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部分活髓切断术无年龄限制:对暴露于龋坏牙髓的恒牙的回顾性评估。

Partial pulpotomy without age restriction: a retrospective assessment of permanent teeth with carious pulp exposure.

机构信息

Department for Periodontology, Endodontology and Cariology, University Center for Dental Medicine UZB, University of Basel, Mattenstrasse 40, CH-4058, Basel, Switzerland.

Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland.

出版信息

Clin Oral Investig. 2022 Jan;26(1):365-373. doi: 10.1007/s00784-021-04007-2. Epub 2021 Jun 2.

Abstract

OBJECTIVES

This study aimed to retrospectively evaluate clinical and radiographic outcomes of partial pulpotomy performed in permanent teeth with carious pulp exposure.

MATERIALS AND METHODS

Records of patients undergoing treatment at an undergraduate dental clinic between 2010 and 2019 were screened for partial pulpotomies in teeth with a presumptive diagnosis of normal pulp or reversible pulpitis. The follow-up had to be ≥ 1 year. Patient data were retrieved and analyzed using Mantel-Cox chi square tests and Kaplan-Meier statistics. The level of significance was set at α = 0.05.

RESULTS

Partial pulpotomy was performed in 111 cases, of which 64 (58%) fulfilled the eligibility criteria. At the time of partial pulpotomy, the mean age was 37.3 (± 13.5) years (age range 18-85). The mean observation period was 3.1 (± 2.0) years. Two early failures (3.1%) and five late failures (7.7%) were recorded. The overall success rate of maintaining pulp vitality was 89.1%, with 98.4% tooth survival. The cumulative pulp survival rates of partial pulpotomy in patients aged < 30 years, between 30 and 40 years, and > 40 years were 100%, 75.5%, and 90.5%, respectively, with no significant difference between the age groups (p = 0.225). At follow-up, narrowing of the pulp canal space and tooth discoloration were observed in 10.9% and 3.1% of cases, respectively.

CONCLUSIONS

Across age groups, partial pulpotomy achieved favorable short and medium-term outcomes in teeth with carious pulp exposure.

CLINICAL RELEVANCE

Adequate case selection provided, partial pulpotomy is a viable operative approach to treat permanent teeth with deep carious lesions irrespective of patients' age.

摘要

目的

本研究旨在回顾性评估有龋暴露的恒牙行部分活髓切断术的临床和影像学结果。

材料与方法

筛选 2010 年至 2019 年期间在本科牙科诊所接受治疗的患者记录,以寻找疑似正常牙髓或可复性牙髓炎的牙齿行部分活髓切断术的病例。随访时间必须≥1 年。使用 Mantel-Cox 卡方检验和 Kaplan-Meier 统计对患者资料进行检索和分析。显著性水平设定为α=0.05。

结果

共行 111 例部分活髓切断术,其中 64 例(58%)符合纳入标准。行部分活髓切断术时,患者的平均年龄为 37.3(±13.5)岁(年龄范围 18-85 岁)。平均观察期为 3.1(±2.0)年。记录到 2 例早期失败(3.1%)和 5 例晚期失败(7.7%)。维持牙髓活力的总成功率为 89.1%,牙齿存活率为 98.4%。年龄<30 岁、30-40 岁和>40 岁的患者行部分活髓切断术的累积牙髓存活率分别为 100%、75.5%和 90.5%,各组间无显著差异(p=0.225)。随访时,分别有 10.9%和 3.1%的病例观察到牙髓管空间变窄和牙齿变色。

结论

在各年龄段,有龋暴露的恒牙行部分活髓切断术均可获得良好的短期和中期效果。

临床相关性

只要选择合适的病例,部分活髓切断术是治疗深龋病损恒牙的可行手术方法,与患者年龄无关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cf23/8791876/7f8f26798576/784_2021_4007_Fig1_HTML.jpg

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