Munir Amina, Zehnder Matthias, Rechenberg Dan-Krister
Preventive Dentistry, Periodontology and Cariology, Center for Dental Medicine, University of Zurich, 8032 Zurich, Switzerland.
J Clin Med. 2020 Apr 1;9(4):984. doi: 10.3390/jcm9040984.
The aim of this study was to systematically review pulp wound lavage in vital pulp therapy (VPT). A search was conducted in six life science databases to identify clinical trials carried out on permanent teeth with a carious pulp exposure and a recall interval of at least six months. Twenty-seven trials of low to moderate risk of bias (RoB-2 and ROBINS-I) were included. Data was extracted and analyzed regarding study characteristics and methods used for pulp wound lavage. The agent used for pulp wound lavage was specified in all included trials. Most of the identified trials (23/27) randomized the pulp capping material. Many (14/27) reported the use of sodium hypochlorite (NaOCl); ten used only saline or water. One trial was identified that compared pulp wound lavage with 2.5% (NaOCl) to saline, another compared 5% glutaraldehyde to water, both in immature molar pulpotomies. Both studies were underpowered. Neither showed a significant difference between treatments. The use of NaOCl was positively correlated to recent year of publication and use of hydraulic calcium silicate cements for pulp capping ( < 0.05). In conclusion, despite a lack of well-designed trials on pulp wound lavage in VPT, a trend towards using NaOCl for this purpose was observed.
本研究的目的是系统评价活髓治疗（VPT）中牙髓创面冲洗的效果。在六个生命科学数据库中进行了检索，以确定对龋源性牙髓暴露的恒牙进行的临床试验，且随访间隔至少为六个月。纳入了27项低至中度偏倚风险（RoB-2和ROBINS-I）的试验。提取并分析了有关研究特征和牙髓创面冲洗所用方法的数据。所有纳入试验均明确了用于牙髓创面冲洗的药剂。大多数已识别的试验（23/27）对牙髓盖髓材料进行了随机分组。许多试验（14/27）报告使用了次氯酸钠（NaOCl）；10项试验仅使用了生理盐水或水。识别出一项试验，该试验在未成熟磨牙牙髓切断术中比较了用2.5%（NaOCl）进行牙髓创面冲洗与用生理盐水冲洗的效果，另一项试验比较了5%戊二醛与水冲洗的效果，这两项研究的样本量均不足。两项研究均未显示出治疗之间的显著差异。NaOCl的使用与近年的发表情况以及用于牙髓盖髓的水硬性硅酸钙水泥的使用呈正相关（<0.05）。总之，尽管缺乏关于VPT中牙髓创面冲洗的设计良好的试验，但观察到有使用NaOCl进行牙髓创面冲洗的趋势。
