Kiatwateeratana T, Kintarak S, Piwat S, Chankanka O, Kamaolmatyakul S, Thearmontree A
Department of Preventive Dentistry, Faculty of Dentistry, Prince of Songkla University, Songkla, Thailand.
Int Endod J. 2009 Jul;42(7):584-92. doi: 10.1111/j.1365-2591.2009.01552.x. Epub 2009 May 8.
To compare the effect of enamel matrix derivative (EMD) and calcium hydroxide [Ca(OH)(2)] on exposed human pulp.
Fifteen pairs of human contralateral premolars were intentionally and partially pulpotomized. The exposed pulps were randomly capped with either EMDgel (Emdogain) or a mix of Ca(OH)(2) and sterile water. The subjects recorded pain or discomfort during the first 10 days and were also interviewed and examined by a blinded examiner at 1 day, 2 weeks, 3 and 6 months post-operation. Periapical radiographs were taken prior to the operation, and 3 and 6 months post-operation. After 6 months, the teeth were extracted and processed for histological evaluation. The data were described and analysed using McNemar test and Kaplan-Meier survival analysis.
The EMDgel-treated teeth had significantly less tooth hypersensitivity than the Ca(OH)(2)-treated teeth during the first 2 weeks (P = 0.031) but were not significantly different after 2 weeks (P = 0.125). No detectable periapical radiographic changes were observed in any teeth and radiographic evidence of dentine bridge formation from both groups were not significantly different during the follow-up periods (P > 0.05). Histological evaluation demonstrated that the Ca(OH)(2)-treated teeth had less inflammation and more dentine bridge formation than those in the EMDgel-treated teeth.
After 6 months, healthy pulps capped with Ca(OH)(2) had more favourable results than counterparts capped with EMDgel. However, similar clinical and radiographic results were seen in both groups.
比较釉基质衍生物(EMD)和氢氧化钙[Ca(OH)₂]对暴露的人牙髓的作用。
选取15对人对侧前磨牙,有意进行部分牙髓切断术。将暴露的牙髓随机用EMD凝胶(Emdogain)或氢氧化钙与无菌水的混合物覆盖。受试者记录前10天的疼痛或不适情况,并且在术后1天、2周、3个月和6个月由一位不知情的检查者进行访谈和检查。在手术前、术后3个月和6个月拍摄根尖片。6个月后,拔除牙齿并进行组织学评估。使用McNemar检验和Kaplan-Meier生存分析对数据进行描述和分析。
在最初2周内,用EMD凝胶处理的牙齿比用氢氧化钙处理的牙齿牙齿过敏反应明显更少(P = 0.031),但2周后差异无统计学意义(P = 0.125)。在任何牙齿中均未观察到可检测到的根尖片变化,并且在随访期间两组牙本质桥形成的影像学证据差异无统计学意义(P > 0.05)。组织学评估表明,与用EMD凝胶处理的牙齿相比,用氢氧化钙处理的牙齿炎症更少,牙本质桥形成更多。
6个月后,用氢氧化钙覆盖的健康牙髓比用EMD凝胶覆盖的牙髓有更有利的结果。然而,两组的临床和影像学结果相似。