Agamy Hadeer A, Bakry Niveen S, Mounir Maha M F, Avery David R
Department of Pediatric Dentistry and Public Health, Faculty of Dentistry, Alexandria University, Alexandria, Egypt.
Pediatr Dent. 2004 Jul-Aug;26(4):302-9.
The aim of this study was to use clinical, radiographic, and histologic examinations to compare the relative success of gray mineral trioxide aggregate (MTA), white MTA, and formocresol as pulp dressings in pulpotomized primary teeth.
Twenty-four children, each with at least 3 primary molars requiring pulpotomy, were selected for this study's clinical and radiographic portion. An additional 15 carious primary teeth planned for serial extraction were selected for this study's histologic portion. All selected teeth were evenly divided into 3 test groups and treated with pulpotomies. Gray MTA was used as the pulp dressing for one third of the teeth, white MTA was the dressing for one third, and the remaining one third were treated with formocresol. The treated teeth selected for the clinical and radiographic evaluations were monitored periodically for 12 months. The treated teeth selected for histologic study were monitored periodically and extracted 6 months postoperatively.
Four children with 12 pulpotomized teeth failed to return for any follow-up evaluations in the clinical and radiographic study. Of the remaining 60 teeth in 20 patients, 1 tooth (gray MTA) exfoliated normally and 6 teeth (4 white MTA and 2 formocresol) failed due to abscesses. The remaining 53 teeth appeared to be clinically and radiographically successful 12 months postoperatively. Pulp canal obliteration was a radiographic finding in 11 teeth treated with gray MTA and 1 tooth treated with white MTA. In the histologic study, both types of MTA successfully induced thick dentin bridge formation at the amputation sites, while formocresol induced thin, poorly calcified dentin. Teeth treated with gray MTA demonstrated pulp architecture nearest to normal pulp by preserving the odontoblastic layer and delicate fibrocellular matrix, yet few inflammatory cells or isolated calcified bodies were seen. Teeth treated with white MTA showed a denser fibrotic pattern, with more isolated calcifications in the pulp tissue along with secondary dentin formation.
Gray MTA appears to be superior to white MTA and formocresol as a pulp dressing for pulpotomized primary teeth.
本研究旨在通过临床、影像学和组织学检查，比较灰色矿物三氧化物凝聚体（MTA）、白色MTA和甲酚甲醛作为乳牙牙髓切断术中牙髓敷料的相对成功率。
本研究的临床和影像学部分选取了24名儿童，每名儿童至少有3颗需要进行牙髓切断术的乳磨牙。本研究的组织学部分选取了另外15颗计划进行序列拔除的龋坏乳牙。所有选取的牙齿均被均匀分为3个试验组，并进行牙髓切断术治疗。三分之一的牙齿使用灰色MTA作为牙髓敷料，三分之一使用白色MTA，其余三分之一使用甲酚甲醛治疗。选取用于临床和影像学评估的治疗牙齿进行为期12个月的定期监测。选取用于组织学研究的治疗牙齿进行定期监测，并在术后6个月拔除。
在临床和影像学研究中，4名患有12颗接受牙髓切断术牙齿的儿童未能返回进行任何随访评估。在20名患者剩余的60颗牙齿中，1颗牙齿（灰色MTA）正常脱落，6颗牙齿（4颗白色MTA和2颗甲酚甲醛）因脓肿而失败。其余53颗牙齿在术后12个月的临床和影像学检查中似乎成功。牙髓管闭塞是11颗接受灰色MTA治疗的牙齿和1颗接受白色MTA治疗的牙齿的影像学表现。在组织学研究中，两种类型的MTA均成功地在切断部位诱导形成了厚厚的牙本质桥，而甲酚甲醛诱导形成的牙本质薄且钙化不良。用灰色MTA治疗的牙齿通过保留成牙本质细胞层和精细的纤维细胞基质，显示出最接近正常牙髓的牙髓结构，但几乎未见炎症细胞或孤立的钙化体。用白色MTA治疗的牙齿显示出更致密的纤维化模式，牙髓组织中有更多孤立的钙化以及继发性牙本质形成。
作为乳牙牙髓切断术的牙髓敷料，灰色MTA似乎优于白色MTA和甲酚甲醛。
