Ansari Ghassem, Chitsazan Aida, Fekrazad Reza, Javadi Fateme
Dept of Pedodontics, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Pedodontist, Private practice, Sari, Iran.
Laser Ther. 2018 Sep 30;27(3):187-192. doi: 10.5978/islsm.27_18-OR-17.
The aim of this investigation was to evaluate clinical and radiographic effects of diode laser pulpotomy on young human primary molars.
This double-blind, split-mouth randomized clinical trial was conducted on 14 children, aged 3-9 years. In total, 20 pairs of teeth were selected from those with pulpal exposure due to caries. Case selection was conducted based on clinical and radiographic criteria with similar teeth in each patient. One tooth was randomly assigned to diode laser pulpotomy as case and the other tooth was pulp-treated using formocresol as control. Diode laser at a 10-W power was applied on the remaining pulp tissue following coronal pulp amputation in the case group, while a cotton pellet with diluted formocresol was placed over the amputated pulp in the control group. Reinforced zinc oxide-eugenol paste was then placed over the pulp stump and the tooth was restored with stainless steel crown. A 6- and 12-month followed-up was conducted clinically and radiographically in order to assess the success rates. Data were analyzed with Fisher's exact test.
Clinical failure rate was almost zero when the cases were followed and examined clinically (100% success), with 95% and 90% of the cases in the case group (diode laser) being judged as successful in radiographic examination after 6 and 12 months, respectively. Cases in the control group (formocresol) had almost the same clinical success rate (100%) with no failure judged by radiographic evaluation at 6 and 12 months. These results did not show any significant differences when analyzed using Fisher's exact test (P > 0.05).
There was no significant difference between diode laser pulpotomy and formocresol pulpotomy of human primary teeth after 6 and 12 months. Only a fraction of cases (5%) had radiographic problems at their follow-up in the laser group.
本研究旨在评估二极管激光牙髓切断术对年轻恒牙的临床和影像学效果。
本双盲、口内对照随机临床试验选取了14名3至9岁的儿童。从因龋齿导致牙髓暴露的牙齿中总共选取了20对牙齿。根据临床和影像学标准进行病例选择,确保每位患者的牙齿情况相似。随机将一颗牙齿指定为二极管激光牙髓切断术治疗组,另一颗牙齿采用甲醛甲酚进行牙髓治疗作为对照组。治疗组在冠髓切断术后,使用功率为10瓦的二极管激光照射剩余牙髓组织,而对照组则在切断的牙髓上放置浸有稀释甲醛甲酚的棉球。然后在牙髓残端上方放置增强型氧化锌丁香酚糊剂,并用不锈钢冠修复牙齿。在术后6个月和12个月进行临床和影像学随访,以评估成功率。数据采用Fisher精确检验进行分析。
临床随访时,治疗组的临床失败率几乎为零(成功率100%),在术后6个月和12个月的影像学检查中,治疗组(二极管激光组)分别有95%和90%的病例被判定为成功。对照组(甲醛甲酚组)的临床成功率几乎相同(100%),在术后6个月和12个月的影像学评估中均未发现失败病例。使用Fisher精确检验分析这些结果时,未显示出任何显著差异(P>0.05)。
二极管激光牙髓切断术和甲醛甲酚牙髓切断术在术后6个月和12个月时对恒牙的治疗效果无显著差异。激光组在随访中仅有一小部分病例(5%)出现影像学问题。