使用2.25%次氯酸钠凝胶进行乳磨牙牙髓切断术的治疗效果：一项随机对照试验
Treatment outcomes of pulpotomy in primary molars utilizing 2.25% sodium hypochlorite gel: a randomized controlled trial.
作者信息
Karkoutly Mawia, Alnour Amirah, Abu Hasna Amjad, Nam Ok Hyung, Al Kurdi Saleh, Bshara Nada
机构信息
Department of Pediatric Dentistry, Faculty of Dentistry, Damascus University, Damascus, Syrian Arab Republic.
Department of Pediatric Dentistry, Damascus University, Damascus, Syrian Arab Republic.
出版信息
BMC Oral Health. 2025 Jul 2;25(1):1052. doi: 10.1186/s12903-025-06438-9.
BACKGROUND
Sodium hypochlorite (NaOCl) gel can be a potential substitute in daily pediatric dentistry practice. Given its high antimicrobial efficacy, NaOCl gel is expected to induce healing and improve pulpotomy treatment outcomes. This study aimed to perform a histological, clinical, and radiographical evaluation of pulpotomy in human primary molars utilizing 2.25% (NaOCl) gel as a medicament, followed by white mineral trioxide aggregate (WMTA) as a base material.
MATERIALS AND METHODS
A randomized, second-blinded, split-mouth clinical trial was conducted in cooperative patients aged 8-10 years with 48 carious first primary molars, which were treated by: (I) NaOCl gel group: following hemostasis, teeth were pulpotomized utilizing 2.25% NaOCl gel, and then WMTA paste was applied as a dressing material, and (II) control group: following hemostasis, WMTA paste was applied as a dressing material. Later, each group was sub-divided into three sub-groups (n = 8) according to the time planned for serial extraction: (I) 7 days, (II) 30 days, and (III) 90 days for histological evaluation. In addition, 40 s primary molars in cooperative patients aged 5-10 years indicated for pulpotomy were randomly allocated into two groups for clinical and radiographical evaluation at 3, 6, and 12 months follow-up. Data were analyzed by applying the chi-square test (p < 0.05).
RESULTS
NaOCl gel improved odontoblastic integrity and dentin bridge formation (p < 0.001) without increasing pulp necrosis or calcifications. The NaOCl gel group showed a 90% clinical and radiographical success rate at 3, 6, and 12 months of follow-up. In the control group, the clinical success rate was 85% after 3, 6, and 12 months, whereas the radiographical success rate was 100% at 3 months and decreased to 85% after 6 and 12 months.
CONCLUSIONS
Utilizing 2.25% NaOCl gel as a medicament in human primary molars pulpotomy improved the treatment outcomes of the WMTA.
TRIAL REGISTRATION
ISRCTN registry, ISRCTN15908457, registered 22 July 2024.
背景
次氯酸钠（NaOCl）凝胶可能成为儿童日常牙科治疗中的一种潜在替代物。鉴于其高抗菌功效，预计NaOCl凝胶可促进愈合并改善牙髓切断术的治疗效果。本研究旨在对使用2.25%（NaOCl）凝胶作为药物、随后使用白色矿物三氧化物聚合体（WMTA）作为基底材料的人类乳磨牙牙髓切断术进行组织学、临床和影像学评估。
材料与方法
对8至10岁合作患者的48颗龋坏第一乳磨牙进行了一项随机、双盲、分口临床试验，治疗方法如下：（I）NaOCl凝胶组：止血后，使用2.25% NaOCl凝胶对牙齿进行牙髓切断术，然后应用WMTA糊剂作为敷料材料；（II）对照组：止血后，应用WMTA糊剂作为敷料材料。之后，根据计划的序列拔牙时间，每组再分为三个亚组（n = 8）：（I）7天，（II）30天，（III）90天用于组织学评估。此外，将5至10岁合作患者中40颗拟行牙髓切断术的乳磨牙随机分为两组，在3、6和12个月随访时进行临床和影像学评估。数据采用卡方检验进行分析（p < 0.05）。
结果
NaOCl凝胶改善了成牙本质细胞的完整性和牙本质桥的形成（p < 0.001），且未增加牙髓坏死或钙化。NaOCl凝胶组在3、6和12个月随访时的临床和影像学成功率为90%。在对照组中，3、6和12个月后的临床成功率为85%，而3个月时的影像学成功率为100%，6个月和12个月后降至85%。
结论
在人类乳磨牙牙髓切断术中使用2.25% NaOCl凝胶作为药物可改善WMTA的治疗效果。
试验注册
ISRCTN注册库，ISRCTN15908457，于2024年7月22日注册。
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