Guang Jianxia, Li Junke, Guo Shiling
JianxiaGuang:Oralmedicine.
JianxiaGuang:Oralmedicine, HebeiEyeHospital.
Cell Mol Biol (Noisy-le-grand). 2022 Feb 28;68(2):178-182. doi: 10.14715/cmb/2022.68.2.25.
Endodontic treatment of immature permanent teeth has various problems. Today, the primary goal in the treatment of such teeth is to preserve the life of the pulp so that roots can develop entirely and naturally. If vital pulp therapy can treat these teeth, the treatment will be simpler and less expensive. Therefore, this study compared vital pulp therapy (including calcium-enriched mixture (CEM) cement and MTA methods) and root canal therapy (RCT) in symptomatic immature permanent molars. Also, the expression of TLR-2 and TLR-4 was evaluated in the gingival tissue of patients for further evaluation. In this clinical trial study, 615 patients randomly received three treatments: pulpotomy with CEM (205 cases), pulpotomy with MTA (207 cases), and root canal therapy (203 cases). The presence of periapical lesion was evaluated radiographically at three-time points: start, six months, and 12 months after treatment. The expression of TLR-2 and TLR-4 was also evaluated in the gingival tissue of patients by the Real-time PCR technique. The one-year follow-up of the periapical index shows that the presence of periapical lesion at six-month follow-up in the three groups of MTA, CEM, and RCT equals 14 cases (8%), 7 cases (4%), and 40 cases (22%). The one-year follow-up equals 12 cases (7%), 9 cases (5%), and 33 cases (18%), respectively. The TLR-2 and TLR-4 gene expression results showed no statistical difference between the three groups (CEM, MTA, and RCT). Still, one year after treatment, there was a statistically different between vital pulp therapy (CEM and MTA) and root canal therapy (P<0.05). Also, the results showed no statistical difference between CEM and MTA treatment in terms of TLR-2 and TLR-4 gene expression before and one year after treatment. In general, the results showed that pulpotomy treatment using two biomaterials, CEM and MTA, is more successful than RCT treatment.
未成熟恒牙的牙髓治疗存在各种问题。如今，此类牙齿治疗的主要目标是保留牙髓的活力，以便牙根能够完全自然发育。如果活髓治疗能够治愈这些牙齿，治疗将会更简单且成本更低。因此，本研究比较了有症状的未成熟恒牙磨牙的活髓治疗（包括富钙混合物（CEM）粘固剂和MTA方法）与根管治疗（RCT）。此外，还评估了患者牙龈组织中TLR - 2和TLR - 4的表达，以进行进一步评估。在这项临床试验研究中，615名患者被随机分为三组接受治疗：使用CEM进行牙髓切断术（205例）、使用MTA进行牙髓切断术（207例）和根管治疗（203例）。在治疗开始、治疗后6个月和12个月这三个时间点，通过影像学评估根尖周病变的存在情况。还通过实时PCR技术评估了患者牙龈组织中TLR - 2和TLR - 4的表达。根尖指数的一年随访显示，在MTA、CEM和RCT三组中，6个月随访时根尖周病变的病例数分别为14例（8%）、7例（4%）和40例（22%）。一年随访时分别为12例（7%）、9例（5%）和33例（18%）。TLR - 2和TLR - 4基因表达结果显示三组（CEM、MTA和RCT）之间无统计学差异。然而，治疗一年后，活髓治疗（CEM和MTA）与根管治疗之间存在统计学差异（P<0.05）。此外，结果显示在治疗前和治疗一年后，CEM和MTA治疗在TLR - 2和TLR - 4基因表达方面无统计学差异。总体而言，结果表明使用CEM和MTA这两种生物材料进行牙髓切断术治疗比根管治疗更成功。
