Alovisi Mario, Baldi Andrea, Comba Allegra, Gamerro Roberta, Paolone Gaetano, Mandurino Mauro, Dioguardi Mario, Roggia Andrea, Scotti Nicola
Department of Surgical Sciences, Dental School, University of Turin, 10124 Turin, Italy.
Department of Dentistry, Dental School, IRCCS San Raffaele Hospital, Vita-Salute University, 20123 Milan, Italy.
J Clin Med. 2024 Jul 6;13(13):3962. doi: 10.3390/jcm13133962.
This retrospective clinical study aimed to assess dental pulp tissue reactions to direct and indirect pulp capping after 10 years of follow-up. A total of 276 permanent teeth with deep carious lesions were evaluated and divided into five groups: Group (1), direct pulp capping with Mineral Trioxide Aggregate cement; Group (2), direct pulp capping with a resin-based glass ionomer; Group (3), direct pulp capping with TheraCal; Group (4), indirect pulp capping with a three-step total-etch adhesive system; and Group (5), indirect pulp capping with a two-step self-etch adhesive system. A 72.5% success rate was achieved overall. A statistically significant difference was found when comparing direct and indirect pulp capping with a success rate of 23.8% and 93.8%, respectively. For direct pulp-capping procedures, the area of pulp exposure was correlated with pulp necrosis ( = 0.035), while bleeding after exposure appeared independent ( = 0.053). Patient age was significantly related to the maintenance of pulp vitality ( = 0.013). A statistically significant correlation between the pulp-capping material and the occurrence of pulp necrosis was discovered ( = 0.017). For the indirect pulp-capping treatments, a significant correlation between patient age ( = 0.021) and the adhesive system ( = 0.019) with pulp necrosis was described. The pulp-capping material, patient age, and the width of the pulp exposure before the procedure should be carefully considered when performing direct pulp-capping treatments. The performance of the etch-and-rinse adhesive systems was superior to the self-etch system during the indirect pulp-capping procedures.
这项回顾性临床研究旨在评估经过10年随访后，牙髓组织对直接盖髓术和间接盖髓术的反应。共评估了276颗患有深龋病变的恒牙，并将其分为五组：第1组，用三氧化矿物凝聚体水门汀进行直接盖髓；第2组，用树脂基玻璃离子体进行直接盖髓；第3组，用TheraCal进行直接盖髓；第4组，用三步全酸蚀粘结系统进行间接盖髓；第5组，用两步自酸蚀粘结系统进行间接盖髓。总体成功率为72.5%。直接盖髓术和间接盖髓术的成功率分别为23.8%和93.8%，比较时发现存在统计学上的显著差异。对于直接盖髓术，牙髓暴露面积与牙髓坏死相关（P = 0.035），而暴露后出血似乎无关（P = 0.053）。患者年龄与牙髓活力的维持显著相关（P = 0.013）。发现盖髓材料与牙髓坏死的发生之间存在统计学上的显著相关性（P = 0.017）。对于间接盖髓治疗，描述了患者年龄（P = 0.021）和粘结系统（P = 0.019）与牙髓坏死之间的显著相关性。在进行直接盖髓治疗时，应仔细考虑盖髓材料、患者年龄以及治疗前牙髓暴露的宽度。在间接盖髓过程中，酸蚀冲洗粘结系统的性能优于自酸蚀系统。
