Quintessence Int. 2021 May 7;52(6):528-537. doi: 10.3290/j.qi.b1244443.
In order to retain primary molars, eg with irreversible pulpitis or pulp necrosis, pulpectomy can be an alternative to extraction. However, reports on the success of pulpectomies in primary teeth vary widely in the literature. Thus, the objective of this study was not only to analyze the success rate of primary tooth pulpectomy 12 months posttreatment in the setting of a specialized clinic, but also to identify and analyze various factors that modify the outcome.
Between 2012 and 2018, a total of 76 dental records of the Department of Preventive and Pediatric Dentistry at the University of Greifswald fulfilled the inclusion criteria, resulting in a 1-year analysis of 62 primary molars with an idoform-calcium hydroxide paste as root canal filling material almost exclusively covered by a stainless steel crown as restoration.
The pulpectomy treatment was successful after 1 year in 93.5%, with a significantly higher survival for mandibular primary molars (100.0% vs 83.3%; chi-square test P = .01). Apart from the very few cases in the mixed dentition, no other factors related to the patient (sex, caries level, general health conditions, distance to clinic), tooth (first or second primary molar, pulpal and periapical condition before treatment), or treatment (indication, academic qualification of the operator, number of visits) proved to be of significance for the treatment outcome due to the overall high success rate.
Pulpectomies for pulpally involved or even necrotic primary molars followed by stainless steel crowns as restoration should be considered as a treatment option, especially in the mandible. (Quintessence Int 2021;52:528-537; doi: 10.3290/j.qi.b1244443).
为了保留乳磨牙，例如对于不可复性牙髓炎或牙髓坏死，可以选择牙髓切除术而非拔牙。然而，文献中关于乳磨牙牙髓切除术成功率的报道差异很大。因此，本研究的目的不仅是分析在专门诊所中，治疗后 12 个月乳磨牙牙髓切除术的成功率，还要确定和分析各种影响治疗效果的因素。
2012 年至 2018 年，格赖夫斯瓦尔德大学预防和儿科牙科系的 76 份牙科记录符合纳入标准，对 62 颗乳磨牙进行了 1 年的分析，这些牙齿的根管填充材料几乎全部为碘仿-氢氧化钙糊剂，并用不锈钢冠作为修复体。
1 年后，牙髓切除术的成功率为 93.5%，下颌乳磨牙的存活率明显更高（100.0%比 83.3%；卡方检验，P=.01）。除了极少数混合牙列中的病例外，患者（性别、龋齿程度、一般健康状况、距诊所的距离）、牙齿（第一或第二乳磨牙、治疗前牙髓和根尖状况）或治疗（适应证、操作者的学历、就诊次数）等方面的其他因素与治疗效果均无显著相关性，因为总体成功率很高。
对于牙髓病变或甚至坏死的乳磨牙进行牙髓切除术，随后用不锈钢冠作为修复体，应被视为一种治疗选择，尤其是在下颌。
