School of Dentistry, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.
Department of Paediatric Dentistry, Westmead Centre for Oral Health, Westmead, New South Wales, Australia.
Dent Traumatol. 2022 Dec;38(6):505-511. doi: 10.1111/edt.12781. Epub 2022 Aug 16.
BACKGROUND/AIM: Complicated crown fractures are frequently encountered in the paediatric population and pulpotomy procedures (either partial or coronal) are recommended to maintain the pulp. The aim of this study was to determine the pulp outcomes of permanent teeth with complicated crown fractures treated with pulpotomy in a hospital-setting and to identify potential factors which may influence the outcomes.
Data for this retrospective study were extracted from dental records of patients with complicated crown fractures and treated with pulpotomies at a single centre between 1 January 2015 and 30 August 2019. Pulp outcomes were determined, and the associations between the outcome and independent variables were assessed using the Chi-Square test of independence and the Point-Biserial Correlation Test. Predictors of outcome were identified using the binary logistic regression model.
The overall success of pulpotomy in managing traumatised permanent teeth was 61%, which was lower than those previously reported. Pulp healing was seen in 54.1% and 73.7% of teeth treated with partial pulpotomies and coronal pulpotomies, respectively. The presence of a radiographically detectable dentine bridge (p < .01) and longer clinical experience of the clinician (p < .04) was significantly associated with successful outcomes. The history of pain and the stage of root development were identified as significant predictors of the outcome.
Pulpotomy is a viable treatment modality for complicated crown fractures in the paediatric population. However, appropriate case selection and further training may be required to ensure improved pulp healing outcomes. A longer follow-up period should be considered to identify late-stage complications.
背景/目的：复杂冠折在儿科人群中较为常见，建议行活髓切断术（部分或冠部）以保留牙髓。本研究旨在确定在医院环境中采用活髓切断术治疗复杂冠折恒牙的牙髓结局，并确定可能影响结局的潜在因素。
本回顾性研究的数据从 2015 年 1 月 1 日至 2019 年 8 月 30 日期间在单一中心接受活髓切断术治疗复杂冠折的患者的牙科记录中提取。通过卡方检验和点二项相关检验评估结局与独立变量之间的关系。采用二元逻辑回归模型确定结局的预测因素。
活髓切断术治疗外伤性恒牙的总体成功率为 61%，低于之前的报道。分别有 54.1%和 73.7%的行部分活髓切断术和冠部活髓切断术治疗的牙齿出现牙髓愈合。影像学上可检测到牙本质桥的存在（p<.01）和医生更长的临床经验（p<.04）与良好的结局显著相关。疼痛史和根尖发育阶段被确定为结局的显著预测因素。
活髓切断术是儿童复杂冠折的一种可行的治疗方法。然而，为了确保更好的牙髓愈合结局，可能需要进行适当的病例选择和进一步的培训。应考虑更长的随访期以确定晚期并发症。
