Department of Pediatric Dentistry, School of Dentistry, Shahed University, Tehran, Iran.
Department of Pediatric Dentistry, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
J Evid Based Dent Pract. 2023 Dec;23(4):101920. doi: 10.1016/j.jebdp.2023.101920. Epub 2023 Aug 26.
Pulpotomy is the most commonly performed treatment for asymptomatic primary molars with exposed dental pulp. This study aimed to assess the clinical /radiographic success of diode laser pulpotomy with mineral trioxide aggregate (MTA), calcium hydroxide (CH), and calcium-enriched mixture (CEM) cement as pulp capping agents.
This split-mouth randomized clinical trial was conducted initially on 34 children aged 3-8 years but 4 patients left the study before the first follow-up visit and the study was accomplished and analyzed with 30 cases. The patients had at least 3 first/second molars with deep caries that in radiographic evaluation revealed that they required pulpotomy. Following pulpotomy, the pulp stump was irradiated with diode laser (noncontact mode, 632 nm, 30 mW power) as photobiomodulation mode. Pulp tissue was then capped with MTA, CH, or CEM cement (n = 30 in each group). Reinforced zinc oxide eugenol was applied over the capping agent, and the teeth were restored with stainless steel crowns. Teeth were clinically/radiographically assessed at 6, 12, 18, and 36 months, after treatment. Data were analyzed by Cochran and McNemar tests.
All 30 patients showed up for clinical/radiographic follow-ups for up to 36 months. Regarding clinical outcomes, the 6-, 12-, 18-, and 36-month success rates of all experimental groups were nearly similar with no significant difference (p > .05). Regarding radiographic outcomes, the 6-month success rates were similar among the groups (p > .05); however, the 12-, 18-, and 36-month outcomes of CEM and MTA groups were similar but significantly superior to that of CH group (p < .05).
Diode laser irradiation and subsequent capping of pulp tissue with MTA or CEM cement can be employed for pulpotomy of primary molars.
活髓切断术是治疗有暴露牙髓的无症状恒前磨牙最常用的方法。本研究旨在评估二极管激光光动力疗法联合三氧化矿物聚合体(MTA)、氢氧化钙(CH)和钙加强型混合物(CEM)作为盖髓剂用于活髓切断术的临床/放射学成功率。
这是一项分口随机临床试验,最初纳入了 34 名 3-8 岁的儿童,但在第一次随访前有 4 名患者退出了研究,因此最终完成并分析了 30 例患者。这些患者至少有 3 颗第一/二恒磨牙有深龋,放射学评估显示需要进行活髓切断术。活髓切断术后,牙髓残端用二极管激光(非接触模式,632nm,30mW 功率)进行光动力治疗。然后用 MTA、CH 或 CEM 水泥(每组 30 例)覆盖牙髓组织。在盖髓剂上涂抹强化氧化锌丁香酚,并用不锈钢冠修复牙齿。治疗后分别在 6、12、18 和 36 个月时进行临床/放射学评估。采用 Cochran 和 McNemar 检验对数据进行分析。
所有 30 例患者均完成了长达 36 个月的临床/放射学随访。关于临床结果,所有实验组的 6、12、18 和 36 个月的成功率非常相似,无显著差异(p>.05)。关于放射学结果,各组的 6 个月成功率相似(p>.05);然而,CEM 和 MTA 组的 12、18 和 36 个月结果相似,但显著优于 CH 组(p<.05)。
二极管激光照射和随后用 MTA 或 CEM 水泥覆盖牙髓组织可用于第一恒磨牙的活髓切断术。