Department of Conservative Dentistry and Endodontics, Post Graduate Institute of Dental Sciences, Rohtak, Haryana, India.
Department of Conservative Dentistry and Endodontics, Post Graduate Institute of Dental Sciences, Rohtak, Haryana, India.
J Endod. 2019 Jul;45(7):840-847. doi: 10.1016/j.joen.2019.02.025. Epub 2019 May 16.
This randomized clinical trial aimed to compare the success rate and postoperative pain of direct pulp capping (DPC) using calcium hydroxide (CH) and mineral trioxide aggregate (MTA) in teeth with carious pulp exposures and reversible pulpitis.
Sixty-four permanent teeth were randomly divided after caries excavation into 2 groups: CH and MTA (n = 32 in each group). Exposed pulps were capped using standardized protocols. The treated teeth were restored with glass ionomer cement and composite restoration. The primary outcome was success rate at the 12-month follow-up, and the secondary outcome was postoperative pain after 7 days. Clinical and radiographic evaluations were performed at 3, 6, and 12 months. Pain was recorded using the visual analog scale every 24 hours for 7 days after intervention.
Fifty-six patients were analyzed at the 12-month follow-up, 29 treated with CH and 27 with ProRoot MTA (Dentsply Tulsa Dental, Tulsa, OK). The success rate was 69% for CH and 93% for ProRoot MTA (P < .05). The kappa value of interrater agreement was 0.773.No significant difference in pain incidence was found between the 2 groups (P > .05) although a significant pain reduction was found 6 hours after the procedure in both the groups. Significantly lower pain scores were reported in the MTA group (6.3 ± 9.5) compared with the CH group (18.5 ± 20.8) after 18 hours.
Teeth with carious pulp exposures and reversible pulpitis can be treated successfully with DPC. MTA proved better than CH in terms of both success rate and pain intensity.
本随机临床试验旨在比较使用氢氧化钙(CH)和三氧化矿物凝聚体(MTA)直接盖髓治疗有龋性牙髓暴露和可复性牙髓炎的成功率和术后疼痛。
在龋蚀挖除后,将 64 颗恒牙随机分为 2 组:CH 组和 MTA 组(每组 n = 32)。采用标准化方案对暴露的牙髓进行盖髓。用玻璃离子水门汀和复合树脂修复治疗牙。主要结局是 12 个月随访时的成功率,次要结局是术后 7 天的疼痛。在 3、6 和 12 个月进行临床和放射学评估。在干预后 7 天内,每 24 小时使用视觉模拟量表记录疼痛。
在 12 个月的随访中,56 例患者进行了分析,其中 29 例用 CH 治疗,27 例用 ProRoot MTA(登士柏牙科,塔尔萨,俄克拉荷马州)治疗。CH 的成功率为 69%,ProRoot MTA 的成功率为 93%(P <.05)。两位观察者之间的kappa 值为 0.773。两组之间的疼痛发生率无显著差异(P >.05),但两组在术后 6 小时疼痛均显著减轻。MTA 组(6.3 ± 9.5)的疼痛评分明显低于 CH 组(18.5 ± 20.8)(18 小时后)。
有龋性牙髓暴露和可复性牙髓炎的牙齿可以用直接盖髓术成功治疗。MTA 在成功率和疼痛强度方面均优于 CH。