半导体激光联合TheraCal® LC直接盖髓术对深龋露髓恒牙的修复效果评价

Evaluation of diode laser combined with TheraCal®LC on direct pulp capping for restoration of carious pulp-exposed permanent teeth

目的评价半导体激光与TheraCal®LC直接盖髓术联合应用对深龋露髓恒牙的临床修复效果。方法选取2022年1月1日至2022年12月31日于青岛市市立医院口腔科接受治疗的120颗深龋露髓恒牙并随机分为A、B、C三组(每组40颗)。A组行半导体激光照射与TheraCal®LC直接盖髓,B、C两组分别行TheraCal®LC和三氧化矿物凝聚体(MTA)直接盖髓,记录盖髓所用时长。修复后第1、3、6、12个月对每颗患牙进行临床和锥形束CT(CBCT)检查,测量并比较各组修复成功率、患牙变色率、牙本质桥的厚度和密度。结果修复中,A、B两组的盖髓时长均比C组短,差异有统计学意义(P<0.001),A、B两组间差异无统计学意义(P>0.05)。在成功率方面,修复后第1、3个月,三组比较差异无统计学意义(P>0.05);修复后第6、12个月,A、B两组均高于C组,差异有统计学意义(P<0.001),A、B两组间差异无统计学意义(P>0.05)。在患牙变色率方面,A、B两组均低于C组,差异有统计学意义(P<0.001),A、B两组间差异无统计学意义(P>0.05)。在牙本质桥的厚度和密度方面,修复后第1、3、6、12个月,A、B、C各组均逐渐增加,A组高于B、C两组,B组又高于C组,差异有统计学意义(P<0.001)。结论TheraCal®LC修复深龋露髓恒牙比MTA盖髓拥有更好的远期成功率,且具有操作时间短和变色少的优点,与半导体激光联合使用时促进牙本质桥形成效果更佳,值得进一步研究和推广。

Objective To evaluate the restorative efficiency of diode laser combined with TheraCal®LC on direct pulp capping in carious pulp-exposed permanent teeth.Methods One hundred and twenty carious pulp-exposed permanent teeth treated from January 1,2022 to December 31,2022 were selected from the Department of Stomatology of Qingdao Municipal Hospital.The patients were randomly divided into groups A,B,and C(40 teeth in each group)and were treated with diode laser combined with TheraCal®LC,TheraCal®LC and MTA,respectively.The duration of direct pulp capping was recorded.Clinical and cone beam CT(CBCT)examinations were performed on each tooth at 1,3,6,and 12 months after surgery to measure and compare success rate,tooth discoloration rate,and thickness and density of dentin bridges.Results During the restoration,the duration of pulp capping was shorter in groups A and B than in group C(P<0.001),but similar between groups A and B(P>0.05).In terms of success rate,at the 1st and 3rd months after repair,the difference between the three groups was not statistically significant(P>0.05);at the 6th and 12th months after repair,groups A and B had higher success rates than group C(P<0.001),while no significant difference was identified between groups A and B(P>0.05).In terms of discoloration rate of affected teeth,groups A and B had lower rates than group C(P<0.001),while the difference between groups A and B was not statistically significant(P>0.05).In terms of thickness and density of dentin bridges,groups A,B,and C all had a gradual increase,with group A higher than groups B and C,and group B higher than group C at 1,3,6,and 12 months after restoration(P<0.001).Conclusion TheraCal®LC has a better long-term success rate than MTA for carious pulp-exposed permanent teeth and offers the advantages of shorter operation time and less discoloration.When used in combination with diode laser,TheraCal®LC is more effective in promoting dentin bridge formation,which warrants further research and promotion.