龋源性露髓成熟恒牙活髓保存术后血流变化的临床研究

Clinical Study of Blood Flow Changes after Vital Pulp Therapy in Carious Pulp-exposed Mature Permanent Teeth

目的:应用激光多普勒血流仪检测龋源性露髓成熟恒牙活髓保存术后的牙髓血流转归趋势。方法:收集2020年1月至2021年1月就诊于右江民族医学院附属医院牙体牙髓科的60例无症状因深龋或继发龋露髓的成熟恒牙,随机分为对照组和实验组,每组30例,分别采用PMTA和iRoot BP Plus行活髓保存术处理,期间应用激光多普勒血流仪记录每组患牙术前与术后1、3、6、12个月的牙髓血流值,并对两组活髓保存术前和术后自身的血流值以及同一观察时间点两组间的血流值进行分析比较。结果:iRoot BP Plus组,术前血流值分别和术后1、3、6、12月之间的比较,以及术后3月与术后6月之间的比较,差异具有统计学意义(P<0.05),其余任意两组之间的比较,差异无统计学意义(P>0.05);MTA组,术前血流值分别和术后1、3、6、12月之间的比较,差异具有统计学意义(P<0.05),术后1、3、6、12月任意两组之间的比较,差异无统计学意义(P>0.05)。iRoot BP Plus组和MTA组在术后3月的血流值的比较差异具有统计学意义(P<0.05),iRoot BP Plus组较MTA组血流值稍高。结论:临床上对于因龋露髓的成熟恒牙,采用iRoot BP Plus或MTA行活髓保存术均可以获得较好的临床疗效;经过1年的随访观察,iRoot BP Plus组和MTA组的血流值能回归到正常临床参考值范围,其中MTA组的血流下降后维持较平稳。

Objective:To detect the trend of pulpal blood flow(PBF)regression after vital pulp therapy(VPT)of pulp-exposed mature permanent teeth by Laser Doppler flowmetry(LED).Methods:A total of 60 asymptomatic mature permanent teeth with deep caries or secondary caries were collected from the department of Dentistry and Endodontics,Affiliated Hospital of Youjiang Medical College for Nationalities from January 2020 to January 2021,which were randomly divided into control group and experimental group with 30 cases in each group.MTA and iRoot BP Plus were used for VPT respectively.LDF was used to record PBF values for each group of teeth before therapy and after 1,3,6,and 12 months.The changes of blood flow values before and after treatment in each group and the blood flow values between two groups at the same observation time point were also analyzed and compared.Results:For iRoot BP Plus group,the differences of blood flow were statistically significant between the preoperative and the postoperative 1 month,3 months,6 months,and 12 months,respectively,and between the postoperative 3 months and 6 months(P<0.05),while the differences between any of the remaining two groups were not statistically significant(P>0.05).For MTA group,the difference of blood flow was statistically significant between the preoperative and the postoperative 1,3,6,and 12 months(P<0.05),respectively,and there was no statistically significant difference between any two groups at 1,3,6,and 12 months postoperatively(P>0.05).The flow values of iRoot BP Plus at 3 months postoperatively was slightly higher than that of the MTA group(P<0.05).Conclusion:Clinically,for mature permanent teeth with caries exposure,VPT with iRoot BP Plus or MTA can achieve good clinical efficacy.After 1-year follow-up,the blood flow values of iRoot BP Plus group and MTA group can return to the normal clinical reference range,among which the blood flow of MTA group remained stable after decreasing.