Maltz Marisa, Alves Luana Severo, Jardim Juliana Jobim, Moura Maurício dos Santos, de Oliveira Elenara Ferreira
Department of Social and Preventive Dentistry, Faculty of Dentistry, UFRGS, Ramiro Barcelos, 2492, Bom Firm 90035-003, Brazil.
Am J Dent. 2011 Aug;24(4):211-4.
To follow-up teeth with deep caries lesions submitted to incomplete caries removal over a 10-year period.
27 subjects (32 permanent posterior teeth) with deep caries lesions composed the sample. In this single-arm long-term prospective study, the inclusion criteria were risk of pulp exposure during caries excavation, positive response to the cold test, absence of spontaneous pain or sensitivity during percussion, and radiographic absence of a periapical lesion. Subjects were submitted to the following procedures: complete caries removal from the surrounding cavity walls, incomplete caries removal from the pulpal wall, capping with a calcium hydroxide cement, and sealing with a modified zinc oxide-eugenol cement. After 6-7 months, the temporary sealing was removed for methodological purposes (no further excavation was performed), and teeth were capped with a calcium hydroxide cement and filled with resin composite. Clinical and radiographic assessments were conducted after 6-7 months, 1.5, 3, 5 and 10 years. Success was defined as clinical and radiographic signs and symptoms of pulp sensitivity while failure was defined as endodontic treatment need.
Over 10 years, one tooth was excluded from the sample (pulp exposure during treatment), five were lost to recall, 10 had therapy failure (five fractures and four necroses leading to endodontic treatment need, and one extraction) and 16 had therapy success (pulp sensitivity). Overall survival rates were 97%, 90%, 82% and 63% at 1.5-, 3-, 5- and 10-year follow-ups, respectively. Teeth with two or more restored surfaces failed significantly more than teeth with one restored surface (P= 0.01).
对接受不完全龋损去除术的深龋患牙进行为期10年的随访。
样本包括27名受试者（32颗恒牙后牙）的深龋患牙。在这项单臂长期前瞻性研究中，纳入标准为龋洞制备过程中存在牙髓暴露风险、冷测试阳性反应、叩诊时无自发痛或敏感，以及根尖周病变的影像学检查阴性。受试者接受以下操作：从龋洞周围洞壁完全去除龋损，从髓壁不完全去除龋损，用氢氧化钙水门汀覆盖，并用改良氧化锌丁香酚水门汀封闭。6 - 7个月后，出于方法学目的去除临时封闭剂（不再进行进一步的龋损去除），患牙用氢氧化钙水门汀覆盖并用树脂复合材料充填。在6 - 7个月、1.5年、3年、5年和10年后进行临床和影像学评估。成功定义为牙髓敏感的临床和影像学体征及症状，失败定义为需要进行牙髓治疗。
在10年期间，1颗患牙从样本中排除（治疗期间牙髓暴露），5颗失访，10颗治疗失败（5颗折断和4颗坏死导致需要进行牙髓治疗，1颗拔除），16颗治疗成功（牙髓敏感）。在1.5年、3年、5年和10年随访时的总体生存率分别为97%、90%、82%和63%。有两个或更多修复面的患牙失败率显著高于有一个修复面的患牙（P = 0.01）。
