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不同衬里材料对部分龋去净后牙髓结局的影响:一项初步的 12 个月随机对照试验。

Effect of Different Liners on Pulpal Outcome after Partial Caries Removal: A Preliminary 12 Months Randomised Controlled Trial.

机构信息

Department of Conservative Dentistry and Endodontics, Post Graduate Institute of Dental Sciences, Rohtak, India.

Department of Conservative Dentistry and Endodontics, Post Graduate Institute of Dental Sciences, Rohtak, India,

出版信息

Caries Res. 2019;53(5):547-554. doi: 10.1159/000499131. Epub 2019 May 16.

Abstract

AIM

The aim of this double-blinded parallel randomised controlled trial was to compare the effect of different liners on 12-month pulp health outcomes after partial caries removal (PCR) with composite restorations in permanent molars.

METHODS

The study was registered at clinicaltrials.gov with registration No. NCT0328695 and conducted in the Department of Conservative dentistry and Endodontics, Post Graduate Institute of Dental Sciences Rohtak with no external financial support. One hundred and ninety-eight participants (116 males, 82 females and age 14-54 years) with vital permanent mature mandibular molars having deep caries involving two-thirds or more of dentin were randomised to calcium hydroxide (CH), resin-modified GIC (RMGIC) and no liner (DC) groups after PCR. After a follow-up time of 12 months, success was defined as positive response to pulp sensibility and absence of periapical alterations.

RESULTS

Categorical variables were compared using chi-square test. Two analytical approaches were used, such as intention-to-treat and per-protocol approach. Success rates in per-protocol approach were 96.8, 96.5, and 94.6% for CH, RMGIC and DC groups, respectively with no significant difference between 3 groups (p = 0.811). None of the baseline variables had any significant influence on the treatment success.

CONCLUSION

Partial caries excavation has a high success rate to treat deep carious lesions in permanent teeth after 12 months of follow-up, indicating that the retention of carious dentin does not interfere with pulp vitality or restoration survival. Also, the success of the treatment is independent of the lining material used over the demineralized dentin.

摘要

目的

本双盲平行随机对照试验的目的是比较不同衬垫材料在 12 个月时对复合树脂修复后磨牙部分龋坏(PCR)去腐质后牙髓健康状况的影响。

方法

本研究在临床Trials.gov 上注册,注册号为 NCT0328695,在罗塔克 PGIDS 牙科研究所牙髓病和牙髓病学系进行,无外部资金支持。198 名参与者(男 116 名,女 82 名,年龄 14-54 岁),下颌恒磨牙有活力,有深龋,累及牙本质的 2/3 或以上,随机分为氢氧化钙(CH)、树脂改良玻璃离子水门汀(RMGIC)和无衬垫(DC)组,在 PCR 后进行随访。12 个月后,将成功定义为牙髓感觉阳性和无根尖病变。

结果

采用卡方检验比较分类变量。采用意向治疗和方案分析两种分析方法。在方案分析中,CH、RMGIC 和 DC 组的成功率分别为 96.8%、96.5%和 94.6%,三组间无显著性差异(p=0.811)。基线变量均无显著性影响。

结论

在 12 个月的随访中,部分龋坏挖除治疗深龋的成功率较高,表明保留龋坏牙本质不会干扰牙髓活力或修复体的存活。此外,治疗的成功率与使用的衬垫材料无关。

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