Department of Conservative Dentistry and Oral Science Research Center, College of Dentistry, Yonsei University, Seoul, Korea.
J Endod. 2013 Mar;39(3):327-31. doi: 10.1016/j.joen.2012.11.034. Epub 2013 Jan 16.
Direct pulp capping is a treatment option for teeth with carious-exposed pulp. Because pulp capping studies have exhibited fluctuations in success rates according to different follow-up times, investigating the clinical pulpal survival rate and the potential factors contributing to the survival with respect to time is necessary.
A total of 175 patients treated between November 2007 and August 2010 met the inclusion criteria. During the follow-up, we investigated 7 clinical variables with respect to the survival of the pulp capping treatment: sex, age, maxilla versus mandible, tooth position, capping materials, temporary filling materials, and exposure site. Survival analysis was performed using the Kaplan-Meier method and the Cox proportional hazard regression model.
The Kaplan-Meier survival curves and log-rank tests revealed that only age, exposure site, and capping material had significant effects on the pulpal survival rate (P< .05). A Cox regression model showed that mineral trioxide aggregate was the sole factor affecting the survival of the treated pulps (P< .05). In the analyses performed separately according to time, there was no conspicuous factor that affected the survival rate before 100 days. However, after 100 days, the type of pulp capping material was the single most important factor influencing the survival rate (P< .05).
The results of this study indicated that careful patient selection and the type of pulp capping material should be taken into consideration when performing a pulp capping treatment.
直接盖髓术是治疗有龋损暴露牙髓的牙齿的一种治疗选择。由于盖髓术的研究结果显示成功率根据不同的随访时间而波动,因此有必要研究临床牙髓存活率以及与时间有关的存活的潜在因素。
共有 175 名 2007 年 11 月至 2010 年 8 月接受治疗的患者符合纳入标准。在随访期间,我们调查了 7 个与盖髓治疗存活有关的临床变量:性别、年龄、上颌与下颌、牙齿位置、盖髓材料、临时填充材料和暴露部位。使用 Kaplan-Meier 生存分析和 Cox 比例风险回归模型进行生存分析。
Kaplan-Meier 生存曲线和对数秩检验显示,只有年龄、暴露部位和盖髓材料对牙髓存活率有显著影响(P<.05)。Cox 回归模型显示,三氧化矿物聚合体是唯一影响治疗后牙髓存活的因素(P<.05)。根据时间分别进行分析时,在 100 天之前,没有明显的因素影响存活率。然而,在 100 天之后,盖髓材料的类型是影响存活率的唯一最重要因素(P<.05)。
本研究结果表明,在进行盖髓治疗时,应仔细选择患者并考虑盖髓材料的类型。