Mishra Sneh, Taneja Sonali, Bhalla Vidhi Kiran, Rathore Akshay
Private Practitioner, I.T.S Centre for Dental Studies and Research, Ghaziabad, Uttar Pradesh, India.
Department of Conservative Dentistry and Endodontics, I.T.S Centre for Dental Studies and Research, Ghaziabad, Uttar Pradesh, India.
J Conserv Dent Endod. 2024 Feb;27(2):205-213. doi: 10.4103/JCDE.JCDE_257_23. Epub 2024 Feb 8.
The study aimed to compare and evaluate the effect of biodentine (BD) alone, BD along with Lyophilised freeze dried platelet rich concentrate (LPC + BD), and BD along with low-level laser therapy (BD + LLLT) after pulpotomy in mature permanent molars with irreversible pulpitis.
The study was designed as a randomized, pragmatic, parallel, double-blinded clinical trial registered under the Clinical Trial Registry-India (CTRI/2020/02/023245). 120 permanent molars fulfilling the inclusion and exclusion criteria with symptoms of irreversible pulpitis were randomized after performing pulpotomy into three pulp capping groups: Group 1, BD; Group 2, lyophilized freeze-dried platelet-rich concentrate + BD (LPC + BD); and Group 3, Low level laser therapy + BD Group 3, LLLT + BD. The intergroup comparison was done using one-way analysis of variance followed by the Bonferroni test. The level of significance and confidence interval were 5% and 95%, respectively. Interobserver reliability was measured using Cohen's kappa analysis.
At 1 week, there was a significant difference (P < 0.005) observed in the mean postoperative pain levels between the three groups with Group 1 (BD) exhibiting the highest postoperative pain followed by Group 2 (LPC + BD) and least pain was exhibited by Group 3 (LLLT + BD). A similar pattern was observed regarding the analgesic intake with maximum frequency in Group 1 (BD) and least with Group 3 (LLLT + BD). No significant difference in success rates was reported among the groups.
Pulpotomy as a treatment option for mandibular molars with irreversible pulpitis has an acceptable clinical success rate; however, long-term overall success rate remains questionable. The outcomes of incorporating adjunctive modalities with BD are remarkable and show tremendous potential for continued development and research.
本研究旨在比较和评估在患有不可逆性牙髓炎的成熟恒牙中，单纯使用生物陶瓷（BD）、生物陶瓷联合冻干富血小板浓缩物（LPC + BD）以及生物陶瓷联合低强度激光治疗（BD + LLLT）进行牙髓切断术后的效果。
本研究设计为一项随机、实用、平行、双盲临床试验，已在印度临床试验注册中心（CTRI/2020/02/023245）注册。120颗符合纳入和排除标准且有不可逆性牙髓炎症状的恒牙在进行牙髓切断术后被随机分为三个盖髓组：第1组，BD；第2组，冻干富血小板浓缩物 + BD（LPC + BD）；第3组，低强度激光治疗 + BD（LLLT + BD）。组间比较采用单因素方差分析，随后进行Bonferroni检验。显著性水平和置信区间分别为5%和95%。采用Cohen's kappa分析测量观察者间的可靠性。
在1周时，观察到三组之间的平均术后疼痛水平存在显著差异（P < 0.005），第1组（BD）术后疼痛最高，其次是第2组（LPC + BD），第3组（LLLT + BD）疼痛最轻。在镇痛药物摄入方面也观察到类似模式，第1组（BD）频率最高，第3组（LLLT + BD）最低。各组之间的成功率没有显著差异。
牙髓切断术作为治疗下颌磨牙不可逆性牙髓炎的一种选择，具有可接受的临床成功率；然而，长期总体成功率仍值得怀疑。将辅助治疗方法与生物陶瓷相结合的效果显著，显示出持续发展和研究的巨大潜力。
