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部分牙髓切断术作为龋源性暴露后牙恒牙的一种适用治疗选择:随机临床试验的系统评价

Partial Pulpotomy as an Applicable Treatment Option for Cariously Exposed Posterior Permanent Teeth: A Systematic Review of Randomized Clinical Trials.

作者信息

Albaiti Sarah S, Albishri Raghad F, Alhowig Moeid T, Tayyar Wessam I, Alqurashi Nouf F, Alghamdi Faisal T

机构信息

General Dentistry, Faculty of Dentistry, King Abdulaziz University, Jeddah, SAU.

Oral Biology, Faculty of Dentistry, King Abdulaziz University, Jeddah, SAU.

出版信息

Cureus. 2022 Jul 5;14(7):e26573. doi: 10.7759/cureus.26573. eCollection 2022 Jul.

Abstract

The major focus of this systematic review is to assess how effective partial pulpotomy is in managing carious vital pulp exposures in permanent posterior teeth. An electronic search for studies published between January 2011 and December 2021 was conducted using the following databases: PubMed, Scopus, Google Scholar, and Web of Science. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) criteria were followed during the search process. We selected human randomized clinical trials (RCTs) that investigated the success rate of partial pulpotomy for the treatment of cariously exposed vital permanent posterior teeth and the success rate of decayed exposed vital human permanent posterior dentition managed with a partial pulpotomy. Exclusively, randomized clinical trial papers were considered for assessment. The Cochrane Collaboration's tool was applied to assess the risk of bias. Four papers were selected for the final analysis from the 321 identified during the initial search. Our results showed that after six, 12, and 24 months of follow-up, the success rate was 94%, 93%, and 90%, respectively. The preoperative pulp state was the only significant predictive factor. Teeth with the presumptive diagnosis of irreversible pulpitis had the worse outcome. The treatment outcome was not influenced by the final restoration, pulp capping agent, apex closure, or patient age. Finally, the available data indicated that partial pulpotomy showed a high success rate in treating cariously exposed permanent posterior teeth for up to 24 months. When assessing the effectiveness of a partial pulpotomy, six months of maintenance is deemed adequate. To enhance treatment success, additional clinical and radiological measures are needed.

摘要

本系统评价的主要重点是评估部分活髓切断术在处理恒牙后牙龋源性露髓方面的效果如何。使用以下数据库对2011年1月至2021年12月发表的研究进行了电子检索:PubMed、Scopus、谷歌学术和科学网。检索过程遵循系统评价和Meta分析的首选报告项目(PRISMA)标准。我们选择了人类随机临床试验(RCT),这些试验调查了部分活髓切断术治疗龋源性露髓恒牙后牙的成功率以及部分活髓切断术治疗龋源性露髓恒牙后牙列的成功率。仅考虑随机临床试验论文进行评估。应用Cochrane协作网的工具评估偏倚风险。从初步检索中确定的321篇论文中选择了4篇进行最终分析。我们的结果显示,在随访6个月、12个月和24个月后,成功率分别为94%、93%和90%。术前牙髓状态是唯一显著的预测因素。初步诊断为不可逆性牙髓炎的牙齿预后较差。治疗结果不受最终修复、牙髓盖髓剂、根尖封闭或患者年龄的影响。最后,现有数据表明,部分活髓切断术在治疗龋源性露髓恒牙后牙方面24个月内成功率较高。在评估部分活髓切断术的效果时,6个月的维持期被认为是足够的。为提高治疗成功率,还需要额外的临床和影像学措施。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8fd5/9351822/9798568a15f9/cureus-0014-00000026573-i01.jpg

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