不同生物材料盖髓剂在乳磨牙活髓切断术中的应用研究

Application of different biomaterial capping agents in pulpotomy of deciduous molars

目的:探讨生物盖髓剂矿物三氧化物聚合体(MTA)、氢氧化钙碘仿糊剂(CHI)、氢氧化钙(CH)在乳磨牙活髓切断术中的应用效果。方法:纳入96例拟行乳磨牙活髓切断术患儿,随机数字表法分组进行对比研究,MTA组、CHI组、CH组各32例,按相应分组应用盖髓剂,术后3、6、12个月定期进行临床、X线复查,统计两组治疗效果,牙根吸收程度。结果:MTA组、CHI组和CH组术后3个月总有效率分别为100%、96. 88%和96. 88%(P> 0. 05),术后6个月总有效率分别为90. 63%、93. 75%和78. 13%(P> 0. 05);术后12个月总有效率分别为87. 50%、84. 38%和59. 38%(P <0. 05)。3组术后3个月、术后6个月牙根吸收情况比较,无明显差异(P> 0. 05);术后12个月MTA组、CHI组和CH组无牙根吸收者分别为93. 75%、87.50%和50. 00%(P <0. 05)。轻、中、重度吸收在MTA组分别为3. 13%、3. 13%和0,在CHI组为9. 38%、3. 13%和0,在CH组为21. 88%、18. 75%和9. 38%(组间比较,P <0. 05)。结论:MTA、CHI应用于活髓切断术术后根内吸收不明显,均具有显著远期疗效,CH盖髓易发生根内吸收,导致手术失败。

Objective: To investigate the effects of biomaterial capping agents mineral trioxide polymer( MTA),calcium hydroxide iodoform paste( CHI) and calcium hydroxide( CH),in the pulpectomy of deciduous molars. Methods: 96 children undewent deciduous molar pulpectomy were included and divided into MTA,CHI and CH groups( n = 32),MTA,CHI and CH were respectively usd as capping agents for the 3 groups. The patients were regularly examined clinically and by X-ray at 3,6 and 12 months after surgery. Results: 3 months after treatment the total effective rate of MTA,CHI and CH groups was 100%,96. 88% and 96. 88% respectively( P> 0. 05),6 months after operation 90. 63%,93. 75% and 78. 13% respectively( P > 0. 05),12 months after operation. 87. 50%,84. 38% and 59. 38% respectively( P < 0. 05). There was no significant difference in root resorption between the 3 groups at 3 months and 6 months after surgery( P > 0. 05). 12 months after operation,the non-root resorption rate of MTA,CHI and CH group was 93.75%,87. 50% and 50. 00% respectively( P < 0. 05). The mild root resorption rate of group MTA,CHI and CH was 3. 13%,9. 38%and 21. 88%;the moderat resorption 3. 13%,3. 13% and 18. 75%;the severe resorption 0,0 and 9. 38,respectively. Conclusion:MTA and CHI used as capping agents are effective in pulpotomy,CH is prone to root absorption,which leads to treatment failure.