Howley Brega, Seale N Sue, McWhorter Alton G, Kerins Carolyn, Boozer Kent B, Lindsey Donna
Pediatr Dent. 2012 Sep-Oct;34(5):112-9.
The purpose of this prospective, randomized, split-mouth investigation was to compare the success rates of formocresol pulpotomies (FC) and Vitapex(®) pulpectomies (RCT) in asymptomatic carious vital primary incisors.
Matched contralateral pairs of asymptomatic, carious, vital primary incisors were randomized to receive FC or RCT by 2 standardized operators and restored with stainless steel crowns. Seventy-four incisors were followed clinically and radiographically for up to 23 months. Two standardized examiners evaluated radiographic findings using separate pulpotomy and pulpectomy scales (modified Zurn/Seale).
Incisors present at each interval (5-9, 10-14, and 15-23 months) showed no clinical failures. One FC incisor was lost early and counted as a failure. Though not significantly different, there were higher numbers of successful radiographic outcomes for FC than RCT at each observation interval. Cumulative final radiographic success was 89% (n=33) for FC and 73% (n=27) for RCT. (P=.11).
Anecdotal claims that pulpotomies are unsuccessful in primary incisors are unfounded. There was no significant difference in success rates of pulpotomies and pulpectomies in the pulp treatment of asymptomatic vital primary incisors. Intracanal resorption of Vitapex(®) was seen in all pulpectomy teeth and did not affect pulpectomy outcome.
本前瞻性、随机、双侧对照研究旨在比较甲醛甲酚活髓切断术（FC）和Vitapex根充术（RCT）治疗无症状龋源性活髓乳前牙的成功率。
将成对的无症状、龋源性、活髓乳前牙随机分为两组，由2名标准化操作人员分别进行FC或RCT治疗，并用不锈钢冠修复。对74颗前牙进行了长达23个月的临床和影像学随访。两名标准化检查人员使用单独的活髓切断术和根管治疗术量表（改良的Zurn/Seale量表）评估影像学检查结果。
在每个随访间隔（5 - 9个月、10 - 14个月和15 - 23个月）时，均未发现临床失败病例。1颗接受FC治疗的前牙早期脱落，计为失败病例。虽然差异无统计学意义，但在每个观察间隔，FC治疗的影像学成功病例数均多于RCT治疗。FC治疗的最终影像学累积成功率为89%（n = 33），RCT治疗为73%（n = 27）。（P = 0.11）
关于活髓切断术治疗乳前牙不成功的传闻是没有根据的。在无症状活髓乳前牙的牙髓治疗中，活髓切断术和根管治疗术的成功率没有显著差异。所有接受根管治疗的牙齿均出现了Vitapex根管内吸收，但这并未影响根管治疗的结果。
