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不完全去除牙本质龋后对深龋病变的监测:14 - 18个月后的结果

The monitoring of deep caries lesions after incomplete dentine caries removal: results after 14-18 months.

作者信息

Oliveira E F, Carminatti G, Fontanella V, Maltz M

机构信息

Department of Dentistry, Faculty of Odontology, Federal University of Pelotas, Pelotas, Rio Grande do Sul, Brazil.

出版信息

Clin Oral Investig. 2006 Jun;10(2):134-9. doi: 10.1007/s00784-006-0033-8. Epub 2006 Mar 21.

DOI:10.1007/s00784-006-0033-8
PMID:16550396
Abstract

This paper aims to assess radiographic changes after incomplete carious dentine removal and tooth sealing. Thirty-two teeth with deep caries lesions were studied. The treatment consisted of incomplete excavation, application of a Ca(OH)2 layer, sealing temporarily for a 6- to 7-month period and then restoration. Standardised bitewing radiographs were taken immediately after the temporary sealing and at 6- to 7- and 14- to 18-month intervals. The digitised images were analysed blind by image subtraction. The quantitative analyses subtractions were performed in the radiolucent zone (RZ) beneath the restoration and in two adjacent control areas (CA). Two cases were lost during the 6- to 7-month period (one pulp necrosis and one pulp exposure during removal of the provisional sealing). No difference (p > 0.05) was observed in the radiographic density of the CA and the RZ in the two experimental periods. The mean and standard deviation (grey tonalities scale) were 129.42+/-5.83 and 127.65+/-4.67 (control areas) and 132.96+/-7.41 and 132.90+/-5.99 (RZ) for the first and second experimental periods, respectively. The radiographic density of the CA differed from the RZ (Tukey test, p < 0.001). Interference in environmental conditions by partial dentine caries removal and tooth sealing arrests lesion progression, suggesting that complete dentine caries removal is not essential to control caries progression.

摘要

本文旨在评估不完全去除龋坏牙本质并进行牙齿封闭后的影像学变化。对32颗患有深龋病变的牙齿进行了研究。治疗包括不完全挖除龋坏组织、应用氢氧化钙层、暂时封闭6至7个月,然后进行修复。在暂时封闭后立即以及在6至7个月和14至18个月的间隔时间拍摄标准化的咬合翼片。通过图像减法对数字化图像进行盲法分析。在修复体下方的透射区(RZ)和两个相邻的对照区域(CA)进行定量分析减法。在6至7个月期间有2例失访(1例在去除临时封闭物时出现牙髓坏死,1例牙髓暴露)。在两个实验阶段,对照区域和透射区的影像学密度未观察到差异(p>0.05)。第一个和第二个实验阶段对照区域的平均灰度值和标准差分别为129.42±5.83和127.65±4.67,透射区分别为132.96±7.41和132.90±5.99。对照区域的影像学密度与透射区不同(Tukey检验,p<0.001)。部分去除牙本质龋并进行牙齿封闭对环境条件的干扰阻止了病变进展,这表明完全去除牙本质龋对于控制龋病进展并非必不可少。

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