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采用三种不同盖髓材料对无症状性龋损乳磨牙行直接盖髓术:前瞻性临床试验。

Direct pulp capping in asymptomatic carious primary molars using three different pulp capping materials: a prospective clinical trial.

机构信息

Department of Pediatric Dentistry, School of Dentistry, National and Kapodistrian University of Athens, 2 Thivon Street, Goudi, 115 27, Athens, Greece.

Clinic of Orthodontics and Pediatric Dentistry, Center of Dental Medicine, University of Zurich, 11 Plattenstrasse Street, 8032, Zurich, Switzerland.

出版信息

Eur Arch Paediatr Dent. 2022 Oct;23(5):803-811. doi: 10.1007/s40368-022-00720-y. Epub 2022 Jul 2.

Abstract

PURPOSE

Τo assess the outcome of direct pulp capping in asymptomatic carious primary molars using three pulp capping materials.

METHODS

In this prospective clinical trial, carious primary molars free of irreversible pulp inflammation signs and symptoms, with negative pain history and pulp exposure following caries removal were included. Teeth were divided into groups: A: Ca(OH), B: Pure Portland cement, C: Biodentine™. Following anaesthesia, isolation, caries removal, pulp exposure, hemorrhage control, pulp capping, additional lining in groups A, B, teeth were restored with composite resin. Descriptive statistics, Chi-squared and Fisher's exact tests, Kaplan-Meier survival curves, multivariable random effects Cox regression model were performed.

RESULTS

Sixty-six patients (25 girls, 41 boys) with mean age 7.2 (± 1.7) years participated. The mean follow-up time was 13 months. Seventy-nine primary molars were assigned to groups A (n = 27), B (29), C (n = 23). The overall failure was 16% and the distribution by group was: A: 5 teeth, B: 5 teeth, C: 3 teeth. No significant differences in failure rates between capping materials, tooth types, age bands and genders were identified.

CONCLUSIONS

Direct pulp capping in asymptomatic carious primary molars may be an acceptable option, when treating an exposed pulp with bioceramic materials as pulp capping agents.

摘要

目的

评估三种牙髓盖髓材料用于无症状龋坏乳磨牙直接盖髓的治疗效果。

方法

本前瞻性临床试验纳入无不可逆性牙髓炎症迹象和症状、无疼痛史且龋损去除后牙髓暴露的乳磨牙。将牙齿分为三组:A 组:氢氧化钙;B 组:纯 Portland 水泥;C 组:Biodentine™。麻醉、隔湿、去腐、暴露牙髓、控制出血后,A、B 组盖髓,C 组垫底后,用复合树脂进行修复。采用描述性统计、卡方检验和 Fisher 确切概率法、Kaplan-Meier 生存曲线、多变量随机效应 Cox 回归模型进行分析。

结果

共 66 名患者(女 25 名,男 41 名),平均年龄 7.2(±1.7)岁,平均随访时间 13 个月。79 颗乳磨牙被分为 A 组(n=27)、B 组(29)、C 组(n=23)。总失败率为 16%,各组分布为:A 组 5 颗牙,B 组 5 颗牙,C 组 3 颗牙。各组间、不同牙位、不同年龄、不同性别间的失败率差异无统计学意义。

结论

对于暴露牙髓的无症状龋坏乳磨牙,使用生物陶瓷类材料作为盖髓剂直接盖髓是一种可行的选择。

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