不同支架材料应用于年轻恒牙急性牙髓炎再生性牙髓治疗中的疗效观察

The efficacy of different scaffold materials in the treatment of regenerative dental pulp in young permanent teeth with acute pulpitis

目的分析年轻恒牙急性牙髓炎再生性牙髓治疗中选择不同支架材料的疗效。方法将我院2017年1月至2018年2月收治的72例(72牙)龋齿、80例(88牙)外伤致年轻恒牙急性牙髓炎患儿,采用随机数字表法分为4个亚组,分别采用三氧化矿物聚合物(MTA)、生物陶瓷材料(iRoot BP Plus)、MTA+富血小板纤维蛋白(PRF)、MTA+脱细胞真皮基质(ADM)支架材料进行牙髓手术。比较各组手术前后患牙检查指标及术后各亚组间疗效。结果龋齿组与外伤组术后总有效率分别为70.83%(51/72)、65.91%(58/88),组间差异无统计学意义(P>0.05);龋齿组与外伤组的各亚组总有效率比较,均显示PRF+MTA亚组较MTA亚组、iRoot BP Plus亚组总有效率明显提高(P<0.05);龋齿组、外伤组的各亚组根尖根管改善情况比较,均显示PRF+MTA亚组根管长度、根管壁厚度增加明显优于MTA亚组与iRoot BP Plus亚组(P<0.05);患牙恢复情况比较,龋齿组的PRF+MTA亚组根尖孔封闭、牙髓活力正常、牙体色泽正常、萌出高度增加率均明显高于MTA亚组与iRoot BP Plus亚组(P<0.05);外伤组的PRF+MTA亚组根尖孔封闭、牙髓活力正常、牙体色泽正常率均明显高于MTA亚组(P<0.05)。结论年轻恒牙急性牙髓炎采用PRF+MTA支架进行再生性牙髓治疗,能更好地恢复牙髓活力,促进根尖孔封闭。

Objective To analyze the effect of different scaffold materials in the treatment of acute pulpitis with regenerative pulp for young permanent teeth.Methods A total of 72 cases(72 teeth)of dental caries and 80 cases(88 teeth)of trauma caused by acute dental pulpitis in young permanent teeth admitted to our hospital from January 2017 to February 2018 were taken as research objects.The sick children were divided into 4 groups according to random table method.They were treated with scaffold materials of mineral trioxide aggregate(MTA),bioceramic material(iRoot BP Plus),MTA+platelet rich fibrin(PRF),and MTA+acellular dermal matrix(ADM)for endodontic surgery,respectively.The indexes of examination of the affected teeth before and after the operation and the curative effect were compared among the subgroups after the operation.Results The total effective rates of the dental caries group and the trauma group were 70.83%(51/72)and 65.91%(58/88)respectively,and there was no significant difference between the groups(P>0.05).For comparison of total effect rate among subgroups in the dental caries group and the trauma group,the PRF+MTA subgroup had significantly higher rate than that of the MTA subgroup and the iRoot BP Plus subgroup(P<0.05).The improvement of the apical root canal of each subgroup in the caries group and the trauma group showed that the increase in root canal length and root canal wall thickness in the PRF+MTA subgroup was significantly better than that of the MTA subgroup and iRoot BP Plus subgroup(P<0.05).Compared with the recovery of the tooth,the obturation of apical foramen,the pulp vitality,the normal rate of tooth color and the increase rate of eruption height in the PRF+MTA subgroup in the caries group were significantly higher than those in the MTA subgroup and iRoot BP Plus subgroup(P<0.05).The PRF+MTA subgroup of the trauma group had higher rate in obturation of apical foramen,normal pulp vitality and normal tooth color than those in the MTA subgroup(P<0.05).Conclusion Young permanent teeth with acute pulpitis using PRF+MTA stent for regenerative pulp treatment can better restore pulp vitality and promote the apical foramen closure.