三种生物盖髓材料在乳磨牙活髓切断术中的应用及其对患牙存活时间的影响

The Application of Three Kinds of Biological Pulp Capping Materials in Pulpotomy of Deciduous Molars and its Effect on the Survival Time of Teeth

目的探讨三种生物盖髓材料在乳磨牙活髓切断术中的应用疗效及其对患牙生存时间的影响。方法选择海南省定安县人民医院2014年1月—2019年1月在海南省定安县人民医院接受治疗的80例(93颗龋齿)患儿,所有龋齿均行活髓切断术治疗,根据盖髓材料的不同,随机分为MTA组31颗、CHI组31颗和CH组31颗,所有患儿治疗后每3个月进行一次随访,总随访时间为18个月,观察记录三组的治疗疗效、牙根吸收程度及患牙存活时间。结果三组患儿术后3个月、6个月的治疗有效率及牙根吸收程度差异均无统计学意义(P>0.05),而术后12个月、18个月治疗有效率及牙根吸收程度差异有统计学意义(P<0.05),MTA组和CHI组治疗有效率均显著高于CH组(P<0.05),MTA组和CHI组牙根吸收程度显著优于CH组(P<0.05),MTA、CHC、CH组患牙18个月存活率分别为80.6%、77.4%、45.2%,MTA组和CHC组患牙术后存活时间均显著高于CH组,差异均有统计学意义(P<0.05),而MTA组和CHC组患牙术后存活时间差异无统计学意义(P>0.05)。结论MTA和CHI用于活髓切除术均具有显著的临床疗效,术后牙根吸收不明显,且患牙存活时间较长,值得临床推广使用,而CH容易产生牙根吸收,手术疗效较差,术后患牙存活时间较短,因此临床不建议使用。

Objective To investigate the effect of three kinds of biological pulp capping materials in pulpotomy of deciduous molars and its influence on the survival time of the teeth.Methods From January 2014 to January 2019,80 children(93 caries)who were treated in Ding'an County People's Hospital were randomly divided into three groups:MTA group(31 teeth),chi group(31 teeth)and CH group(31 teeth).All children were followed up every 3 months after treatment.The total follow-up time was 18 months.The therapeutic effect and root absorption process of the three groups,degree and survival time of teethwere observed and recorded.Results There was no significant difference in the treatment efficiency and root resorption between the three groups at 3 and 6 months(P>0.05),but there was significant differencein the treatment efficiency and root resorption between the MTA group and the chi group at 12 and 18 months(P<0.05).The treatment efficiency of the MTA group and the chi group was significantly higher than that of the CH group(P<0.05).The root resorption of the MTA group and the chi group was significantly better than that of the CH group(P<0.05).The 18 month survival rate of teeth was 80.6%,77.4%and 45.2%respectively.The survival time of teeth in MTA group and CHC group was significantly higher than that in CH group(P<0.05),but there was no significant difference between MTA group and CHC group(P>0.05).MTA and Chi have significant clinical effect in the treatment of pulpectomy.Conclusion The root resorption is not obvious after the operation,and the survival time of the affected teeth is long,which is worthy of clinical application.Ch is easy to produce root resorption,with poor surgical effect,and the survival time of the affected teeth is short,so it is not recommended for clinical use.