Coll James A
Department of Pediatric Dentistry, University of Maryland Dental School, Baltimore, Maryland, USA.
J Endod. 2008 Jul;34(7 Suppl):S34-9. doi: 10.1016/j.joen.2008.02.033.
Formocresol pulpotomy (FP) in the United States is most frequently used to treat asymptomatic caries near the pulp in primary teeth. Indirect pulp therapy (IPT) is also indicated and has a significantly higher long-term success. Pulpotomy is thought to be indicated for primary teeth with carious pulp exposures, but research shows the majority of such teeth are nonvital or questionable for treatment with vital pulp therapy. IPT has a significantly higher success in treating all primary first molars, but especially those with reversible pulpitis compared with FP. The purpose of this article was to review the dental literature and new research in vital pulp therapy to determine the following: (1) Is a pulpotomy indicated for a true carious pulp exposure? (2) Is there a diagnostic method to reliably identify teeth that are candidates for vital pulp therapy? (3) Is primary tooth pulpotomy out of date, and should indirect pulp therapy replace pulpotomy?
在美国，甲醛甲酚活髓切断术（FP）最常用于治疗乳牙牙髓附近的无症状龋齿。间接盖髓术（IPT）也适用，且长期成功率显著更高。活髓切断术被认为适用于牙髓因龋齿暴露的乳牙，但研究表明，大多数此类牙齿已无活力或采用活髓治疗存疑。与FP相比，IPT在治疗所有乳牙第一磨牙时成功率显著更高，尤其是那些患有可逆性牙髓炎的牙齿。本文旨在回顾牙髓治疗方面的牙科文献和新研究，以确定以下几点：（1）对于真正因龋齿导致的牙髓暴露，是否应进行活髓切断术？（2）是否有一种诊断方法能可靠地识别适合进行活髓治疗的牙齿？（3）乳牙活髓切断术是否过时，间接盖髓术是否应取代活髓切断术？
