Durmus Basak, Tanboga Ilknur
Department of Pediatric Dentistry, Faculty of Dentistry, Marmara University , Istanbul, Turkey .
Photomed Laser Surg. 2014 May;32(5):289-95. doi: 10.1089/pho.2013.3628. Epub 2014 Apr 9.
The purpose of this study was to assess whether the diode laser (DL) pulpotomy method is a suitable alternative to formocresol (FC) and ferric sulphate (FS) pulpotomies in human primary teeth.
Pulpotomy is the amputation of infected coronal pulp to maintain radicular pulp vitality and function. Although FC is regarded as the gold standard for pulpotomy in primary teeth, concerns about its safety have been reported. Lasers are an effective nonpharmacological alternative for treating pulp in children.
This study included 120 primary molars in 58 children 5-9 years of age who underwent an identical conventional pulpotomy technique; the molars were allocated to FC, FS, and DL groups. After removal of the coronal tissue, complete hemostasis of the remaining pulp in the DL group was achieved by DL at 1.5 W, 30 Hz, and 50 mJ, with a 10 sec exposure time. For the FC group, diluted FC (1:5 Buckley's formocresol) was used for 5 min., and for the FS group, a 15.5% FS solution was used for 15 sec. Treatments in all groups were completed with stainless steel crowns and monitored clinically and radiographically at 1, 3, 6, 9, and 12 months.
The clinical success rates at 12 months were 97%, 95%, and 100%, whereas the radiographic success rates were 87%, 79%, and 75%, for the FC, FS and DL groups, respectively. The differences in the results were not statistically significant according to the χ(2) test (p>0.05).
DL pulpotomy offers a high clinical success rate, however considering radiographic success rate, it may not replace traditional FC and FS pulpotomies in primary molars.
本研究旨在评估二极管激光(DL)活髓切断术在人类乳牙治疗中是否是甲醛甲酚(FC)和硫酸铁(FS)活髓切断术的合适替代方法。
活髓切断术是切除感染的冠髓以维持根髓的活力和功能。尽管FC被视为乳牙活髓切断术的金标准,但已有关于其安全性的担忧报道。激光是治疗儿童牙髓的一种有效的非药物替代方法。
本研究纳入了58名5至9岁儿童的120颗乳磨牙,这些乳磨牙均接受相同的传统活髓切断术;将这些乳磨牙分为FC组、FS组和DL组。在去除冠部组织后,DL组通过1.5W、30Hz、50mJ的DL进行照射,暴露时间为10秒,以实现剩余牙髓的完全止血。FC组使用稀释的FC(1:5巴克利甲醛甲酚)处理5分钟,FS组使用15.5%的FS溶液处理15秒。所有组均用不锈钢冠完成治疗,并在1、3、6、9和12个月时进行临床和影像学监测。
FC组、FS组和DL组在12个月时的临床成功率分别为97%、95%和100%,而影像学成功率分别为87%、79%和75%。根据χ(2)检验,结果差异无统计学意义(p>0.05)。
DL活髓切断术具有较高的临床成功率,然而考虑到影像学成功率,它可能无法替代乳牙传统的FC和FS活髓切断术。