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北京大学学报（医学版） ›› 2022, Vol. 54 ›› Issue (1): 113-118. doi: 10.19723/j.issn.1671-167X.2022.01.018

• 论著 • 上一篇    下一篇

两种硅酸钙类材料用于成熟恒牙牙髓切断术的临床效果

钱锟,潘洁,朱文昊,赵晓一,刘畅,雍颹()   

  1. 北京大学口腔医学院·口腔医院综合科,国家口腔医学中心,国家口腔疾病临床医学研究中心,口腔数字化医疗技术和材料国家工程实验室,口腔数字医学北京市重点实验室,国家卫生健康委员会口腔医学计算机应用工程技术研究中心,国家药品监督管理局口腔生物材料重点实验室,北京 100081
  • 收稿日期:2021-09-13 出版日期:2022-02-18 发布日期:2022-02-21
  • 通讯作者: 雍颹 E-mail:yongwei1004@sina.com
  • 基金资助:
    北京大学口腔医院临床新技术新疗法项目(PKUSSNCT-17A14)

Evaluation of bioceramic putty repairmen iRoot and mineral trioxide aggregate in mature permanent teeth pulpotomy

QIAN Kun,PAN Jie,ZHU Wen-hao,ZHAO Xiao-yi,LIU Chang,YONG Wei()   

  1. Department of General Dentistry, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology & NHC Research Center of Engineering and Technology for Computerized Dentistry & NMPA Key Laboratory for Dental Materials, Beijing 100081, China
  • Received:2021-09-13 Online:2022-02-18 Published:2022-02-21
  • Contact: Wei YONG E-mail:yongwei1004@sina.com
  • Supported by:
    New Clinical Technology Program of Peking University Hospital and Stomatology(PKUSSNCT-17A14)

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摘要：

目的: 评价两种硅酸钙类材料——生物陶瓷材料iRoot和三氧化矿物凝聚体(mineral trioxide aggregate, MTA)在成熟恒牙牙髓切断治疗中的应用效果。方法: 选择2017 年 11月至2019 年9 月在北京大学口腔医院综合科就诊患者,对龋源性露髓的成熟恒前磨牙、磨牙行牙髓切断术,随机分组,使用iRoot(iRoot组,n=22)和MTA(MTA组,n=21)作为盖髓剂,并分别于术后3、6、12个月通过临床检查(温度测试和电活力测试)及影像学检查评价临床疗效。对患者、评价者采用盲法,但由于两种盖髓剂性状有明显差异,因此对实施治疗者(接诊医师)未能采用盲法。结果: 两组患者的性别、平均年龄、牙列及牙位分布差异均无统计学意义(P>0.05)。术后12个月随访时失访7例(iRoot组4例,MTA组3例)。两组各有1例在3个月复查时出现一过性敏感,而在6个月复查时牙髓活力正常。iRoot组有1例在12个月复查时出现一过性敏感。两组12个月随访时的成功率均为100%,治愈率分别为94.4%(iRoot组)及100%(MTA组), 差异无统计学意义(P>0.05)。iRoot组无病例发生明显的牙冠变色,而MTA组有3例患牙出现明显牙冠变色。结论: 12个月观察期内, iRoot用于成熟恒牙活髓保存治疗取得与MTA相似的令人满意的临床效果;iRoot不易造成治疗后牙齿变色且操作便利,因此拥有更好的临床应用前景。

关键词: 牙髓切断术, 成熟恒牙, 生物陶瓷材料, 三氧化矿物凝聚体

Abstract:

Objective: To evaluate the clinical characteristics and effectiveness of pulpotomy in mature permanent teeth with bioceramic putty repairmen iRoot and mineral trioxide aggregate (MTA). Methods: Pulpotomy was performed on mature permanent premolars and molars with carious exposures at the Department of General Dentistry of Peking University School and Hospital of Stomatology,from November 2017 to September 2019. The patients were randomly divided into 2 groups, Group iRoot (n=22) and Group MTA (n=21). In Group iRoot, bioceramic putty repairmen iRoot was used as pulp capping agent, while in Group MTA, mineral trioxide aggregate was used as pulp capping agent. All the patients had signed informed consent forms. The clinical efficacy was evaluated by clinical examinations (temperature and electrical activity test) and imaging examinations 3, 6, and 12 months after surgery. Blinding was used for the patients and evaluators, but due to the obvious differences in the properties of the two pulp capping agents, the blinding method was not used for the treatment provider (the attending physician). Results: There was no significant difference in gender, average age, dentition and tooth position distribution between the two groups (P>0.05). In the study, 7 cases were lost to follow-up 12 months after operation (4 cases in Group iRoot, and 3 cases in Group MTA). One case in each of the two groups had transient sensitivity at the end of the 3-month follow-up, and the pulp vitality was normal at the end of the 6-month follow-up. One case in Group iRoot showed sensitivity at the end of the 12-month follow-up. The success rates of the two groups at the end of 12-month follow-up were 100%, and the cure rates were 94.4% (Group iRoot) and 100% (Group MTA), respectively, and the difference was not statistically significant (P>0.05). No cases in Group iRoot had obvious crown discoloration, while 3 cases in Group MTA had. Conclusion: The clinical characteristics and effectiveness of pulpotomy in mature permanent teeth with bioceramic putty repairmen iRoot were similar with MTA. Bioceramic putty repairmen iRoot is an acceptable material when used in pulpotomy of mature permanent teeth. Because it is not easy to cause tooth discoloration after treatment and is convenient to operate, bioceramic putty repairmen iRoot has a better clinical application prospect.

Key words: Pulpotomy, Mature permanent teeth, Bioceramic putty repairmen, Mineral trioxide aggregate

中图分类号: 

  • R781.3

表1

入组病例基本资料"

Items Group iRoot (n=22) Group MTA (n= 21) t/χ2 P value
Gender, n
Male 6 7 0.187 0.665
Female 16 14
Average age/years, M(Min, Max) 30.7 (16, 59) 30.4 (21, 55) 0.093 0.926
Jaw, n
Upper 16 12 1.149 0.284
Lower 6 9
Tooth position, n
Premolar 9 6 0.72 0.396
Molar 13 15

图1

iRoot组典型病例:右侧上颌第一磨牙牙髓切断术术前及术后随访X线片"

图2

三氧化矿物凝聚体组典型病例:左侧上颌第一磨牙牙髓切断术术前及术后随访X线片"

图3

左侧下颌第一磨牙牙髓切断术术后6个月随访典型病例临床照片"

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