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部分活髓切断术后的结果:前瞻性临床 MMP-9 研究的长期结果。

Outcome after Partial Pulpotomy: Long-term Results of the Prospective Clinical MMP-9 Study.

出版信息

Oral Health Prev Dent. 2023 Sep 27;21:331-338. doi: 10.3290/j.ohpd.b4438901.

Abstract

PURPOSE

While the objective of partial pulpotomy is to preserve the vitality and function of the pulp tissue, the preopera-tive pulp status is the main prognostic factor for its success. To date, however, there is little data on long-term success rates. Therefore, the aim of this prospective pilot study was to assess the long-term outcome of partial pulpotomy in per-manent teeth after carious pulp exposure without signs or symptoms of irreversible pulpitis, verified clinically, radio-graphically, and via MMP-9 levels.

MATERIALS AND METHODS

Patients in whom permanent teeth with extremely deep carious lesions were diagnosed as com-pletely asymptomatic (n = 8) or with signs of reversible pulpitis (n = 10) underwent non-selective caries removal followed by a blood test to assess the level of MMP-9. The teeth were thereafter partially pulpotomised, MTA-capped, and immedi-ately restored with composite resin. Follow-up examinations were performed by endodontically experienced examiners focusing on clinical and radiographic assessment.

RESULTS

One patient could not be contacted and was lost to follow-up. Overall, the follow-up period ranged from 2-8 years (mean = 4.4 years). The majority of teeth remained functional and without pathology; one tooth was classified as having failed because of a vertical root fracture. There was no statistically significant difference in the groups' success rate (p = 0.3). The estimated overall survival rate was 94.1% (95% CI: 0.84-1.00) after 4 years according to the Kaplan-Meier method.

CONCLUSION

Pulp vitality in permanent teeth can be preserved with high success rates by means of partial pulpotomy after carious pulp exposure in asymptomatic teeth or in teeth with reversible pulpitis.

摘要

目的

虽然部分活髓切断术的目的是保留牙髓组织的活力和功能,但术前牙髓状态是其成功的主要预后因素。然而,迄今为止,关于长期成功率的数据很少。因此,本前瞻性初步研究旨在评估在无不可逆性牙髓炎的临床、放射学和 MMP-9 水平证实的龋暴露后恒牙行部分活髓切断术的长期疗效。

材料和方法

诊断为完全无症状(n=8)或有可逆性牙髓炎症状(n=10)的恒牙极深龋患者行非选择性龋损去除,随后进行血液检查以评估 MMP-9 水平。然后对牙齿进行部分活髓切断术,用 MTA 覆盖,并立即用复合树脂修复。由牙髓经验丰富的检查者进行随访检查,重点进行临床和放射学评估。

结果

有 1 名患者无法联系,随访丢失。总体而言,随访时间为 2-8 年(平均 4.4 年)。大多数牙齿保持功能正常,无病理变化;1 颗牙齿因垂直根折而被归类为失败。两组的成功率(p=0.3)无统计学差异。根据 Kaplan-Meier 方法,4 年后总体生存率估计为 94.1%(95%CI:0.84-1.00)。

结论

在无症状牙齿或有可逆性牙髓炎的牙齿中,通过龋暴露后行部分活髓切断术可以保留恒牙牙髓活力,成功率较高。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/16f3/11619879/ad23e531653a/ohpd-21-331-g001.jpg

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