龋源性露髓成熟恒牙活髓保存的2种生物陶瓷材料盖髓效果比较

Comparison of the efficacy of two bioceramic materials in vital pulp preservation of mature permanent teeth with exposed pulp of caries origin

目的比较2种生物陶瓷材料iRoot BPPlus和三氧化矿物凝聚体(MTA)在龋源性露髓成熟恒牙的活髓盖髓效果,为此类患牙选择合适的盖髓剂提供参考。方法选择浙江中医药大学附属杭州市中医院口腔科就诊的龋源性露髓的成熟恒牙并行活髓保存术的120例患者及其120颗患牙,随机分为两组,分别使用iRoot BPPlus和MTA作为盖髓剂。术后定期复诊,通过临床检查和影像学检查评估盖髓效果。结果iRoot组60例,其中男性23例,女性37例;年龄M(QR)为41(12)岁;患牙在前磨牙27例,磨牙33例;Ⅰ类洞8例,Ⅱ类洞52例。MTA组60例,其中男性29例,女性31例;年龄M(QR)为39(14)岁;患牙在前磨牙21例,磨牙39例;Ⅰ类洞10例,Ⅱ类洞50例。两组性别、年龄、患牙位置和洞型差异均无统计学意义(P>0.05)。术后12个月,iRoot组和MTA组盖髓成功率分别为91.67%和88.33%,牙髓感染率分别为8.33%和11.67%,差异均无统计学意义(P>0.05);但MTA组牙冠变色占61.67%,iRoot组无变色。结论12个月观察期内,iRoot BPPlus和MTA在龋源性露髓成熟恒牙活髓保存中均能取得较好的盖髓效果,无明显差异,但MTA盖髓后存在牙冠变色问题。两种材料的远期临床效果还有待进一步研究。

Objective To compare the efficacy of two bioceramic materials,iRoot BP Plus and mineral trioxide aggre⁃gate(MTA)in the preservation of vital pulp of mature permanent teeth with exposed pulp of caries origin,so as to pro⁃vide insights into appropriate selection of pulp capping agents in clinical process.Methods Vital pulp therapy were performed on 120 mature permanent teeth with carious exposure at the Department of Stomatology of Hangzhou Tradi⁃tional Chinese Medicine Hospital Affiliated to Zhejiang Chinese Medical University.The teeth were randomly divided in⁃to two groups which were treated respectively by iRoot BP Plus(iRoot group)and MTA(MTA group).The clinical effi⁃cacy was evaluated by clinical examinations and imaging examinations.Results There were 60 cases in iRoot group,in⁃cluding 23 males and 37 females,27 cases affected premolars and 33 cases affected molars,and 8 cases of Class I and 52 cases of Class II cavity type,with a median age of 41(interquartile range,12)years.There were 60 cases in MTA group,including 29 males and 31 females,21 cases affected premolars and 39 cases affected molars,and 10 cas⁃es of Class I and 50 cases of Class II cavity type,with a median age of 39(interquartile range,14)years.There were no significant differences in gender,age,affected tooth location and cavity type between the two groups(P>0.05).The success rate of iRoot group at 12 months was 91.67%while the MTA group was 88.33%,and the pulp infection rate of iRoot group at 12 months was 8.33%while the MTA group was 11.67%.There were no significant differences in success rate and pulp infection rate between the two groups(P>0.05).The rate of crown discoloration in MTA group was 61.67%,while there was no discoloration in iRoot group.Conclusions During 12 months,iRoot BP Plus and MTA can both achieve great effects in the treatment of mature permanent teeth with carious pulp exposure,but there is a problem of tooth discoloration after pulp covering using MTA.The long-term clinical effects of the two materials need to be further studied.