可吸收明胶海绵支架联合三氧化矿物凝聚体与氢氧化钙覆盖诱导体内牙髓再生的疗效比较

Comparison of Pulp Regeneration with Absorbable Gelatin Sponge Stent Combined MTA and Calcium Hydroxide Cover

目的比较可吸收明胶海绵支架联合三氧化矿物凝聚体(MTA)与氢氧化钙覆盖诱导体内牙髓再生的疗效。方法选取重庆三峡中心医院收治的122例(130颗患牙)不可复性牙髓炎患者,采用随机数字表法将其分为观察组61例(66颗患牙)和对照组61例(64颗患牙)。其中观察组采用可吸收明胶海绵支架联合MTA封闭治疗,对照组采用氢氧化钙覆盖治疗,经3个月随访,观察比较两组患者的治疗效果、牙龈活力变化情况。结果术后1周,观察组总的初步成功率为50.0%(33/66),明显高于对照组[12.5%(8/64)],差异有统计学意义(P<0.01);其中观察组急性牙髓炎、慢性闭锁性牙髓炎成功率均高于对照组,差异有统计学意义(P<0.01)。术后1个月,观察组总的阶段成功率为62.1%(41/66),明显高于对照组[18.8%(12/64)],差异有统计学意义(P<0.01);其中观察组急性牙髓炎、慢性闭锁性牙髓炎、慢性增生性牙髓炎成功率均高于对照组,差异有统计学意义(P<0.05)。术后3个月,观察组总的最终成功率为66.7%(44/66),明显高于对照组[21.9%(14/64)],差异有统计学意义(P<0.01);且观察组各型牙髓炎成功率均高于对照组,差异有统计学意义(P<0.05)。结论可吸收明胶海绵支架联合MTA可有效诱导体内牙髓再生,对各型不可复性牙髓炎均有较好的效果,值得推广应用于临床。

Objective To compare the efficacy of pulp regeneration induced by absorbable gelatin sponge stent combined mineral trioxide aggregate（MTA） and calcium hydroxide cover. Methods Total of 122 patients （130 sick teeth） with irreducible pulpitis in Chongqing Three Gorges Central Hospital were chosen,and were randomly divided into observation group 61 cases （66 sick teeth） and control group 61 cases（64 skck teeth） according to a random number table. The observation group was given absorbable gelatin sponge as the scaffold combined MTA for closed therapy. The control group was given calcium hydroxide cover treatment. After three months of fallow-up, the therapeutic effect and pulp situation of the two groups were observed and compared. Results I week after surgery, the primary total success rate of the observation group was 50. 0% （33/66） ,significantly higher than the control group[ 12.5% （8/64） ] ,the difference was statistically significant（ P 〈 0. 01 ）. The success rate of acute pulpitis, chronic pulptitis of the observation group were higher than the control group, the differences were statistically significant （ P 〈 0.01 ）. 1 month after surgery, the total success rate of the observation group was 62. 1% （41/66）, significantly higher than the control group [lg. 8% （ 12/64 ） ], the difference was statistically significant （ P 〈 0.01 ）. The success rate of acute pulpitis, chronic pulptitis, chronic hyperplastic pulp of the observation group were higher than the control group, the differences were statistically significant （ P 〈 0.05 ）. 3 months after surgery, the total success rate of the observation group was 66.7% （44/66）, which was significantly higher than the control group [ 21.9% （ 14/64 ） ] , the difference was statistically significant （ P 〈 0. 01 ）. The success rate of each type of the observation group was higher than the control group, the differences were statistically significant （P 〈 0. 05 ）. Conclusion Absorbable gelatin sponge stent combined MTA can effectively induce pulp regeneration in vivo. It is effective for all types of irreducible pulpitis, thus is worthy of promotion in clinical.