State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China.
State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, Department of Pediatric Dentistry, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China.
PeerJ. 2024 Nov 12;12:e18453. doi: 10.7717/peerj.18453. eCollection 2024.
Pulpotomy is a widely recommended treatment for deep caries and reversible pulpitis in primary teeth. However, there is a significant lack of large-scale clinical studies evaluating the long-term efficacy of pulpotomy in primary molars, especially in studies with follow-up periods extending beyond a two years.
This study aimed to evaluate the long-term efficacy of mineral trioxide aggregate (MTA) and iRoot BP Plus for pulpotomy in primary molars performed under general anesthesia and to investigate factors influencing the success rate.
In this retrospective study, a total of 942 primary molars from 422 children who met the inclusion criteria underwent pulpotomy. Propensity score matching method (PSM) was used to match the MTA and iRoot BP Plus groups in a 1:1 ratio based on covariates. Efficacy was assessed using the Zurn & Seale criteria. Kaplan-Meier survival analysis and Cox proportional hazards model were performed to analyze the outcomes.
PSM resulted in 266 pairs of matched teeth from 532 teeth of 291 children (mean age: 4.64 ± 1.07 years, ranging from 2 to 8 years). Long-term clinical and radiographic evaluations revealed higher success rates for iRoot BP Plus (24-month: 99.54%/97.25%; 36-month: 97.22%/95.83%) compared to MTA (24-month: 94.76%/95.29%; 36-month: 92.50%/91.25%). Survival analysis indicated a statistically significant difference between two groups ( = 0.0042). Age, gender, tooth position, and decayed tooth surface showed no significant impact on pulpotomy success, whereas the choice of pulp capping materials significantly influenced the outcome (HR [95% CI]=0.3745[0.1857-0.7552], = 0.006).
Clinical and radiographic evaluations support the use of iRoot BP Plus for pulpotomy in primary molars.
活髓切断术是一种广泛推荐的治疗乳磨牙深龋和可复性牙髓炎的方法。然而，目前缺乏大规模的临床研究来评估活髓切断术在乳磨牙中的长期疗效，特别是在随访时间超过两年的研究中。
本研究旨在评估在全身麻醉下使用三氧化矿物凝聚体（MTA）和 iRoot BP Plus 进行乳磨牙活髓切断术的长期疗效，并探讨影响成功率的因素。
在这项回顾性研究中，共有 942 颗符合纳入标准的乳磨牙来自 422 名儿童，这些儿童接受了活髓切断术。采用倾向评分匹配法（PSM）按照协变量将 MTA 和 iRoot BP Plus 组以 1:1 的比例进行匹配。采用 Zurn & Seale 标准评估疗效。采用 Kaplan-Meier 生存分析和 Cox 比例风险模型分析结果。
PSM 后，从 291 名儿童的 532 颗牙齿中得到了 266 对匹配的牙齿（平均年龄：4.64 ± 1.07 岁，范围为 2-8 岁）。长期临床和影像学评估显示，iRoot BP Plus 的成功率更高（24 个月：99.54%/97.25%；36 个月：97.22%/95.83%），而 MTA 的成功率为（24 个月：94.76%/95.29%；36 个月：92.50%/91.25%）。生存分析显示两组之间存在统计学差异（=0.0042）。年龄、性别、牙齿位置和龋坏牙面均对活髓切断术的成功率无显著影响，而牙髓盖髓材料的选择显著影响治疗效果（HR [95% CI]=0.3745[0.1857-0.7552]，=0.006）。
临床和影像学评估支持使用 iRoot BP Plus 进行乳磨牙活髓切断术。
