MTA活髓切断术对龋源性露髓恒牙治疗效果的系统评价与meta分析

MTA pulpotomy for cariously exposed permanent teeth: A systematic review and meta-analysis

目的评价MTA活髓切断术治疗龋源性露髓恒牙的疗效。方法通过meta分析的方法,比较MTA和氢氧化钙活髓切断术治疗龋源性露髓恒牙疗效的差异,计算MTA活髓切断术对于可复性牙髓炎组和早期不可复性牙髓炎组平均治疗成功率,研究根尖孔情况和术式对成功率的影响。结果MTA活髓切断术2年疗效优于氢氧化钙,其可复性牙髓炎组1年、2年和不可复性牙髓炎组1年的成功率均为99%。可复性牙髓炎组中根尖孔闭合和未闭合1年成功率分别为100%vs.99%,2年成功率为97%vs.99%,不可复性牙髓炎组中两者1年成功率分别为99%vs.99%;可复性牙髓炎组中全部和部分冠髓切断术1年成功率为100%vs.99%,2年成功率为99%vs.97%,不可复性牙髓炎组中两者1年成功率为100%vs.87%。结论MTA活髓切断术优于氢氧化钙。根尖孔未闭合及全部冠髓切断术可能会有利于提高活髓切断术的成功率。

Objective To evaluate the clinical efficacy of mineral trioxide aggregate(MTA)pulpotomy treatment for managing carious vital pulp exposure in permanent teeth.Methods The efficacies of pulpotomy with MTA and calcium hydroxide(CH)as pulp capping agents were compared.The weighted mean success rates(WSR)of reversible pulpitis group and irreversible pulpitis group of MTA pulpotomy were estimated,and subgroup analyses were conducted to assess the effects of different surgical procedures and apical development on the success rate of reversible pulpitis group and irreversible pulpitis group.Results MTA group was better than CH group in two-year curative effect.The one-year and two-year WSRs of reversible pulpitis group and the one-year WSR of irreversible pulpitis group were all 99%.In the subgroup of the reversible pulpitis group,one-year WSR and two-year WSR in mature permanent teeth group were respectively 100%and 97%,while in young permanent teeth group they were all 99%,in the coronal pulpotomy group they were 100%and 99%,in the partial pulpotomy group they were 99%and 97%.In the subgroup of the irreversible pulpitis group,one-year WSR in mature permanent teeth group was 99%,in young permanent teeth group it was 99%,in the coronal pulpotomy group it was 100%,and in the partial pulpotomy group it was 87%.Conclusion MTA is superior to calcium hydroxide from the perspective of the later results.The coronal pulpotomy and young permanent teeth may be beneficial to increase the success rate after operation.