Rocha Maria José de Carvalho, Cardoso Mariane
Pediatric Dentistry Department, Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil.
Dent Traumatol. 2004 Dec;20(6):314-26. doi: 10.1111/j.1600-9657.2004.00261.x.
This research sought to evaluate periapical repair in 28 traumatized deciduous teeth that had suffered endodontic intervention due to the presence of internal or external inflammatory resorption or replacement root resorption. After obtaining endodontic access, work length and biomechanical preparation, the root canals were filled with calcium hydroxide and propylene glycol under the form of a dense slurry, during 12 months. Replacement of the intracanal dressing was performed when monthly radiographic examinations showed its absence. After 12 months the teeth were obturated with zinc oxide and eugenol cement. Halting of the inflammatory and replacement root resorption (64.3%; n = 28) occurred 9 months after the use of calcium hydroxide dressings, in a total of 18 successful cases. Fisher's test was applied to relate success with the type of trauma, work length time, child's age and pulpal condition. The test did not present statistical significance (P < 0.05). However, in the qualitative analysis, failure was observed in those cases (35.7%) where replacement resorption was already present at the moment of treatment (up to two-thirds) associated with severe trauma cases. The authors concluded that endodontic treatment must be initiated at an early stage, and must be coincident with the radiographic signs of resorption. Success of the treatment is directly related to the seriousness of the sequelae at the moment of the first examination or the endodontic treatment.
本研究旨在评估28颗因存在内部或外部炎性吸收或替代性牙根吸收而接受牙髓治疗的创伤性乳牙的根尖周修复情况。在获得开髓通路、工作长度并进行生物力学预备后,根管内填充氢氧化钙和丙二醇的浓稠糊剂,持续12个月。当每月的影像学检查显示根管内敷料缺失时,进行更换。12个月后,用氧化锌丁香油粘固剂对牙齿进行充填。在使用氢氧化钙敷料9个月后,共18例成功病例出现炎性和替代性牙根吸收停止(64.3%;n = 28)。应用Fisher检验将成功与创伤类型、工作长度时间、患儿年龄和牙髓状况相关联。该检验无统计学意义(P < 0.05)。然而,在定性分析中,观察到在治疗时已存在替代性吸收的病例(35.7%)(高达三分之二)以及重度创伤病例中治疗失败。作者得出结论,牙髓治疗必须在早期开始,且必须与吸收的影像学征象相符。治疗的成功与首次检查或牙髓治疗时后遗症的严重程度直接相关。