Purpose: To evaluate the effect of combination of auxiliary irrigation technology and root canal irrigation solution in the treatment of chronic apical periodontitis with fistula, and try to seek a more effective and minimally invasive therapeutic strategy.
Methods: One hundred and fifty patients with fistulous chronic apical periodontitis who were diagnosed in Hefei Stomatological Hospital from January 2021 to January 2022 were randomly divided into 6 groups, 25 cases in each group. The 6 groups were as follows, group A: 0.5%NaOCl +ultrasonically activated irrigation; Group B: 1.0%NaOCl+ultrasonically activated irrigation; Group C: 2.0%CHX+ultrasonically activated irrigation; Group D: 0.5%NaOCl+sonic activation; Group E: 1.0%NaOCl+sonic activation; Group F: 2.0%CHX+sonic activation. The fistula healing time, treatment effect and postoperative pain were observed in each group. The data were analyzed with SPSS 20.0 software package.
Results: In terms of fistula healing, the 10-day fistula healing rate of group E and group F was higher than that of group A and group D，and the difference was statistically significant(P＜0.05); but there was no significant difference between group E and group F (P＞0.05). The effective rate at 1 month after operation in group A was lower, and the difference was significant (P＜0.05). In terms of postoperative pain, the VAS score of group A was lower than that of group E and group F at all time points, and the difference was statistically significant(P＜0.05).
Conclusions: In the treatment of chronic apical periodontitis with fistula, 1.0% NaOCl or 2.0% CHX combined with ultrasonically activated irrigation or sonic activation obtain a better short-term effect，of which the sonic activation group can also obtain early healing of the fistula, but the incidence of postoperative pain is higher when sonic activation is used.
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