复合树脂充填修复后牙髓反应的原因分析

The Causal Analysis of the Reaction of Pulp after the Filling Restoration with Composite Resin

目的 临床观察分析活髓后牙龋洞用超钻复合树脂充填修复后牙髓反应的发生原因。方法 据后牙龋一类窝洞的深度 ,将 10 8例患牙分为深层窝洞组 (位于釉牙本质界下 1～ 1.5 mm) 30例 ,中层窝洞组 (位于釉牙本质界下 0 .5～ 1mm) 4 6例 ,浅层窝洞组 (位于釉牙本质界下 <0 .5 m m) 32例。其中 ,深层窝洞用 Dycal护髓 ,GIC垫底后用超钻复合树脂充填修复 ,中层窝洞和浅层窝洞直接用复合树脂充填。充填修复后 2周、1～ 2个月和 12个月进行复查。结果 深层窝洞组激发痛的发生率为 6 6 .6 7% ,中层窝洞组为 2 3.91% ,浅层窝洞组为 6 .2 5 %。经卡方检验 ,P<0 .0 1,三者差异具有统计学意义。结论 复合树脂应用于活髓后牙深层窝洞的充填修复时 ,复合树脂中的未聚合单体、酸蚀、固化灯照射产生的热量和边缘微渗漏形成的细菌侵入等因素 ,均会引起不同程度的牙髓反应。

Objectives To analyze the reasons of the reaction of pulp after the filling restoration with composite resin in vivo. Methods According to the depth of cavity, a total of 108 posterior teeth were divided into three groups: deep cavity (30 cases); moderate cavity (46 cases); shallow cavity (32 cases).After the deep cavities were caped with Dycal and the bottom was rebased with glass ionorner cement, composite resin filling was performed. For the moderate and shallow cavity groups, only composite resin filling was done.Patients were rechecked 2 weeks, 1～2 months and twelve months after filling to observe the pulp reaction.Results For deep cavity group, the rate of irritative pain was 66.67%; for moderate cavity group 23.91%; for shallow cavity group 6.25%.The statistical difference among three groups was significant with using χ 2 test (P<0.001).Conclusion For the restoration of deep cavity of vital pulp teeth, the residue monomerin composite resin, etching,hot energy generated during light curing and marginal microleakage could result in the different reaction of pulp.