三氧化矿物凝聚体在年轻恒牙外伤冠髓切断术中的疗效观察

The effect of mineral trioxide aggregate on coronal pulpotomyof trauma young permanent teeth

目的:探讨三氧化矿物凝聚体(MTA)用于年轻恒牙外伤冠髓切断术中的疗效。方法:选取60颗年轻上前外伤露髓恒牙,分别采用MTA(MTA组)和氢氧化钙[Ca(OH)2,CH](CH组)进行冠髓切断术。分别记录术前、术后的临床及X线片牙根发育情况,比较两组术后临床表现及X线片情况。结果:2年后,两组的病例牙髓活力正常,无叩痛,软组织无肿胀及根尖无窦道出现等症状或体征;X线片显示无根尖周的低密度影、无牙根吸收、牙根继续发育完全,成功率均为100%。MTA组在术后1个月牙本质桥形成15例(50.0%),CH组25例(83.3%),两组比较,差异具有统计学意义(P=0.006);两组中所有病例在术后3个月均形成明显的牙本质桥,而CH组6个月后所有病例均出现根管钙化。结论:MTA和CH用于年轻恒牙外伤冠髓切断术的疗效无明显差别,但MTA不引起根管钙化,更有利于后续根管治疗及冠修复。

Objective:To explore the curative effect of mineral trioxide aggregate(MTA)appling in vital pulpotomy of young permanent teeth.Methods:A total of60 young anterior trauma permanent teeth with pulp exposure after trauma were selected to conduct pulpotomy by MTA(MTA group)or calcium hydroxide[Ca(OH)2,CH](CH group).Preoperative and postoperativeclinical condition and apex development were recorded and compared.Results:Two years later,both groups had normal pulp activity,and no percussive pain,no swelling and appearance of sinus in soft tissue were observed;X ray showed no periapical low density shadow,no root absorption,and the root continued to develop completely,the success rate in both groups rate was 100%.Only 15 cases in MTA group formed dentin bridge 1 month after pulpotomy but CH group was 25 casesin the meantime,whichconstituted statistically significance(P=0.006);all cases in two groups formed evident dentin bridge3 months after pulpotomy,besides,whole CH group cases showed root canal calcification 6 month after pulpotomy.Conclusion:MTA’s curative effect on coronal pulpotomy of trauma young teeth showed no difference with CH,nevertheless,MTA does not cause root canal calcification,which was more conducive to subsequent root canal therapy and crown restoration.