School of Dentistry, University of Leeds, Leeds, UK.
Faculty of Dentistry, National University of Singapore, Singapore, Singapore.
Int J Paediatr Dent. 2018 Jan;28(1):12-22. doi: 10.1111/ipd.12314. Epub 2017 Jul 9.
In the last few years, conventional restorations including complete removal of carious tissue (CT) with or without pulp therapy for the treatment of carious lesions (CL) in primary teeth have been challenged and a more biological approach has been suggested. This approach involves the use of less invasive techniques which alter the environment of the CL isolating it from the cariogenic biofilm and substrate. Two of these treatment approaches that are becoming increasingly widely accepted and used in paediatric dentistry are the Hall Technique and indirect pulp capping (IPC).
To investigate the outcome of the conventional versus the biological approaches for the treatment of deep CL in the primary teeth in children, delivered in a specialist paediatric dentistry training environment.
This was a retrospective cohort study of 246 children aged 4-9 years, treated with either approach, conventional and biological, in two UK specialist hospital settings. Data were extracted from clinical dental records and post-operative radiographs of patients treated during the period 2006-2012. The outcome of the treatment in this study was categorised into three main categories: clinical, radiographic, and final outcome. Clinical and final outcomes were further described as success, minor, and major failure.
In total, 836 primary teeth were included. In the conventional approach, 324 teeth had complete CT removal and 104 teeth had a pulpotomy. In the biological approach, 388 teeth had Hall Technique preformed metal crowns (PMC) placed and 20 teeth received indirect pulp capping. PMC were the restoration of choice for most of the cases where a pulpotomy had been carried out, and resin composite was most frequently used restorative material for the complete CT removal group. The majority of the primary teeth treated with either approach remained asymptomatic after a follow-up period of up to 77 months, 95.3% in the conventional and 95.8% in the biological. No significant association was found between the final outcome and the approach used for treatment, age of the patient, gender and number of carious surfaces or tooth type.
Both the conventional and biological treatment approaches had similar final outcomes and were equally successful for management of CL in the primary dentition.
在过去的几年中，对于乳牙龋病的治疗，包括常规的龋坏组织完全去除（CT）以及牙髓治疗，已经受到了挑战，并且提出了一种更具生物学性的方法。这种方法涉及使用微创技术，改变龋病环境，将其与致龋生物膜和基质隔离开来。两种在儿童牙科中越来越广泛接受和使用的治疗方法是 Hall 技术和间接盖髓术（IPC）。
在儿童专科牙科培训环境中，研究常规与生物方法治疗乳牙深龋的结果。
这是一项回顾性队列研究，共纳入了 246 名年龄在 4-9 岁的儿童，他们分别接受了常规和生物方法治疗，这两种方法分别在英国的两个专科医院中使用。从 2006 年至 2012 年期间接受治疗的患者的临床牙科记录和术后 X 光片中提取数据。本研究的治疗结果分为三大类：临床、放射学和最终结果。临床和最终结果进一步描述为成功、轻微和重大失败。
总共纳入了 836 颗乳牙。在常规方法中，有 324 颗牙进行了完全 CT 去除，有 104 颗牙进行了牙髓切断术。在生物方法中，有 388 颗牙进行了 Hall 技术预成金属冠（PMC）放置，有 20 颗牙接受了间接盖髓术。牙髓切断术的大多数病例选择了 PMC 作为修复体，而完全 CT 去除组最常使用的修复材料是树脂复合材料。在长达 77 个月的随访期内，接受两种方法治疗的大多数乳牙均无症状，常规组为 95.3%，生物组为 95.8%。未发现最终结果与治疗方法、患者年龄、性别、龋坏面数或牙位之间存在显著相关性。
常规和生物治疗方法的最终结果相似，对于乳牙龋齿的治疗同样有效。
