老年患者活髓切断术的临床疗效观察

Clinical efficacy of pulpotomy in elderly patients

目的观察老年患者因龋露髓患牙活髓切断术的临床疗效。方法采用随机对照研究的方法,将2019年10月至2022年3月就诊于北京大学口腔医院综合科的龋源性露髓老年患者46例,随机分为试验组22例和对照组24例,试验组患牙进行活髓切断术、对照组患牙进行根管治疗术。试验组和对照组患牙术后1周、术后6个月及术后12个月进行复查,采用视觉模拟评分量表(VAS)对试验组术前及术后1周,对照组术前、第2次就诊(诊间1)、第3次就诊(诊间2)及术后1周内的自觉疼痛症状进行评分。结果以VAS量表衡量患者术前平均疼痛评分,试验组(1.09±1.19)分,与对照组(1.13±1.23)分比较差异无统计学意义(t=-0.096、P=0.924)。试验组术后疼痛评分(0.27±0.77)分,对照组治疗后整体疼痛(诊间1、诊间2以及术后1周)平均评分为(1.19±1.82)分,试验组术后疼痛明显低于对照组(t=-3.416、P=0.001)。两组12个月临床成功率均为100%,治愈率分别为95.24%(20/21)(试验组)及100%(22/22)(对照组),两组治愈率比较差异无统计学意义(χ^(2)=1.458、P=0.488)。结论活髓切断术用于治疗老年因龋露髓患者能够获得较好的临床疗效。

Objective To evaluate the clinical efficacy of pulpotomy in elderly patients with caries-related exposed pulp.Methods A randomized controlled study was conducted at the Department of General Dentistry,Peking University Stomatology Hospital from October 2019 to March 2022.The study included 46 elderly patients with carious exposure,who were randomly divided into two groups:an experimental group with 22 cases and a control group with 24 cases.The teeth in the experimental group underwent pulpotomy,while the teeth in the control group underwent root canal treatment.The patients in both groups were followed up at 1 week,6 months,and 12 months after the operation.Self-perceived pain symptoms were assessed using a visual analogue scale(VAS)before and 1 week after treatment in the experimental group,and before,at the second visit(visit 1),at the third visit(visit 2),and 1 week after treatment in the control group.Results The mean preoperative pain score of the patients,as measured by the VAS scale,was(1.09±1.19)in the experimental group.There was no statistically significant difference when compared to the control group(1.13±1.23)(t=-0.096,P=0.924).The postoperative pain score of the experimental group was(0.27±0.77).On the other hand,the average overall pain score of the control group after treatment(visit 1,visit 2,and 1 week postoperatively)was(1.19±1.82).The postoperative pain score of the experimental group was significantly lower than that of the control group(t=-3.416,P=0.001).The effective rates were 95.24%(20/21)(experimental group)and 100%(22/22)(control group)respectively.There was no significant difference between the cure rates of the two groups(χ^(2)=1.458,P=0.488).Conclusions The findings suggest that pulpotomy can be an effective method for managing elderly patients with exposed pulp due to caries.