Linsuwanont Pairoj, Wimonsutthikul Kongthum, Pothimoke Uht, Santiwong Busayarat
Department of Operative Dentistry, Chulalongkorn University, Bangkok, Thailand.
Department of Operative Dentistry, Chulalongkorn University, Bangkok, Thailand.
J Endod. 2017 Feb;43(2):225-230. doi: 10.1016/j.joen.2016.10.027. Epub 2016 Dec 29.
This study aimed to illustrate the treatment outcomes of mineral trioxide aggregate (MTA) pulpotomy in vital permanent teeth with carious pulp exposure.
MTA pulpotomy was performed in 66 vital permanent teeth with carious pulp exposure including teeth with signs and symptoms of irreversible pulpitis and the presence of periapical radiolucency. Patients were assessed for clinical and radiographic outcomes by 2 examiners. The relationship between treatment outcomes and factors was analyzed by means of univariate analysis and binary logistic regression.
Fifty patients (a total of 55 teeth) attended the follow-up examination. The age of the patients ranged from 7-68 years old (mean = 29 years old). For the follow-up period as far as 62 months, 48 teeth showed successful outcomes (success rate = 87.3%). Teeth with clinical signs of irreversible pulpitis and the presence of periapical radiolucency could be treated successfully by MTA pulpotomy with success rates of 84% and 76%, respectively.Three of 7 failed cases required pulpectomy after MTA pulpotomy to relieve painful pulpitis. Four other failed cases were asymptomatic, and failure was detected from radiographic examination. The relationship between treatment outcomes and treatment factors could not be detected statistically.
Teeth with carious pulp exposure can be treated successfully by MTA pulpotomy. Clinical signs of irreversible pulpitis and the presence of periapical radiolucency should not be considered as a contraindication for pulpotomy.
本研究旨在阐明用三氧化矿物凝聚体(MTA)进行活髓切断术治疗龋源性露髓恒牙的治疗效果。
对66颗龋源性露髓的恒牙进行MTA活髓切断术,这些牙齿包括有不可逆性牙髓炎体征和症状以及根尖周透射影的牙齿。由2名检查者对患者的临床和影像学结果进行评估。通过单因素分析和二元逻辑回归分析治疗结果与各因素之间的关系。
50名患者(共55颗牙齿)参加了随访检查。患者年龄在7至68岁之间(平均29岁)。在长达62个月的随访期内,48颗牙齿治疗成功(成功率=87.3%)。有不可逆性牙髓炎临床体征和根尖周透射影的牙齿通过MTA活髓切断术均可成功治疗,成功率分别为84%和76%。7例失败病例中有3例在MTA活髓切断术后需要进行根管治疗以缓解疼痛性牙髓炎。其他4例失败病例无症状,失败是通过影像学检查发现的。治疗结果与治疗因素之间的关系未发现有统计学意义。
龋源性露髓的牙齿通过MTA活髓切断术可成功治疗。不可逆性牙髓炎的临床体征和根尖周透射影不应被视为活髓切断术的禁忌证。