical periodontitis, which can be performed as either single-visit or multiple-visit root canal treatment. However, the efficacy of these two approaches remains controversial. Although multiple-visit root canal therapy is currently more prevalent, single-visit treatment may offer advantages for elderly patients, such as a shorter treatment duration and higher patient compliance, potentially improving the quality and comfort of root canal therapy. Based on this perspective, this review evaluates the clinical outcomes of single-visit root canal therapy in chronic periapical periodontitis by analyzing key indicators such as the treatment process, success rate, recurrence rate, and postoperative pain, while exploring various factors influencing therapeutic efficacy. Studies indicate that for complex cases or severe chronic periapical periodontitis, the efficacy of single-visit root canal therapy does not significantly differ from that of multiple-visit treatment, while reducing economic burden and travel frequency. Additionally, factors such as the anatomical structure of the root canal system, severity of infection, disinfection during treatment, and the type of filling material used significantly impact the final therapeutic outcome. In summary, clinicians can increase the application rate of single-visit root canal therapy based on disease severity, patient needs, and available treatment techniques. Future research should further investigate new materials, technologies, and optimized treatment protocols to enhance the efficacy of single-visit root canal therapy in elderly patients with chronic periapical periodontitis and refine root canal treatment approaches.