抗菌光动力疗法治疗磨牙切牙矿化不全牙齿的对照临床试验。

Antimicrobial photodynamic therapy on teeth with molar incisor hypomineralization-controlled clinical trial.

作者信息

Vieira Letícia Diniz Santos, Paschoal Marco Aurelio Benini, de Barros Motta Pamella, Ferri Elza Padilha, Ribeiro Caroline Diniz Pagani Vieira, Dos Santos-Pinto Lourdes Aparecida Martins, Motta Lara Jansiski, Gonçalves Marcela Letícia Leal, Horliana Anna Carolina Ratto Tempestini, Fernandes Kristianne Porta Santos, Ferrari Raquel Agnelli Mesquita, Deana Alexandre Melo, Bussadori Sandra Kalil

机构信息

FACIPLAC, Brasília, DF.

Department of Pediatric Dentistry and Orthodontics, Federal University of Minas Gerais, Belo Horizonte, MG.

出版信息

Medicine (Baltimore). 2019 Sep;98(39):e17355. doi: 10.1097/MD.0000000000017355.

DOI:10.1097/MD.0000000000017355

PMID:31574879

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6775381/

Abstract

BACKGROUND

Molar incisor hypomineralization (MIH) is a change in the formation of dental enamel of systemic origin that affects at least one of the first 4 permanent molars and usually affects incisors. During the eruption, the affected surfaces tend to fracture, exposing the dentin, which causes excessive sensitivity in addition to making the region very susceptible to the appearance of carious lesions. The objective of this research will be to evaluate the clinical effect of antimicrobial photodynamic therapy (aPDT) in permanent teeth with severe and sensitive MIH.

METHODS

The methodology will be based on the selection of patients from 6 to 12 years of age with permanent molar teeth, randomly divided in 2 groups. The selected teeth should have MIH on the occlusal surface, indicated for clinical restorative treatment. In Group 1, aPDT will be applied for the treatment of infected dentin. Afterward, the teeth will be restored with high viscosity glass ionomer cement. In Group 2, the removal of the softened dentin around the side walls of the cavity with sharp dentine curettes and posterior restoration with high viscosity glass ionomer cement will be performed. All patients will have clinical and radiographic follow-up with a time interval of 6 and 12 months. The data obtained will be submitted to descriptive statistical analysis to evaluate the association of categorical variables. Chi-square test and Fisher exact test will be applied, to analyze the correlation between the continuous variables, Pearson correlation test will be applied. For the analysis of dentin density in the scanned radiographic images and the microbiological results for colony-forming units, ANOVA and Kruskal-Wallis will be applied.

DISCUSSION

Often in the presence of severe MIH, the presence of dentin sensitivity is also associated with caries lesion, making it even more necessary to respect the principles of minimal intervention.

TRIAL REGISTRATION

NCT03904641.

摘要

背景

磨牙症伴切牙低矿化（MIH）是一种源于全身因素的牙釉质形成改变，影响至少4颗第一恒磨牙中的一颗，且通常累及切牙。在萌出过程中，受影响的表面容易折断，暴露牙本质，这除了使该区域极易出现龋损外，还会导致过度敏感。本研究的目的是评估抗菌光动力疗法（aPDT）对患有严重且敏感的MIH恒牙的临床效果。

方法

该方法将基于选择6至12岁有恒磨牙的患者，随机分为2组。所选牙齿应在咬合面上有MIH，适用于临床修复治疗。在第1组中，将应用aPDT治疗感染的牙本质。之后，用高粘性玻璃离子水门汀修复牙齿。在第2组中，用锐利的牙本质刮匙去除龋洞侧壁周围软化的牙本质，并用高粘性玻璃离子水门汀进行后续修复。所有患者将在6个月和12个月的时间间隔进行临床和影像学随访。所获得的数据将进行描述性统计分析，以评估分类变量的关联性。将应用卡方检验和Fisher精确检验来分析连续变量之间的相关性，将应用Pearson相关检验。对于扫描的影像学图像中的牙本质密度分析和菌落形成单位的微生物学结果，将应用方差分析和Kruskal-Wallis检验。