活髓切断术在成人不可复性牙髓炎中的疗效分析
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摘要
目的探讨活髓切断术在由龋病所致的成人不可复性牙髓炎中的临床作用。方法选择2014年1月至2015年12月安徽医科大学第一附属医院24例符合标准的牙髓炎患者,局部麻醉下使用牙科手机去尽患牙龋损,用生理盐水冲洗暴露牙髓直至牙髓停止出血,再使用三氧化物聚合体(MTA)作为盖髓剂,进而观察患者术后牙髓状况及X线片表现。结果经过活髓切断术后,符合要求的24例成人24颗恒磨牙不可复性牙髓炎中,21例患者活髓保存成功,活髓保存成功率较高,达到87.5%。结论与乳牙和年轻恒牙相比,活髓切断术在牙根发育完全的成人不可复性牙髓炎中也具有较高的临床使用价值。
Objective To investigate the clinical effects of the vital pulpotomy in adults with irreversible pulpitis caused by dental caries. Methods Twenty-four patients with dental pulpitis who met the standard in the First Affiliated Hospital of Anhui Medical University from January 2014 to December 2015 were treated with dental turbines to remove dental caries under local anesthesia,saline to rinse the exposed pulp until the pulp stop bleeding,and then trioxide polymer( MTA) as a pulp capping agent the dental pulp status and X-ray manifestations were then observed. Results Twenty-four adults with irreversible pulpitis of 24 permanent molars were observed. After the pulpotomy,the patients were followed up for 18 months. Vital pulps of 21 patients proved to be successfully preserved,and the survival rate of the pulp preservation was higher to 87. 5%. Conclusion Vital pulpotomy has great clinical value in adult irreversible pulpitis with complete root development compared with primary teeth and young permanent teeth.
Objective To investigate the clinical effects of the vital pulpotomy in adults with irreversible pulpitis caused by dental caries. Methods Twenty-four patients with dental pulpitis who met the standard in the First Affiliated Hospital of Anhui Medical University from January 2014 to December 2015 were treated with dental turbines to remove dental caries under local anesthesia,saline to rinse the exposed pulp until the pulp stop bleeding,and then trioxide polymer( MTA) as a pulp capping agent the dental pulp status and X-ray manifestations were then observed. Results Twenty-four adults with irreversible pulpitis of 24 permanent molars were observed. After the pulpotomy,the patients were followed up for 18 months. Vital pulps of 21 patients proved to be successfully preserved,and the survival rate of the pulp preservation was higher to 87. 5%. Conclusion Vital pulpotomy has great clinical value in adult irreversible pulpitis with complete root development compared with primary teeth and young permanent teeth.
引文
[1]石四箴.儿童口腔医学[M].4版.北京:人民卫生出版社,2014:146-151.
[2]FUKS AB.Vital pulp therapy with new materials for primary teeth:new directions and treatment perspectives[J].J Endod,2008,34(7 Suppl):18-24.
[3]WITHERSPOON DE.Vital pulp therapy with new materials:new directions and treatment perspectives—permanent teeth[J].Pediatr Dent,2008,30(3):220-224.
[4]ASGARY S,EGHBAL MJ,FAZLYAB M,et al.Five-year results of vital pulp therapy in permanent molars with irreversible pulpitis:a non-inferiority multicenter randomized clinical trial[J].Clin Oral Investig,2015,19(2):335-341.
[5]ASGARY S,EGHBAL MJ,GHODDUSI J.Two-year results of vital pulp therapy in permanent molars with irreversible pulpitis:an ongoing multicenter randomized clinical trial[J].Clin Oral Investig,2014,18(2):635-641.
[6]ASGARY S,EGHBAL MJ,FAZLYAB M,et al.Five-year results of vital pulp therapy in permanent molars with irreversible pulpitis:a non-inferiority multicenter randomized clinical trial[J].Clin Oral Investig,2015,19(2):335-341.
[7]ZANINI M,HENNEQUIN M,COUSSON PY.A review of criteria for the evaluation of pulpotomy outcomes in mature permanent teeth[J].J Endod,2016,42(8):1167-1174.
[8]AGUILAR P,LINSUWANONT P.Vital pulp therapy in vital permanent teeth with cariously exposed pulp:a systematic review[J].J Endod,2011,37(5):581-587.
[9]BARNGKGEI IH,HALBOUB ES,ALBONI RS.Pulpotomy of symptomatic permanent teeth with carious exposure using mineral trioxide aggregate[J].Iranian Endodontic Journal,2013,8(2):65-68.
[10]EGHBAL MJ,ASGARY S,BAGLUE RA,et al.MTA pulpotomy of human permanent molars with irreversible pulpitis[J].Australian Endodontic Journal,2009,35(1):4-8.
[11]CHUEH LH,CHIANG CP.Histology of Irreversible pulpitis premolars treated with mineral trioxide aggregate pulpotomy[J].Oper Dent,2010,35(3):370-374.
[12]MATSUO T,NAKANISHI T,SHIMIZU H,et al.A clinical study of direct pulp capping applied to carious-exposed pulps[J].J Endod,1996,22(10):551-556.
[13]ALQADERI HE,AL-MUTAWA SA,QUDEIMAT MA.MTA pulpotomy as an alternative to root canal treatment in children's permanent teeth in a dental public health setting[J].J Dent,2014,42(11):1390-1395.
[14]RICUCCI D,LOGHIN S,SIQUEIRAJF JR.Correlation between clinical and histologic pulp diagnoses[J].J Endod,2014,40(12):1932-1939.
[15]樊明文,周学东.牙髓病和根尖周病病因与发病机制[M]//牙体牙髓病学.4版.北京:人民卫生出版社,2013:177-185.
[16]孙玉亮,梁学萍,赵今.比较一次法与多次法根管治疗术治疗慢性牙髓炎、根尖周炎疗效的系统评价[J].牙体牙髓牙周病学杂志,2011,21(8):452-458.
[17]高学军,岳林.牙体牙髓病学[M].2版.北京:北京大学医学出版社,2015:340-341.
[18]KIRZIOGLU Z,GUNGOR OE,CIFTCI ZZ.Evaluation of the restoration success of endodontic therapy of the primary molars[J].Eur J Dent,2011,5(4):415-422.
[19]TRAIRATVORAKUL C,KOOTHIRATRAKARN A.Calcium hydroxide partial pulpotomy is an alternative to formocresol pulpotomy based on a 3-year randomized trial[J].Int J Paediatr Dent,2012,22(5):382-389.
[2]FUKS AB.Vital pulp therapy with new materials for primary teeth:new directions and treatment perspectives[J].J Endod,2008,34(7 Suppl):18-24.
[3]WITHERSPOON DE.Vital pulp therapy with new materials:new directions and treatment perspectives—permanent teeth[J].Pediatr Dent,2008,30(3):220-224.
[4]ASGARY S,EGHBAL MJ,FAZLYAB M,et al.Five-year results of vital pulp therapy in permanent molars with irreversible pulpitis:a non-inferiority multicenter randomized clinical trial[J].Clin Oral Investig,2015,19(2):335-341.
[5]ASGARY S,EGHBAL MJ,GHODDUSI J.Two-year results of vital pulp therapy in permanent molars with irreversible pulpitis:an ongoing multicenter randomized clinical trial[J].Clin Oral Investig,2014,18(2):635-641.
[6]ASGARY S,EGHBAL MJ,FAZLYAB M,et al.Five-year results of vital pulp therapy in permanent molars with irreversible pulpitis:a non-inferiority multicenter randomized clinical trial[J].Clin Oral Investig,2015,19(2):335-341.
[7]ZANINI M,HENNEQUIN M,COUSSON PY.A review of criteria for the evaluation of pulpotomy outcomes in mature permanent teeth[J].J Endod,2016,42(8):1167-1174.
[8]AGUILAR P,LINSUWANONT P.Vital pulp therapy in vital permanent teeth with cariously exposed pulp:a systematic review[J].J Endod,2011,37(5):581-587.
[9]BARNGKGEI IH,HALBOUB ES,ALBONI RS.Pulpotomy of symptomatic permanent teeth with carious exposure using mineral trioxide aggregate[J].Iranian Endodontic Journal,2013,8(2):65-68.
[10]EGHBAL MJ,ASGARY S,BAGLUE RA,et al.MTA pulpotomy of human permanent molars with irreversible pulpitis[J].Australian Endodontic Journal,2009,35(1):4-8.
[11]CHUEH LH,CHIANG CP.Histology of Irreversible pulpitis premolars treated with mineral trioxide aggregate pulpotomy[J].Oper Dent,2010,35(3):370-374.
[12]MATSUO T,NAKANISHI T,SHIMIZU H,et al.A clinical study of direct pulp capping applied to carious-exposed pulps[J].J Endod,1996,22(10):551-556.
[13]ALQADERI HE,AL-MUTAWA SA,QUDEIMAT MA.MTA pulpotomy as an alternative to root canal treatment in children's permanent teeth in a dental public health setting[J].J Dent,2014,42(11):1390-1395.
[14]RICUCCI D,LOGHIN S,SIQUEIRAJF JR.Correlation between clinical and histologic pulp diagnoses[J].J Endod,2014,40(12):1932-1939.
[15]樊明文,周学东.牙髓病和根尖周病病因与发病机制[M]//牙体牙髓病学.4版.北京:人民卫生出版社,2013:177-185.
[16]孙玉亮,梁学萍,赵今.比较一次法与多次法根管治疗术治疗慢性牙髓炎、根尖周炎疗效的系统评价[J].牙体牙髓牙周病学杂志,2011,21(8):452-458.
[17]高学军,岳林.牙体牙髓病学[M].2版.北京:北京大学医学出版社,2015:340-341.
[18]KIRZIOGLU Z,GUNGOR OE,CIFTCI ZZ.Evaluation of the restoration success of endodontic therapy of the primary molars[J].Eur J Dent,2011,5(4):415-422.
[19]TRAIRATVORAKUL C,KOOTHIRATRAKARN A.Calcium hydroxide partial pulpotomy is an alternative to formocresol pulpotomy based on a 3-year randomized trial[J].Int J Paediatr Dent,2012,22(5):382-389.