MTA、玻璃离子水门汀和银汞合金修补髓室底穿孔疗效观察

Clinical Study on the Effect of MTA, Glass Ionomer Cement and Silver Amalgam on Repairing Pulp Perforation

对比研究矿物三氧化物凝聚体（MTA）、玻璃离子水门汀和银汞合金在修补髓室底穿孔的临床疗效。选取2013年1月至2016年6月于我院行髓室底患牙穿孔的患者120例,共120颗患牙,根管治疗后随机分为MTA组、玻璃离子水门汀组及银汞合金组,每组40例,分别采用MTA、玻璃离子水门汀、银汞合金进行髓室底修补,1年后复查,对比三种不同方法的临床疗效。术后1年后复查,MTA组治疗后成功的有37例,成功率为92.5%;玻璃离子水门汀组治疗后成功的有28例,成功率为70.0%;银汞合金组治疗后成功的有21例,成功率为52.5%;MTA组修补成功率显著高于其它两组（p〈0.05）。MTA组修复成功率优于另外两组,与患者年龄、髓室底穿孔直径、穿孔等原因有关,即年龄越大、穿孔直径越大者髓室底穿孔修复成功率越低,且有统计学差异（χ^2=5.33,χ^2=8.12;p〈0.05）;医源性髓室底穿孔修复成功率显著高于龋源性（χ^2=7.56,p〈0.05）。MTA应用于患牙髓室底穿孔具有良好的生物活性及组织相容性,显著提高了患牙保留率,临床疗效较好。

Comparative of the three condensates of mineral oxides（MTA）, the clinical curative effect of glass ionomer cement and silver amalgam in repairing perforation of pulp floor were studied. Choose 120 patients with dental pulp chamber perforation in our hospital from January 2013 to June 2016, a total of 120 teeth after root canal therapy were randomly divided into MTA group, glass ionomer group and silver amalgam group, 40 cases in each group, respectively with MTA, glass ionomer cement and silver amalgam of pulp floor repair. Review after 1 years, comparison of three different methods of clinical efficacy. After 1 years later, there are 37 patients was successful of MTA group after treatment, the success rate is 92.5%; there are 28 cases was successful of glass ionomer group after treatment, the success rate is 70%; there are 21 cases was successful of silver amalgam group after treatment, the success rate is 52.5%; the success rate of MTA group was significantly higher than that of other two repair group（p〈0.05）. MTA group had better success rate than the other two groups in terms of age, diameter of perforation and perforation of the medulla. The higher the diameter, the higher the perforation diameter,the lower the success rate of perforation repair, and the difference was statistically significant（χ^2=5.33, χ^2=8.12;p〈0.05）. The successful rate of iatrogenic perforation repair was significantly higher than that of carious origin（χ^2=7.56, p〈0.05）. MTA was applied to the patients with pulp chamber bottom perforation with good biological activity and tissue compatibility, which significantly improved the tooth retention rate, and the clinical effect was good.