Department of Restorative Dentistry, National Dental Centre of Singapore, Singapore.
Department of Restorative Dentistry, National Dental Centre of Singapore, Singapore.
J Endod. 2022 Dec;48(12):1476-1485.e1. doi: 10.1016/j.joen.2022.09.002. Epub 2022 Sep 21.
Cracked teeth with reversible pulpitis can be managed with orthodontic bands in the interim before definitive restorations. The aim of this study was to determine short-term outcomes of these teeth following orthodontic band placement. The time taken for definitive pulp diagnoses after orthodontic band placement and associated prognostic factors was also analyzed.
One hundred twenty-five patients with a cracked tooth with reversible pulpitis each were recruited. Preoperative data including patient and tooth factors were collected. Cracked teeth were banded and reviewed until symptoms resolved before referral for coronal coverage. Kaplan-Meier and Cox analyses were performed to analyze pulp survival of these teeth. Prognostic factors were investigated using Pearson's chi-square and Student's t-test.
One hundred twenty-two cracked teeth were analyzed. One hundred thirteen (92.6%) teeth had the pulpitis resolved within 2 months (median 40.0; interquartile range 28-61). The median time taken for progression to irreversible pulpitis or pulp necrosis for teeth that required root canal treatment was 3 months (median 90.0; interquartile range 68-110). No prognostic factors were associated with the resolution of pulpal symptoms. However, higher preoperative triggered pain scores (P < .05, hazards ratio 1.547) and absence of a distal marginal ridge crack (P < .05, hazards ratio 0.638) were correlated with a longer duration before definitive pulp diagnoses.
Following orthodontic band placement, a normal pulp diagnosis was achieved in 92.6% of cracked teeth with preoperative reversible pulpitis. Definitive pulp diagnoses could be determined in approximately 2 months. Teeth with higher preoperative triggered pain scores may require a longer review period.
对于可逆性牙髓炎的牙隐裂，可以在最终修复前使用正畸带暂时处理。本研究旨在确定正畸带放置后这些牙齿的短期结果。同时还分析了正畸带放置后进行明确牙髓诊断所需的时间以及相关的预后因素。
招募了 125 名患有可逆性牙髓炎的牙隐裂患者，每位患者各有一颗患牙。收集了包括患者和牙齿因素在内的术前数据。对隐裂牙进行带环固定，并在转介进行冠覆盖之前，观察直至症状缓解。采用 Kaplan-Meier 和 Cox 分析评估这些牙齿的牙髓存活率。使用 Pearson's chi-square 和 Student's t-test 分析预后因素。
分析了 122 颗隐裂牙。113 颗（92.6%）牙齿的牙髓炎在 2 个月内（中位数 40.0；四分位间距 28-61）得到解决。需要根管治疗的牙齿进展为不可逆性牙髓炎或牙髓坏死的中位时间为 3 个月（中位数 90.0；四分位间距 68-110）。没有预后因素与牙髓症状的缓解有关。然而，较高的术前激发痛评分（P<.05，风险比 1.547）和无远中边缘嵴裂纹（P<.05，风险比 0.638）与明确牙髓诊断前的较长时间相关。
在正畸带放置后，术前可逆性牙髓炎的牙隐裂中，92.6%的牙齿获得正常牙髓诊断。大约 2 个月后可以做出明确的牙髓诊断。术前激发痛评分较高的牙齿可能需要更长的观察期。
