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采用两种牙髓血运重建方案治疗的创伤未成熟恒牙。

Traumatized immature teeth treated with 2 protocols of pulp revascularization.

作者信息

Nagata Juliana Yuri, Gomes Brenda Paula Figueiredo de Almeida, Rocha Lima Thiago Farias, Murakami Lia Saori, de Faria Danielle Elaine, Campos Gabriel Rocha, de Souza-Filho Francisco José, Soares Adriana de Jesus

机构信息

Department of Restorative Dentistry, Endodontics Area, State University of Campinas-UNICAMP, Piracicaba, São Paulo, Brazil.

Department of Dentistry, Endodontics Area, São Leopoldo Mandic Faculty, Campinas, São Paulo, Brazil.

出版信息

J Endod. 2014 May;40(5):606-12. doi: 10.1016/j.joen.2014.01.032. Epub 2014 Mar 6.

Abstract

INTRODUCTION

Pulp revascularization may be considered a promising alternative for traumatized necrotic immature teeth. The aim of this study was to evaluate traumatized immature teeth treated with 2 protocols of pulp revascularization.

METHODS

Twenty-three teeth of young patients (7-17 years old) with necrotic upper incisors caused by dental trauma were divided into 2 groups; one group was treated with triple antibiotic paste (metronidazole, ciprofloxacin, and minocycline) (TAP) (n = 12), and the other was medicated with combination of calcium hydroxide and 2% chlorhexidine gel (CHP) (n = 11). Patients were treated and followed up for a period from 9-19 months in 2 dental institutions for evaluation of clinical and radiographic data.

RESULTS

Most of the teeth were affected by lateral luxation (47.8%). Clinical evaluation in group TAP showed significant reduction in spontaneous pain (P = .01), pain on horizontal percussion (P = .007), and pain on palpation (P = .03), whereas group CHP showed significant reduction in pain on vertical percussion (P = .03). Crown discoloration was observed significantly more in teeth of group TAP (83.3%) (P < .002). On radiographic exam, periapical repair was found in all TAP-treated teeth (P = .03). Similarly, the same findings were found for all teeth treated with CHP with exception of 1 tooth (P = .21). Apical closure was significantly observed in both groups (P < .05). Increase in root length was demonstrated in 5 teeth (41.7%) and 3 teeth (27.3%) of groups TAP and CHP, respectively. Thickening of lateral dentinal walls was observed in 5 teeth of each group.

CONCLUSIONS

Revascularization outcomes for traumatized patients treated with the tested protocols presented similar clinical and radiographic data. However, TAP caused esthetic problem leading to tooth discoloration, which can be considered a disadvantage when compared with CHP.

摘要

引言

牙髓血管再生术可能是治疗外伤致坏死的未成熟恒牙的一种有前景的替代方法。本研究旨在评估采用两种牙髓血管再生术方案治疗外伤未成熟恒牙的效果。

方法

将23例7至17岁因牙外伤导致上颌切牙坏死的年轻患者的患牙分为两组;一组用三联抗生素糊剂(甲硝唑、环丙沙星和米诺环素)(TAP)治疗(n = 12),另一组用氢氧化钙与2%氯己定凝胶联合用药(CHP)(n = 11)。在两家牙科机构对患者进行治疗并随访9至19个月,以评估临床和影像学数据。

结果

大多数牙齿受到侧方脱位影响(47.8%)。TAP组的临床评估显示自发痛(P = .01)、水平叩诊痛(P = .007)和触压痛(P = .03)显著减轻,而CHP组垂直叩诊痛显著减轻(P = .03)。TAP组牙齿的冠部变色明显更多(83.3%)(P < .002)。影像学检查发现,所有接受TAP治疗的牙齿均有根尖修复(P = .03)。同样,除1颗牙齿外,所有接受CHP治疗的牙齿也有相同表现(P = .21)。两组均观察到明显的根尖闭合(P < .05)。TAP组和CHP组分别有5颗牙齿(41.7%)和3颗牙齿(27.3%)的牙根长度增加。每组均有5颗牙齿观察到侧方牙本质壁增厚。

结论

采用所测试方案治疗的外伤患者的血管再生结果呈现出相似临床和影像学数据。然而,TAP导致美观问题,即牙齿变色,与CHP相比,这可被视为一个缺点。

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