Liu S Y, Gong W Y, Liu M Q, Long Y Z, Dong Y M
Department of Cariology and Endodontology, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China.
Department of Radiology, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China.
Zhonghua Kou Qiang Yi Xue Za Zhi. 2020 Dec 9;55(12):945-951. doi: 10.3760/cma.j.cn112144-20200327-00173.
To evaluate the clinical efficacy and influence factors of direct pulp capping using a bioactive ceramic in mature permanent teeth with carious pulp exposure, in order to explore the feasibility and indications of vital pulp therapy for such teeth. From January 2016 to September 2017, 57 patients (57 teeth) with carious pulp exposure in mature permanent teeth were selected from the Department of Cariology and Endodontology, Peking University School and Hospital of Stomatology. All the teeth were preoperatively diagnosed as deep caries with normal pulp or reversible pulpitis. After rubber dam isolation, all the carious dentin was removed and the exposed pulp tissue was observed under microscope. Hemostasis should be achieved within 3 min by using 2.5% sodium hypochlorite cotton pellets with a gently press. A resin composite restoration was performed immediately or 2 weeks later after direct pulp capping by using a bioceramic material (iRoot BP Plus). The patients were re-examined 12 to 50 months after operation (average 30 months) and the outcomes were evaluated by symptoms, clinical examination and X-ray. Kaplan-Meier survival analysis was used to calculate the success rate and influence factors were analyzed by Log-Rank test. Totally 50 patients [age (32±13) years old (13-68 years old), 12 males and 38 females] received the follow-up examination more than one year. The overall success rate was 90% (45/50) and the success rates at 1 year, 2 years, 3 years and more were 98%, 89% and 81%, respectively. Age, gender, symptom, tooth and cavity type, pulpal exposure size and coronal restoration material had no significant correlations with the treatment outcome (0.05). Direct pulp capping of mature permanent teeth with carious pulp exposure by using iRoot BP Plus might have high success rate. There's no significant correlations between the major clinical factors and the treatment outcome.
评价生物活性陶瓷用于成熟恒牙龋源性露髓直接盖髓术的临床疗效及影响因素,以探讨此类牙齿活髓治疗的可行性及适应证。2016年1月至2017年9月,从北京大学口腔医学院牙体牙髓科选取57例成熟恒牙龋源性露髓患者(57颗牙齿)。所有患牙术前诊断为深龋且牙髓正常或为可复性牙髓炎。橡皮障隔离后,去除所有龋坏牙本质,在显微镜下观察暴露的牙髓组织。用2.5%次氯酸钠棉球轻压3分钟内止血。使用生物陶瓷材料(iRoot BP Plus)直接盖髓后立即或2周后进行树脂复合体修复。术后12至50个月(平均30个月)对患者进行复查,通过症状、临床检查及X线评估疗效。采用Kaplan-Meier生存分析计算成功率,用Log-Rank检验分析影响因素。共有50例患者[年龄(32±13)岁(13至68岁),男性12例,女性38例]接受了1年以上的随访检查。总体成功率为90%(45/50),1年、2年、3年及以上的成功率分别为98%、89%和81%。年龄、性别、症状、患牙及龋洞类型、牙髓暴露大小及冠部修复材料与治疗结果均无显著相关性(P>0.05)。使用iRoot BP Plus对成熟恒牙龋源性露髓进行直接盖髓术可能具有较高的成功率。主要临床因素与治疗结果之间无显著相关性。