Faculty of Dentistry, Department of Endodontics, Cairo University, Cairo, Egypt.
Faculty of Dentistry, Department of Endodontics, Cairo University, Cairo, Egypt.
J Endod. 2021 Nov;47(11):1672-1682. doi: 10.1016/j.joen.2021.08.009. Epub 2021 Aug 31.
The purpose of this study was to compare clinically and radiographically the effects of potassium nitrate in polycarboxylate cement and mineral trioxide aggregate (MTA) as pulpotomy agents in vital immature mandibular first molars.
The trial design was a parallel randomized, 1:1 allocation ratio, with both the participants and the data assessor blinded. A total of 50 molars of 48 eligible children aged 6-9 years were studied. The children had mandibular immature first molars with extensive caries that revealed pulp exposure during caries excavation. Patients were randomly allocated equally into 2 groups in which potassium nitrate in polycarboxylate cement (the intervention group) and MTA (the control group) were used as pulpotomy biomaterials. The treated teeth were restored permanently. The primary outcome was clinical/radiographic assessment after 1 week, 6 months, and 12 months. The secondary outcomes were radiometric analysis at 6 and 12 months to determine dimensional changes during maturogenesis. The digital radiographs were imported to image processing software to perform radiometric measurements. Data were tabulated and statistically analyzed with significance set at P ≤ .05.
Only a single tooth failed at the 6-month recall, and another one was lost during recall in each group. Thus, the overall success rate for cases/group who finally attended the 12-month follow-up time point was 92% (23/25) with no statistically significant difference between the 2 groups. At the 12-month recall, successful cases showed root development with an increase in root length and a decrease in apical foramen width. Complete apical closure was observed in 65.2% of the roots in the intervention group and 52.1% in the control group.
The clinical and radiographic success reported in the present study reveals that potassium nitrate in polycarboxylate cement could be used as a biological and economic alternative to MTA as a pulpotomy agent in vital immature mandibular first molars. Further follow-up for longer periods is recommended.
本研究旨在比较聚羧酸酯水泥中的硝酸钾和三氧化物聚合体（MTA）作为活髓保存剂在下颌恒前磨牙牙髓切断术中的临床和影像学效果。
试验设计为平行随机、1:1 分配比，参与者和数据评估者均设盲。共有 48 名 6-9 岁符合条件的儿童的 50 颗磨牙参与了本研究。这些儿童患有下颌恒前磨牙广泛龋坏，在龋坏挖除过程中暴露牙髓。患者被随机平均分配到两组，聚羧酸酯水泥中的硝酸钾（干预组）和 MTA（对照组）被用作牙髓切断生物材料。治疗后的牙齿被永久修复。主要结局是治疗后 1 周、6 个月和 12 个月的临床/影像学评估。次要结局是在 6 个月和 12 个月进行放射测量分析，以确定在成熟过程中牙体尺寸的变化。数字射线照片被导入图像处理软件进行放射测量。数据以表格形式呈现，并进行统计学分析，显著性水平设置为 P≤.05。
只有 1 颗牙在 6 个月的随访中失败，每组还有 1 颗牙在随访中丢失。因此，最终在 12 个月随访时间点参加的病例/组的总体成功率为 92%（23/25），两组间无统计学差异。在 12 个月的随访中，成功的病例显示出根发育，根长增加，根尖孔宽度减小。干预组 65.2%的根出现完全根尖闭合，对照组为 52.1%。
本研究报道的临床和影像学成功表明，聚羧酸酯水泥中的硝酸钾可作为 MTA 的生物和经济替代物，用于活髓保存剂在下颌恒前磨牙牙髓切断术中。建议进行更长时间的随访。
