摘要目的:观察奥硝唑联合米诺环素封闭治疗对慢性牙髓炎患者牙周指标及龈沟液炎症因子水平的影响。方法:收集2021年5月至2023年5月在泰安市口腔医院就诊的慢性牙髓炎患者82例（90颗牙）为研究对象，采用随机对照研究方法，利用随机数字表法分为联合治疗组（41例，45颗牙，采用奥硝唑+米诺环素封闭治疗）、对照组（41例，45颗牙，采用米诺环素封闭治疗），观察两组临床疗效，比较两组治疗前、治疗后牙周指标［龈沟出血指数（SBI）、探诊深度（PD）］、龈沟液炎症因子［肿瘤坏死因子α（TNF-α）、C反应蛋白（CRP）］水平变化、咀嚼功能［咬合力、咀嚼效率］，记录患者牙齿疼痛、咬合不适等并发症发生情况。结果:联合治疗组总有效率为95.56%（43/45），显著高于对照组的80.00%（36/45）（χ 2=5.08， P=0.024）。治疗后，联合治疗组PD、SBI均显著低于对照组［（1.89±0.22）mm比（3.09±0.42）mm、（0.81±0.09）分比（1.36±0.17）分， t=16.98、19.17，均 P < 0.001］；联合治疗组龈沟液TNF-α、CRP水平均显著低于对照组［（1.24±0.21）μg/L比（2.10±0.31）μg/L、（4.14±0.51）mg/L比（6.05±0.71）mg/L， t=15.41、14.66，均 P < 0.001］；联合治疗组咬合力、咀嚼效率均显著高于对照组［（132.85±13.79）Ibs比（117.14±12.64）Ibs、（90.16±9.34）%比（81.05±8.75）%， t=5.59、4.78，均 P < 0.001］。联合治疗组咬合不适、牙齿疼痛等并发症总发生率为4.44%（2/45），显著低于对照组的17.78%（8/45）（χ 2=4.05， P=0.044）。 结论:奥硝唑联合米诺环素封闭治疗慢性牙髓炎可显著改善患者牙周情况，减轻炎症反应，提高患者咀嚼功能，降低根管治疗后并发症发生率，整体疗效显著。

abstractsObjective:To investigate the effects of blockade therapy using ornidazole combined with minocycline on periodontal indicators and inflammatory factor levels in gingival crevicular fluid of patients with chronic pulpitis.Methods:A total of 82 patients with chronic pulpitis who received treatment at the Taian Stomatological Hospital from May 2021 to May 2023 were included in this study. The patients were randomly assigned to receive blockade therapy with either ornidazole combined with minocycline ( n = 41 patients, 45 teeth, combined treatment group) or minocycline alone ( n = 41 patients, 45 teeth, control group). Clinical efficacy was compared between the two groups. Additionally, changes in periodontal indexes (sulcus bleeding index and probing depth), levels of inflammatory factors in gingival crevicular fluid (tumor necrosis factor-α and C-reactive protein), and chewing function (bite force and chewing efficiency) were compared between the two groups before and after treatment. Complications, such as tooth pain and occlusal discomfort, were recorded. Results:The total effective rate in the combined treatment group was significantly higher than that in the control group [95.56% (43/45) vs. 80% (36/45), χ2 = 5.08, P = 0.024]. After treatment, the probing depth and sulcus bleeding index in the combined treatment group were significantly lower than those in the control group [(1.89 ± 0.22) mm vs. (3.09 ± 0.42) mm, (0.81 ± 0.09) points vs. (1.36 ± 0.17) points, t = 16.98, 19.17, both P < 0.001]. The levels of tumor necrosis factor-α and C-reactive protein in the combined treatment group were significantly lower than those in the control group [(1.24 ± 0.21) μg/L vs. (2.10 ± 0.31) μg/L, (4.14 ± 0.51) mg/L vs. (6.05 ± 0.71) mg/L, t = 15.41, 14.66, both P < 0.001]. Additionally, the bite force and chewing efficiency in the combined treatment group were significantly higher than those in the control group [(132.85 ± 13.79) lbs vs. (117.14 ± 12.64) lbs, (90.16 ± 9.34)% vs. (81.05 ± 8.75)%, t = 5.59, 4.78, both P < 0.001]. The total incidence rate of complications, such as occlusal discomfort and tooth pain, in the combined treatment group was significantly lower than that in the control group [4.44% (2/45) vs. 17.78% (8/45), χ2 = 4.05, P = 0.044]. Conclusion:Ornidazole combined with minocycline for the treatment of chronic pulpitis can significantly improve periodontal conditions, reduce inflammatory responses, enhance masticatory function, and decrease the incidence of complications following root canal treatment. This combined therapy demonstrates a marked curative effect.