The Effects Of Minocycline Hydrochloride Dressing For Chronic Apical Periodontitis With Fistula

BackgroundThe chronic apical periodontitis with fistula is often difficult to cure.In clinic,we often meet some cases,though after many times of the root canal cleaning,rinsing and dressing process,the disease were still unable to control.We have to choose an apical surgery or even the tooth extraction.Generally speaking,there are two causes that may lead to the above problems.First,the circuitous fistula obstructs cleaning microbial infection.Secondly,the type and number of causative bacteria is complex.So it is difficult to eliminate them.Chronic apical periodontitis combined with fistula is often a mixed infection with anaerobic bacteria dominant.We found that minocycline hydrochloride has a strong antibacterial effect against gram-negative anaerobic bacteria.Therefore,we conducted the present clinical study using minocycline hydrochloride ointment in root canal therapy combined with the fistula rinse,expecting that we could lay a solid foundation in the application of minocycline hydrochloride ointment in the treatment of chronic apical periodontitis with fistula.ObjectiveThe aim of this study is to confirm the effectiveness of minocycline hydrochloride ointment in the root canal treatment of chronic apical periodontitis with fistula.By comparing with the routine formula:Calcium hydroxide and Vitapex,we expect to provide a novel idea in dealing with chronic apical periodontitis with fistula.MethodsPatients who meet the standard and visit the department of endodontics of Stomatological Hospital of Shandong University from September 2015 to December 2016 were chosen into the experiment.A total of 90 cases were included.They were randomly divided into the experimental group and the control group.After being told the disease,pathogenic condition,treatment process and the possible outcomes,the patients signed the Information Consent Form on their own accord.First,patients took preoperative X-ray and received the common root canal therapy,and then,had their fistula rinsed.After that patients had different intracanal medication and made another appointment with the doctor.We evaluated the effect of the treatment according to the review times,the situation of fistula and X-ray.Result1.Three cases are lost in the total of 90 patients.One is in the calcium hydroxide group and the two others are in the group of Vitapex.2.There is no case which need to accept apical surgery or need to take tooth extraction due to the chronic apical periodontitis combined with fistula.3.Among the experimental groups:the group of minocycline hydrochloride ointment has fifteen excellent result,ten good result and five bad result.The group of Vitapex has thirteen excellent result,nine good result,six bad result and in this group there are two cases lost.The group of Calcium hydroxide has eight excellent result,fourteen good result,seven bad result and in this group there is one case lost.4、the number of times of subsequent visit:The group of minocycline hydrochloride ointment is about 2.37 times on average.The group of Vitapex is about 2.60 times on average.The group of Calcium hydroxide is about 2.83 times on average.From therapeutic results,the group of minocycline hydrochloride ointment for chronic apical periodontitis combined with fistula reaches statistical significance in the excellent and good results(p<0.05),compared with the group of Calcium hydroxide.It also has a statistical significance in the excellentresults(p<0.05),compared with the group of Vitapex.However,there is no statistical significance between the minocycline hydrochloride ointment and Vitapex group in the good result;The curative effect of the group of minocycline hydrochloride ointment for chronic apical periodontitis combined with fistula has statistical significance in the badresult(p<0.05)compared with the group of Calcium hydroxide;However,there is no statistical significance in the bad result(p>0.05)between the minocycline hydrochloride ointment and Vitapex group.Conclusion1、The group of minocycline hydrochloride ointment for chronic apical periodontitis combined with fistula reaches statistical significance in the excellent,good and bad results(p<0.05),compared with the group of Calcium hydroxide,meaning that minocycline hydrochloride ointment has a better curative effect in the treatment of chronic apical periodontitis with fistula than Calcium hydroxide.2.The group of minocycline hydrochloride ointment for chronic apical periodontitis combined with fistula reaches statistical significance in the excellentresult(p<0.05),compared with the group of Vitapex,but showed no statistical significance in the good and bad results(p>0.05),compared with the Vitapex group.3.From the number of times of subsequent visit,minocycline hydrochloride ointment is most advisable for the patient.