关键词: 牙周牙髓联合病变, 五倍子, 穿心莲内酯, 超声荡洗, 牙周内窥镜

Abstract: Objective: To study the clinical effect of Chinese medicine gallnut and andrographolide extract combined with ultrasonic irrigation and periodontal endoscope in the treatment of periodontal-endodontic combined lesions, and to provide a theoretical basis for the effective treatment of periodontal-endodontic combined lesions. Methods: A total of 108 patients with periodontal-endodontic combined lesions were divided into control group, hydrogen peroxide (H₂O₂) group and experimental group, there were 36 cases in each group. Root canal preparation was carried out in all 3 groups, and distilled water, 3%hydrogen peroxide, gallnut and andrographolide extract were used for root canal irrigation. After preparation, ultrasonic irrigation and different washing agents were used for alternating chemical washing.The medicine was sealed. After the inflammation was eliminated, the root canal was closed. And the X-ray examination results showed that the root canal was filled exactly. After supragingival scaling of the affected tooth, subgingival scaling was performed assisted with periodontal endoscope, the periodontal pockets of the patients in three groups were washed respectively with different washing agents. All patients in various groups were treated for 3 months. The periodontal indexes including modified sulcus bleeding index (mSBI), modified plaque index (mPLI),probing depth(PD)and attachment loss(AL) of the patients in various groups were observed before and after treatment; and the levels of interleukin-1β(IL-1β)in the gingival crevicular fluid(GCF)of the patients in various groups were detected after one course of treatment. Results: There were no significant differences in the periodontal indexes and the levels of IL-1β in GCF of the patients before treatment between various groups(P>0.05).Compared with control group, the PD and AL, the level of IL-1β in GCF of the patients in H₂O₂ group after treatment were reduced(P<0.05);the mSBI, mPLI, PD and AL, the level of IL-1β in GCF of the patients in experimental group were significantly reduced(P<0.05).Compared with H₂O₂ group, the mSBI, mPLI, PD and AL, the level of IL-1β in GCF of the patients in experimental group after treatment were obviously reduced(P<0.05). Conclusion: Gallnut and andrographolide exact combined with ultrasonic irrigation and periodontal endoscope has a better therapeutic effect on the periodontal-endodontic combined lesions, which could improve the periodontal indexes and reduce the level of IL-1β in GCF of the patients.

Key words: periodontal-endodontic combined lesions, gallnut, andrographolide, ultrasonic irrigation, periodontal endoscope