Brustolin Juliane Priscila, Mariath Adriela Azevedo Souza, Ardenghi Thiago Machado, Casagrande Luciano
Department of Surgery and Orthopedics, UFRGS - Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil.
Department of Stomatology, Post-Graduate Program in Pediatric Dentistry, UFSM - Universidade Federal de Santa Maria, Santa Maria, RS, Brazil.
Braz Dent J. 2017 Jan-Feb;28(1):121-128. doi: 10.1590/0103-6440201601009. Epub 2016 Dec 12.
Although endodontic treatment is widely recommended for compromised dental pulp, there is no information regarding the factors associated with failures in primary teeth. The aim of this study was to evaluate the survival and factors associated with failure of pulpectomies performed in primary teeth by dental students. The sample comprised patients treated at a University Dental Service and required endodontic treatment in primary teeth. The study investigated treatment-related variables and patient factors potentially associated with treatment failure. Pulpectomy survival was analyzed by Kaplan-Meier estimator followed by log-rank test (p<0.05). The analysis included 81 pulpectomies performed in 62 children (5.6±1.5 years). The survival reached 62.9% up to 12 months follow-up. Most failures occurred in the first 3 months (p<0.001). Teeth with carious lesions at the start of treatment presented more failures than those with restorations or history of trauma (p=0.002). The survival of endodontically treated teeth restored with composite was higher than the ones filled with GIC (p=0.006). Pulpectomy performed in two or more sessions resulted in more failures (p=0.028). Patients presenting gingivitis had more failures in the endodontic treatment (p=0.022). The failures of root canal treatment in primary teeth were more prone to occur in a short time and when the treatment was performed in teeth presenting carious lesions. The use of composite instead of GIC increased the survival of pulpectomies. Repeated sessions for endodontic treatment and lack of oral hygiene habits had a negative effect on the results.
尽管牙髓治疗被广泛推荐用于受损的牙髓，但关于乳牙治疗失败相关因素的信息却很少。本研究的目的是评估牙科学生对乳牙进行牙髓切断术的成功率及失败相关因素。样本包括在大学牙科诊所接受治疗且需要进行乳牙牙髓治疗的患者。该研究调查了与治疗失败潜在相关的治疗相关变量和患者因素。采用Kaplan-Meier估计量分析牙髓切断术的成功率，随后进行对数秩检验（p<0.05）。分析纳入了62名儿童（5.6±1.5岁）接受的81次牙髓切断术。随访12个月时成功率达62.9%。大多数失败发生在最初3个月（p<0.001）。治疗开始时患有龋损的牙齿比有修复体或外伤史的牙齿失败率更高（p=0.002）。用复合树脂修复的牙髓治疗牙齿的成功率高于用玻璃离子水门汀充填的牙齿（p=0.006）。分两次或更多次进行的牙髓切断术失败率更高（p=0.028）。患有牙龈炎的患者牙髓治疗失败率更高（p=0.022）。乳牙根管治疗失败更易在短时间内发生，且在患有龋损的牙齿上进行治疗时更容易出现。使用复合树脂而非玻璃离子水门汀可提高牙髓切断术的成功率。牙髓治疗的重复疗程和缺乏口腔卫生习惯对治疗结果有负面影响。
