Frankenberger Roland, Koch Andreas, Plohmann Lina, Beck-Broichsitter Benedicta, Becker Stephan
Department of Operative Dentistry, Endodontics, and Pediatric Dentistry, Medical Center for Dentistry, University Medical Center Giessen and Marburg, Georg-Voigt-Str. 3, D-35039 Marburg, Germany.
Zahnarztpraxis Sommer, Hauptstraße 67, 23898 Sandesneben, Germany.
Dent J (Basel). 2025 Apr 22;13(5):182. doi: 10.3390/dj13050182.
(1) The aim of this in vitro study was to evaluate the success of indirect pulp capping (IPC) procedures over a period of 40 years. (2) The investigation of 1412 dental records included 159 patients with 366 IPC teeth having been treated from 1969 to 1980. The teeth revealed caries within the inner third of dentin, were symptom-free, and showed no pulp exposure. The caries were excavated thoroughly and teeth with accidentally exposed pulp were excluded. Zinc-oxide-eugenol was used for the IPC procedures. The posterior teeth were restored with amalgam, and the anterior teeth received direct resin composite fillings. The gathered parameters with possible influences on survival rates were age, gender, tooth locations/positions, dates of vital therapy, the number of filled surfaces, types of primary restoration material, successional treatments on each tooth, and the last dates of surveillance. Data collection and statistical analysis were performed using Excel sheets and DataTab. Significant differences among groups were computed by cox regression analysis and the significance level was set at = 0.05. Kaplan-Meier curves were utilized to illustrate the survival rates. (3) Treatment success was measured by the maintenance of vitality beyond 365 days. The loss of vitality within 365 days was determined as treatment failure. Treatment outcomes were assessed after different time periods (1 and 6 months; 1, 2, 5, 10, 20, and 40 years). Pulp vitality dropped from 95% after 3 months to 32% after 40 years. Cavity size had a significant influence on the survival of pulp, but tooth position did not; however, third molars at least initially showed a better outcome. Beyond the 1-year recall, no differences for the evaluated parameters were present. (4) IPC showed excellent long-term success rates, revealing a 1.7% annual failure rate after 40 years of clinical service. Larger defects suffer more pulp damage in the long run.
(1) 这项体外研究的目的是评估间接盖髓术（IPC）在40年期间的成功率。(2) 对1412份牙科记录的调查包括159名患者，他们在1969年至1980年期间接受了366颗IPC牙齿的治疗。这些牙齿在牙本质内三分之一处有龋坏，无症状，且未暴露牙髓。龋坏被彻底去除，意外暴露牙髓的牙齿被排除。IPC手术使用氧化锌丁香油。后牙用银汞合金修复，前牙采用直接树脂复合材料充填。收集可能影响生存率的参数包括年龄、性别、牙齿位置/部位、重要治疗日期、充填面数量、初次修复材料类型、每颗牙齿的后续治疗以及最后一次随访日期。使用Excel表格和DataTab进行数据收集和统计分析。通过Cox回归分析计算组间的显著差异，显著性水平设定为α = 0.05。采用Kaplan-Meier曲线来说明生存率。(3) 治疗成功的衡量标准是牙髓活力维持超过365天。365天内牙髓活力丧失被判定为治疗失败。在不同时间段（1个月和6个月；1年、2年、5年、10年、20年和40年）评估治疗结果。牙髓活力从3个月后的95%下降到40年后的32%。洞腔大小对牙髓的存活有显著影响，但牙齿位置没有；然而，第三磨牙至少在最初显示出较好的结果。在1年的随访之后，所评估的参数没有差异。(4) IPC显示出优异的长期成功率，在40年的临床服务后年失败率为1.7%。从长远来看，较大的缺损对牙髓的损害更大。
