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两种硅酸钙基材料对牙髓炎恒牙进行牙髓活力保存治疗的临床影响因素:一项随机临床试验

Clinical influencing factors of vital pulp therapy on pulpitis permanent teeth with 2 calcium silicate-based materials: A randomized clinical trial.

作者信息

Zhang Linlin, Yin Li, Wu Jianbo, Wang Xiaoyan, Huang Jiahui, Li Quanli

机构信息

Institute of Oral Science, Department of Stomatology, Longgang Otorhinolaryngology Hospital, Shenzhen, China.

出版信息

Medicine (Baltimore). 2024 May 3;103(18):e38015. doi: 10.1097/MD.0000000000038015.

Abstract

BACKGROUND

Compared with traditional root canal therapy (RCT), vital pulp therapy (VPT) is a personalized and minimally invasive method for the treatment of pulpitis caused by dental caries. However, there are still no clear guidelines for VPT because high-quality randomized clinical trials are scarce. This prospective cohort study evaluated the clinical efficacy of VPT with the light-curable calcium silicate-based material TheraCal LC (TH) and bioceramic material iRoot BP Plus (BP) in reversible and irreversible pulpitis permanent teeth with carious exposures.

METHODS

115 teeth with reversible or irreversible pulpitis caused by deep care were randomly divided into 2 groups. TheraCal LC and iRoot BP Plus were used for the pulp capping. Direct pulp capping (DPC), partial pulpotomy (PP) and full pulpotomy (FP) were performed based on observation of the exposed pulp. Postoperative discomforts were enquired and recorded via follow-up phone calls. Clinical and radiographic evaluations were performed 3, 6, and 12 months postoperatively.

RESULTS

The overall clinical success rate in the first year was 90.4% (47/52) in both groups. The TH group required less operating time, showed lower levels of pain, and had shorter pain duration post-operative (P < .001). According to the binary logistic regression model, preoperative pain duration was significantly correlated with the prognosis of VPT (P = .011).

CONCLUSION

VPT with TheraCal LC and iRoot BP Plus in pulpitis permanent carious teeth both achieved good clinical outcomes, and TheraCal LC can be easily operated for clinical use. Preoperative pain duration of the affected tooth might have a significant correlation with the prognosis of VPT.

摘要

背景

与传统根管治疗(RCT)相比,活髓治疗(VPT)是一种针对龋源性牙髓炎的个性化、微创治疗方法。然而,由于高质量的随机临床试验较少,VPT仍没有明确的指南。这项前瞻性队列研究评估了光固化硅酸钙基材料TheraCal LC(TH)和生物陶瓷材料iRoot BP Plus(BP)对有龋洞暴露的可逆性和不可逆性牙髓炎恒牙进行VPT的临床疗效。

方法

115颗由深龋引起的可逆性或不可逆性牙髓炎患牙被随机分为2组。采用TheraCal LC和iRoot BP Plus进行盖髓。根据暴露牙髓的情况进行直接盖髓(DPC)、部分牙髓切断术(PP)和完全牙髓切断术(FP)。通过随访电话询问并记录术后不适情况。术后3、6和12个月进行临床和影像学评估。

结果

两组第一年的总体临床成功率均为90.4%(47/52)。TH组所需手术时间更短,疼痛程度更低,术后疼痛持续时间更短(P < 0.001)。根据二元逻辑回归模型,术前疼痛持续时间与VPT的预后显著相关(P = 0.011)。

结论

用TheraCal LC和iRoot BP Plus对牙髓炎恒牙进行VPT均取得了良好的临床效果,且TheraCal LC在临床应用中操作简便。患牙术前疼痛持续时间可能与VPT的预后有显著相关性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5ffe/11062667/413c147392ea/medi-103-e38015-g001.jpg

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