Hu Xiaoyan, Liang Zhaojia, Wang Qun, Liu Laikui
Jiangsu Province Key Laboratory of Oral Diseases, Department of Basic Science of Stomatology, Jiangsu Province Engineering Research Center of Stomatological Translational, The Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing, China.
Key Laboratory of Oral Diseases Research of Anhui Province, Department of Pediatric Dentistry, College & Hospital of Stomatology, Anhui Medical University, Hefei, China.
Int J Paediatr Dent. 2023 Mar;33(2):216-226. doi: 10.1111/ipd.13037. Epub 2022 Dec 13.
Pulpotomy has been successfully performed in immature and mature permanent teeth with irreversible pulpitis but rarely in primary teeth.
To evaluate the outcomes of iRoot BP Plus pulpotomy and Vitapex pulpectomy in primary molars with irreversible pulpitis.
We selected 130 primary molars of 99 patients, aged 3-7 years, diagnosed with irreversible pulpitis with coronal pulp tissue and treated with iRoot BP Plus pulpotomy or Vitapex pulpectomy (median follow-up period: 18 months). They were divided into the pulpotomy (n = 88) and pulpectomy (n = 42) groups according to treatment procedure. The pulpotomy group was further divided into asymptomatic (n = 46) and symptomatic (n = 42) subgroups according to preoperative symptoms. The chi-squared test and Cox regression were performed to analyze the outcomes.
Clinical and radiographic success rates were significantly higher in the pulpotomy group (98.9% and 95.5%) than in the pulpectomy group (88.1% and 54.8%) and did not differ significantly between asymptomatic and symptomatic pulpotomy subgroups.
Irreversible pulpitis of primary molars with coronal pulp tissue can be successfully treated with iRoot BP Plus pulpotomy. Early intraradicular resorption of materials is the main adverse outcome of Vitapex pulpectomy.
牙髓切断术已成功应用于患有不可复性牙髓炎的恒牙（包括未成熟恒牙和成熟恒牙），但在乳牙中很少应用。
评估iRoot BP Plus牙髓切断术和Vitapex根管充填术治疗患有不可复性牙髓炎的乳磨牙的疗效。
我们选取了99例年龄在3至7岁、被诊断为患有不可复性牙髓炎且伴有冠髓组织的患者的130颗乳磨牙，采用iRoot BP Plus牙髓切断术或Vitapex根管充填术进行治疗（中位随访期：18个月）。根据治疗方法将其分为牙髓切断术组（n = 88）和根管充填术组（n = 42）。牙髓切断术组根据术前症状进一步分为无症状亚组（n = 46）和有症状亚组（n = 42）。采用卡方检验和Cox回归分析疗效。
牙髓切断术组的临床成功率（98.9%）和影像学成功率（95.5%）显著高于根管充填术组（88.1%和54.8%），无症状和有症状牙髓切断术亚组之间无显著差异。
伴有冠髓组织的乳磨牙不可复性牙髓炎采用iRoot BP Plus牙髓切断术可成功治疗。Vitapex根管充填术的主要不良后果是根管内材料早期吸收。
