不同盖髓剂直接盖髓术在年轻恒牙龋源性漏髓治疗中的应用

Application of direct pulp capping with different pulp capping agents in the treatment of cariogenic pulp leakage in young permanent teeth.

目的探讨生物陶瓷(iRoot BP)、矿物三氧化物聚合体(MTA)及氢氧化钙(CH)三种材料在年轻恒牙龋源性漏髓治疗中的应用效果。方法选择2022年3月至2023年3月中部战区总医院口腔科收治的63例年轻恒牙龋源性漏髓患者作为研究对象,根据随机数表法将患者分为三组,每组21例。A组患者给予iRoot BP覆盖,B组患者给予MTA覆盖,C组患者给予CH覆盖,均治疗1个月。治疗1个月后,比较三组患者的治疗成功率、牙髓活力及盖髓操作时间,记录治疗前、治疗1个月时患者视觉模拟疼痛(VAS)评分及牙体功能变化,统计三组患者的并发症发生情况。结果A组患者的治疗成功率为95.24%,明显高于B组的85.71%和C组的61.90%,且B组明显高于C组,差异均有统计学意义(P<0.05);A组患者的牙髓活力正常率为95.24%,明显高于B组的76.19%和C组的57.14%,且B组明显高于C组,差异均有统计学意义(P<0.05);A组患者的盖髓操作时间为(2.71±0.42)min,明显短于B组的(3.84±0.56)min和C组的(4.92±0.49)min,且B组明显短于C组,差异均有统计学意义(P<0.05);治疗1个月、3个月后,A组患者的VAS评分分别为(2.98±0.50)分、(2.17±0.36)分,明显低于B组的(3.76±0.38)分、(3.21±0.31)分和C组的(4.81±0.42)分、(3.82±0.68)分,且B组明显低于C组,差异均有统计学意义(P<0.05);A组患者的固定功能、舒适功能、美观度评分分别为(8.93±1.53)分、(8.47±1.73)分、(8.49±1.29)分,明显高于B组的(7.28±1.47)分、(7.21±1.32)分、(7.26±1.35)分和C组的(6.21±1.32)分、(6.28±1.30)分、(6.11±1.27)分,且B组明显高于C组,差异均有统计学意义(P<0.05);A组患者的并发症发生率为4.76%,明显低于B组的23.81%和C组的38.10%,差异有统计学意义(P<0.05),而B组和C组并发症发生率比较差异无统计学意义(P>0.05)。结论iRoot BP应用于年轻恒牙龋源性漏髓的治疗中,可缩短盖髓操作时间,缓解疼痛,提高牙髓活力及牙体功能,减少并发症,临床应用效果好,具有较好的应用前景。

Objective To investigate the application effect of three materials:bioceramics(iRoot BP),mineral trioxide polymer(MTA),and calcium hydroxide(CH)in the treatment of cariogenic pulp leakage of young permanent teeth.Methods Sixty-three patients with carious pulp leakage of young permanent teeth admitted to the Department of Stomatology at the Central Theater Command General Hospital from March 2022 to March 2023 were selected as the research subjects.The patients were divided into three groups using a random number table method,with 21 cases in each group:the teeth of patients in group A,group B,group C were covered with iRoot BP,MTA,and CH,respectively,all for one month.After one month of treatment,the success rate,pulp vitality,and pulp capping operation time were compared among the three groups of patients.The Visual Analogue Scale(VAS)scores and changes in dental function were recorded before and at one month after treatment,and the incidence of complications in the three groups of patients were statistically analyzed.Results The success rate of treatment in group A was 95.24%,which was higher than 85.71%in group B and 61.90%in group C;the rate was significantly higher in group B than group C;the differences were statistically significant(P<0.05).The normal rate of pulp vitality in group A was 95.24%,which was significantly higher than 76.19%in group B and 57.14%in group C;the rate was significantly higher in group B than group C;the differences were statistically significant(P<0.05).The pulp capping operation time of group A was(2.71±0.42)min,which was significantly shorter than(3.84±0.56)min in group B and(4.92±0.49)min in group C;the time was also significantly shorter in group B than group C;the differences were statistically significant(P<0.05).After 1 month and 3 months of treatment,the VAS scores of patients in group A were(2.98±0.50)points and(2.17±0.36)points,which were significantly lower than(3.76±0.38)points and(3.21±0.31)points in group B and(4.81±0.42)points and(3.82±0.68)points in group C;the scores were also significantly lower in group B than group C;the differences were statistically significant(P<0.05).The scores of fixed function,comfort function,and aesthetics in group A were(8.93±1.53)points,(8.47±1.73)points,and(8.49±1.29)points,which were significantly higher than(7.28±1.47)points,(7.21±1.32)points,(7.26±1.35)points in group B and(6.21±1.32)points,(6.28±1.30)points,and(6.11±1.27)points in group C;the scores were also significantly higher in group B than group C;the differences were statistically significant(P<0.05).The incidence of complications in group A was 4.76%,which was significantly lower than 23.81%in group B and 38.10%in group C(P<0.05);however,there was no statistically significant difference in the incidence of complications between group B and group C(P>0.05).Conclusion The application of iRoot BP in the treatment of young permanent teeth with carious pulp leakage can shorten the pulp capping operation time,relieve pain,improve pulp vitality and dental function,reduce complications,and have good clinical application effects and good application prospects.