三氧化矿化物凝聚体用于深龋意外穿髓的疗效观察

Clinical Efficacy of Mineral Trioxide Aggregate(MTA) in Unexpected Pulp Exposure in Deep Caries

目的评价三氧化矿化物凝聚体(MTA)用于深龋意外穿髓时直接盖髓术的临床疗效。方法将38例患者(38颗牙)按随机数字表法分为MTA组和氢氧化钙糊剂组,每组19颗。先用2%利多卡因小棉球置于龋洞内表面麻醉,去尽腐质,备洞,生理盐水缓慢冲洗窝洞,隔湿。分别将MTA和氢氧化钙糊剂覆盖于暴露的牙髓上约1.0 mm厚,用小棉球吸取多余水分,然后用丁香油氧化锌糊剂暂封,观察15 d无症状后行永久充填。治疗后6个月和1年随访,观察盖髓后患牙症状、牙髓活力、X线片等的变化指标。结果所有患者术后均获6个月和1年的随访,MTA组19颗患牙16颗成功,成功率为84.2%。牙髓活力正常,X线片可见修复性牙本质形成;3颗失败。氢氧化钙糊剂组19颗患牙7颗成功,成功率为36.8%;12颗失败。2组疗效比较差异有统计学意义(P<0.05)。结论 MTA是用于成人恒牙直接盖髓术有效的盖髓剂。

Objective To evaluate the clinical efficacy direct pulp capping agent in unexpected pulp exposure in with accidental pulp exposure （38 patients） were randomly calcium hydroxide （calcium hydroxide, n = 19）. containing cotton ball into the pulp cavity. Then, of mineral trioxide aggregate deep caries. Methods Thirty （MTA） as a -eight teeth treated with MTA（MTA group, n=19） or Anesthesia was performed by placing 2% lidocaine- the cavity was rinsed with saline after detritus removal and cavity preparation. The exposed pulp was covered with calcium hydroxide and MTA at a thickness of 1 mm, respectively. Excess closed with zinc oxide eugenol water was absorbed with cotton balls. The cavities were temporarily cement, and were permanently filled after no symptoms were observed for 15 days. Symptoms, pulp vitality and X-ray results were observed 6 and 12 months after pulp capping. Results In MTA group, 16 teeth （84.2%）were successfully treated and showed normal pulp vitality and reparative dentin formation. In calcium hydroxide group, 7 teeth （36.8%） were treated successfully. There was a significant difference in the success rate between the two groups （P〈O.05）. is an effective pulp capping agent for carious exposed pulps.