MTA与iRoot BP Plus行直接盖髓术治疗龋源性露髓恒磨牙临床疗效分析

Clinical Analysis of Direct Pulp Capping with MTA and iRoot BP Plus in the Treatment of Carious Exposed Pulp of Mature Permanent Molars

目的:观察成熟恒磨牙去龋未净时露髓使用无机三氧化物聚合体(Mineral trioxide aggregate,MTA)和生物陶瓷类材料(iRoot BP Plus)行直接盖髓术的临床疗效,探讨此类术式的可行性及其影响因素,比较两种盖髓剂疗效的差异。方法:选取2018年4月-2019年10月就诊于笔者科室符合纳入标准的53例患者,共53颗患牙,随机分为M组和B组,分别使用MTA与iRoot BP Plus行直接盖髓术,术后定期复查,比较两组的临床疗效。结果:共计45例患者(45颗患牙)完成2年随访,总体成功率84.4%;M组和B组分别为85.7%、83.3%,两组比较差异无统计学意义(P>0.05)。性别、年龄、露髓孔大小等因素对疗效均无显著影响(P>0.05)。结论:成熟恒磨牙术中露髓时使用MTA或iRoot BP Plus行直接盖髓术均可获得良好疗效;相较于性别、年龄、露髓孔大小等因素,如何简单准确评判牙髓状态及避免龈下微渗漏更加值得关注。

Objective To evaluate the clinical efficacy of direct pulp capping using MTA and iRoot BP Plus in mature molars teeth with carious pulp exposure,in order to explore the feasibility and influencing factors of such vital pulp therapy,and to compare the difference in the efficacy of the two pulp capping agents.Methods Patients from April 2018 to October 2019 in the author's department were randomly recruited.53 teeth that met the inclusion criteria were randomly divided into group M and group B,and MTA or iRoot BP Plus were used respectively for direct pulp capping and permanent resin filling immediately.The clinical effects of the two groups were compared after regular postoperative follow-up.Results A total of 45 teeth were followed up for 2 years,with an overall success rate of 84.4%.Group M and Group B were 85.7%and 83.3%,respectively,and there was no significant difference between the two groups(P>0.05).Sex,age,the size of the exposed pulp hole and other factors had no significant effect on the curative effect(P>0.05).Conclusion MTA or iRoot BP Plus can get good results in direct pulp capping of mature permanent molars with carious pulp exposure.Compared with the factors such as gender,age,and size of pulp opening,how to simply and accurately evaluate the pulp status and avoid subgingival microleakage should be paid more attention.