Centre de Recherche en Odontologie Clinique, Université Clermont Auvergne, Clermont-Ferrand, France; Unité de Soins Spécifiques, Service d'Odontologie, Centre Hospitalier Universitaire Clermont-Ferrand, Clermont-Ferrand, France.
Centre de Recherche en Odontologie Clinique, Université Clermont Auvergne, Clermont-Ferrand, France; Unité de Soins Spécifiques, Service d'Odontologie, Centre Hospitalier Universitaire Clermont-Ferrand, Clermont-Ferrand, France; Service de Chirurgie Ambulatoire, Centre Hospitalier Guy Thomas, Riom, France.
J Endod. 2020 Nov;46(11):1597-1604. doi: 10.1016/j.joen.2020.08.003. Epub 2020 Aug 13.
Endodontic procedures for patients requiring treatment in a single, short session need to be validated. This study aimed at evaluating the long-term outcome of full pulpotomy in permanent molars performed with reinforced zinc oxide-eugenol cement (Intermediate Restorative Material [IRM], Dentsply Sirona, Versailles, France) immediately restored using stainless steel crowns under general anesthesia.
The absence of clinical signs and symptoms and the evolution of the periapical index between the treatment date and the longest follow-up time were used to grade the pulpotomy outcome as "effective," "uncertain," or "ineffective." The impact of different criteria on the pulpotomy outcome was tested (ie, the etiology of the lesion, tooth maturity, endodontic difficulty related to the coronal shape and the root canal shape, and endodontic difficulty related to the radiographic root canal appearance).
Among the 608 teeth (338 patients) treated in a single session with IRM full pulpotomy and stainless steel preformed crowns, 263 (143 patients) were evaluated after a median follow-up period of 24 months. Overall, 89% of the pulpotomies were effective, 7.6% were of uncertain outcome, and 3.4% were ineffective. No tested criteria influenced the rate of effectiveness.
Long-term outcomes of IRM pulpotomy are similar to those of calcium silicate-based cement pulpotomy observed in the literature. This procedure should not be restricted to patients treated under general anesthesia because it is relevant for all special conditions that impose the provision of endodontic treatment in a single, short session, such as dental care emergencies during humanitarian crises or pandemic periods.
对于需要在单次短疗程内接受治疗的患者，需要对根管治疗术进行验证。本研究旨在评估使用强化氧化锌丁香酚水泥（Intermediate Restorative Material [IRM]，Dentsply Sirona，Versailles，法国）进行的全盖髓术在全麻下立即用不锈钢冠修复的长期疗效。
根据治疗日期和最长随访时间之间的临床症状和体征的缺失以及根尖指数的变化，将盖髓术的结果分为“有效”、“不确定”或“无效”。测试了不同标准对盖髓术结果的影响（即病变的病因、牙齿成熟度、与冠部形状和根管形状相关的根管难度以及与根管影像相关的根管难度）。
在 338 名患者的 608 颗牙齿中，用 IRM 进行一次性全盖髓术和不锈钢预成冠治疗，有 143 名患者在中位随访 24 个月后进行了评估。总的来说，89%的盖髓术是有效的，7.6%的效果不确定，3.4%的效果无效。没有一个测试标准会影响有效率。
IRM 盖髓术的长期效果与文献中观察到的基于硅酸钙的水泥盖髓术相似。该方法不应仅限于在全麻下治疗的患者，因为它适用于所有特殊情况，这些情况都需要在单次短疗程内提供根管治疗，例如人道主义危机或大流行期间的牙科急诊。
