北京大学学报(医学版) ›› 2022, Vol. 54 ›› Issue (6): 1196-1201. doi: 10.19723/j.issn.1671-167X.2022.06.023
Shuang WANG,Chu-fang PENG,He LIU*()
摘要:
目的: 对新型生物陶瓷材料iRoot BP Plus和三氧化矿物凝聚体(mineral trioxide aggregate, MTA)作为盖髓剂应用于乳磨牙牙髓切断术的疗效进行评价,比较两者成功率,并分析影响因素。方法: 通过检索北京大学口腔医院电子病历数据库,筛选2017年1月至2018年12月期间于北京大学口腔医院儿童口腔科门诊就诊、有乳磨牙诊断为慢性牙髓炎、行牙髓切断术的患儿,选择符合纳入标准且盖髓剂为iRoot BP Plus或MTA的患牙,盖髓剂为iRoot BP Plus的患牙全部纳入实验组(iRoot BP Plus组),使用倾向评分匹配法选择性别、年龄、牙位、医生级别、牙髓状态、冠部修复方式和随访时长作为协变量进行1 ∶ 1匹配盖髓剂为MTA的患牙纳入对照组(MTA组)。收集各组患牙治疗前自觉症状、临床检查、影像学表现、治疗情况、随访情况,比较两组治疗成功率,并分别分析影响因素。结果: 共纳入132例患儿,178颗患牙,每组各89颗,平均随访时间(462±99) d,截止至2019年12月,iRoot BP Plus组和MTA组成功率分别为89.9%、93.3%,iRoot BP Plus组成功率稍低于MTA组,差异无统计学意义。通过Cox比例风险模型进行分析发现,牙髓状态的好坏显著影响iRoot BP Plus组的治疗成功率,而年龄、牙位、医生级别、冠部修复方式对成功率均无显著影响。结论: iRoot BP Plus作为盖髓剂应用于乳磨牙牙髓切断术可以取得与MTA相似的治疗效果,牙髓状态是影响治疗效果的主要因素,其远期疗效及影响因素仍需进行更大样本、更长随访时间的研究。
中图分类号:
1 | Fuks AB . Current concepts in vital primary pulp therapy[J]. Eur J Paediatr Dent, 2002, 3 (3): 115- 120. |
2 |
Subramaniam P , Konde S , Mathew S , et al. Mineral trioxide aggregate as pulp capping agent for primary teeth pulpotomy: 2 year follow up study[J]. J Clin Pediatr Dent, 2009, 33 (4): 311- 314.
doi: 10.17796/jcpd.33.4.r83r38423x58h38w |
3 |
Tani-Ishii N , Hamada N , Watanabe K , et al. Expression of bone extracellular matrix proteins on osteoblast cells in the presence of mineral trioxide[J]. J Endod, 2007, 33 (7): 836- 839.
doi: 10.1016/j.joen.2007.02.003 |
4 |
Moghaddame-Jafari S , Mantellini MG , Botero TM , et al. Effect of ProRoot MTA on pulp cell apoptosis and proliferation in vitro[J]. J Endod, 2005, 31 (5): 387- 391.
doi: 10.1097/01.don.0000145423.89539.d7 |
5 |
Alsubait S , Al-Haidar S , Al-Sharyan N . A comparison of the discoloration potential for endosequence bioceramic root repair material fast set putty and ProRoot MTA in human teeth: An in vitro study[J]. J Esthet Restor Dent, 2017, 29 (1): 59- 67.
doi: 10.1111/jerd.12264 |
6 |
Moinzadeh AT , Portoles CA , Wismayer PS , et al. Bioactivity potential of endo sequence BCRRM putty[J]. J Endod, 2016, 42 (4): 615- 621.
doi: 10.1016/j.joen.2015.12.004 |
7 |
Rifaey HS , Villa M , Zhu Q , et al. Comparison of the osteogenic potential of mineral trioxide aggregate and endosequence root repair material in a 3-dimensional culture system[J]. J Endod, 2016, 42 (5): 760- 765.
doi: 10.1016/j.joen.2016.02.001 |
8 |
Shokouhinejad N , Nekoofar MH , Razmi H , et al. Bioactivity of endosequence root repair material and Bioaggregate[J]. Int Endod J, 2012, 45 (12): 1127- 1134.
doi: 10.1111/j.1365-2591.2012.02083.x |
9 | Carvalho CN . Effect of root repair materials and bioactive glasses on microhardness of dentin[J]. Iran Endod J, 2018, 13 (3): 337- 341. |
10 | Caliendo M , Kopeinig S . Some practical guidance for the implementation of propensity score matching[J]. J Econ Surv, 2005, 22 (1): 31- 72. |
11 |
Taha NA , Safadi RA , Alwedaie MS . Biocompatibility evaluation of EndoSequence root repair paste in the connective tissue of rats[J]. J Endod, 2016, 42 (10): 1523- 1528.
doi: 10.1016/j.joen.2016.07.017 |
12 |
Zhang J , Zhu LX , Cheng X , et al. Promotion of dental pulp cell migration and pulp repair by a bioceramic putty involving FGFR-mediated signaling pathways[J]. J Dent Res, 2015, 94 (6): 853- 862.
doi: 10.1177/0022034515572020 |
13 |
Zhang S , Yang X , Fan M . BioAggregate and iRoot BP Plus optimize the proliferation and mineralization ability of human dental pulp cells[J]. Int Endod J, 2013, 46 (10): 923- 929.
doi: 10.1111/iej.12082 |
14 |
Öncel TZ , Torun D , Demirkaya K , et al. Effects of iRoot BP and white mineral trioxide aggregate on cell viability and the expression of genes associated with mineralization[J]. Int Endod J, 2015, 48 (10): 986- 993.
doi: 10.1111/iej.12393 |
15 |
Liu S , Wang S , Dong Y . Evaluation of a bioceramic as a pulp capping agent in vitro and in vivo[J]. J Endod, 2015, 41 (5): 652- 657.
doi: 10.1016/j.joen.2014.12.009 |
16 | 雷玥, 杨颖婷, 战园. 生物陶瓷材料在乳牙牙髓切断术中的应用[J]. 北京大学学报(医学版), 2019, 51 (1): 70- 74. |
17 | Matthias Z , Nicolas D , Yunling D , et al. Cytokine gene expression: Part of host defence in pulpitis[J]. Cytokine, 2003, 22 (3): 84- 88. |
18 |
Wang Z , Ma J , Shen Y , et al. Acidic pH weakens the microhardness and microstructure of three tricalcium silicate materials[J]. Int Endod J, 2015, 48 (4): 323- 332.
doi: 10.1111/iej.12318 |
19 |
Hansen SW , Marshall JG , Sedgley CM . Comparison of intracanal EndoSequence root repair material and ProRoot MTA to induce pH changes in simulated root resorption defects over 4 weeks in matched pairs of human teeth[J]. J Endod, 2011, 37 (4): 502- 506.
doi: 10.1016/j.joen.2011.01.010 |
20 |
Asgary S , Eghbal MJ . Treatment outcomes of pulpotomy in permanent molars with irreversible pulpitis using biomaterials: A multi-center randomized controlled trial[J]. Acta Odontol Scand, 2013, 71 (1): 130- 136.
doi: 10.3109/00016357.2011.654251 |
21 | Holan G , Fuks AB , Ketlz N . Success rate of formocresol pulpotomy in primary molars restored with stainless steel crown vs. amalga[J]. Pediatr Dent, 2002, 24 (3): 212- 216. |
22 | Soxman JA . Stainless steel crown and pulpotomy: procedure and technique for primary molars[J]. Gen Dent, 2000, 48 (3): 294- 297. |
23 | Dhar V , Marghalani AA , Crystal YO . Use of vital pulp therapies in primary teeth with deep caries lesions[J]. Pediatr Dent, 2017, 39 (5): 146- 159. |
24 | Ibricevic H , Al-Jame Q . Ferric sulfate as pulpotomy agent in primary teeth: Twenty month clinical follow-up[J]. J Clin Pediatr Dent, 2000, 24 (4): 269- 272. |
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