Fuks Anna B
Department of Pediatric Dentistry, Hadassah School of Dental Medicine, Hebrew University, Jerusalem, Israel.
J Endod. 2008 Jul;34(7 Suppl):S18-24. doi: 10.1016/j.joen.2008.02.031.
Vital pulp therapy aims to treat reversible pulpal injury and includes 2 therapeutic approaches: (1) indirect pulp treatment for deep dentinal cavities and (2) direct pulp capping or pulpotomy in cases of pulp exposure. Indirect pulp treatment is recommended as the most appropriate procedure for treating primary teeth with deep caries and reversible pulp inflammation, provided that this diagnosis is based on a good history, a proper clinical and radiographic examination, and that the tooth has been sealed with a leakage-free restoration. Formocresol has been a popular pulpotomy medicament in the primary dentition and is still the most universally taught pulp treatment for primary teeth. Concerns have been raised over the use of formocresol in humans, and several alternatives have been proposed. Controlled clinical studies have been critically reviewed, and mineral trioxide aggregate and ferric sulfate have been considered appropriate alternatives to formocresol for pulpotomies in primary teeth with exposed pulps. In most of the studies reviewed, the caries removal method has not been described. The use of a high-speed handpiece or laser might result in an exposure of a "normal" pulp that would otherwise not be exposed.
活髓治疗旨在治疗可逆性牙髓损伤，包括两种治疗方法：（1）针对深龋洞的间接盖髓术，以及（2）牙髓暴露时的直接盖髓术或牙髓切断术。间接盖髓术被推荐为治疗患有深龋和可逆性牙髓炎的乳牙的最合适方法，前提是该诊断基于良好的病史、适当的临床和影像学检查，并且牙齿已用无渗漏修复体密封。甲醛甲酚一直是乳牙牙髓切断术中常用的药物，并且仍然是最普遍教授的乳牙牙髓治疗方法。人们对在人体中使用甲醛甲酚提出了担忧，并提出了几种替代方法。对对照临床研究进行了严格审查，对于暴露牙髓的乳牙牙髓切断术，矿物三氧化物凝聚体和硫酸铁被认为是甲醛甲酚的合适替代品。在大多数综述研究中，未描述龋洞去除方法。使用高速手机或激光可能会导致“正常”牙髓暴露，否则不会暴露。
