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乳牙牙髓摘除术长期疗效及影响因素的回顾性研究

A retrospective study on the long-term outcomes of pulpectomy and influencing factors in primary teeth.

作者信息

Dou Guili, Wang Dandan, Zhang Sun, Ma Wenli, Xu Mindi, Xia Bin

机构信息

Department of Pediatric Dentistry, Peking University School and Hospital of Stomatology & National Center 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 & Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health & NMPA Key Laboratory for Dental Materials, Beijing, China.

出版信息

J Dent Sci. 2022 Apr;17(2):771-779. doi: 10.1016/j.jds.2021.10.007. Epub 2021 Oct 21.

Abstract

BACKGROUND/PURPOSE: Pulpectomy is the last means to preserve primary teeth with pulpitis or pulp necrosis. The aim of the study was to investigate the survival rate of primary teeth after pulpectomies and to explore the factors influencing the prognosis of pulpectomy.

MATERIALS AND METHODS

This retrospective study was performed on patients who received primary tooth pulpectomy in the Department of Pediatric Dentistry at Peking University Hospital of Stomatology between January 2014 and February 2019. The demographic characteristics of children and the information of teeth treated were collected, and the clinical and radiographic examination after treatment were evaluated. Survival analysis was performed to determine the influencing factor of pulpectomy failure.

RESULTS

A total of 592 primary anterior teeth and 583 primary molars were included. The 30-month survival rate of primary anterior teeth was 58.5% and that of primary molars was 37.0%. The survival rate of postoperative primary molars was lower than that of primary anterior teeth ( < 0.05). Primary anterior tooth interventions with preoperative periapical lesions, Vitapex® filling, or nongeneral anesthesia treatment had a higher failure risk ( < 0.05). Treatment at an older age and glass ionomer cement filling indicated a higher failure risk for primary molar pulpectomies.

CONCLUSION

Primary anterior teeth after pulpectomies had a higher survival rate than primary molars. Periapical lesions, treatment methods, and root filling materials had significant impacts on the prognosis of primary anterior pulpectomies, and children's age significantly affected the prognosis of primary molar pulpectomies, which has not been reported before.

摘要

背景/目的:牙髓摘除术是保存患有牙髓炎或牙髓坏死的乳牙的最后手段。本研究的目的是调查牙髓摘除术后乳牙的存活率,并探讨影响牙髓摘除术预后的因素。

材料与方法

本回顾性研究对2014年1月至2019年2月期间在北京大学口腔医院儿童口腔科接受乳牙牙髓摘除术的患者进行。收集儿童的人口统计学特征和治疗牙齿的信息,并评估治疗后的临床和影像学检查。进行生存分析以确定牙髓摘除术失败的影响因素。

结果

共纳入592颗乳前牙和583颗乳磨牙。乳前牙30个月的存活率为58.5%,乳磨牙为37.0%。术后乳磨牙的存活率低于乳前牙(P<0.05)。术前有根尖周病变、使用Vitapex®充填或非全身麻醉治疗的乳前牙干预失败风险较高(P<0.05)。年龄较大时进行治疗以及使用玻璃离子水门汀充填表明乳磨牙牙髓摘除术失败风险较高。

结论

牙髓摘除术后乳前牙的存活率高于乳磨牙。根尖周病变、治疗方法和根充材料对乳前牙牙髓摘除术的预后有显著影响,儿童年龄对乳磨牙牙髓摘除术的预后有显著影响,这在以前尚未见报道。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/41e0/9201929/cd1ac1beabbc/gr1.jpg

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