中国实用口腔科杂志

中国实用口腔科杂志

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应用牙髓切断术与牙髓摘除术治疗深龋机械性露髓乳磨牙的临床效果对比研究

张百泽1，邬礼政2，葛鑫1，王军辉1，田忠松3，王小竞1   

  1. 1. 军事口腔医学国家重点实验室，口腔疾病国家临床医学研究中心，陕西省口腔疾病临床医学研究中心，第四军医大学口腔医院儿童口腔科，陕西  西安  710032；2. 天津武警特色医学中心口腔科，天津  300171；3. 西藏军区总医院，西藏  拉萨 540100
  • 出版日期:2020-10-15 发布日期:2020-11-23
  • 基金资助:
    国家自然科学基金（81470743）

  • Online:2020-10-15 Published:2020-11-23

摘要： 目的　对比研究应用矿物三氧化物凝聚体（mineral trioxide aggragate，MTA）牙髓切断术与Vitapex牙髓摘除术治疗深龋机械性露髓乳磨牙的临床效果。方法　选取2014年6—12月于第四军医大学口腔医院就诊并符合纳入标准的深龋患儿108例，共计患牙224颗。将所有患儿随机均分为牙髓切断组（119颗患牙）和牙髓摘除组（105颗患牙），分别采用MTA牙髓切断术和Vitapex牙髓摘除术进行治疗。术后6、12、18个月随访观察两组治疗效果，并进行治疗成功率评价。结果　随访患者共92例，共计患牙192颗，其中牙髓切断组患牙101颗，牙髓摘除组患牙91颗。术后6、12、18个月牙髓切断组治疗效果均优于牙髓摘除组；比较术后18个月两组治疗成功率发现，牙髓切断组治疗成功率（90.10%）高于牙髓摘除组（79.12%），差异有统计学意义（χ2 = 4.50，P = 0.04）。结论　相较于Vitapex牙髓摘除术，MTA牙髓切断术治疗深龋机械性露髓乳磨牙的短期疗效更好，推荐临床医生应用。

关键词: 深龋, 乳磨牙, 矿物三氧化物凝聚体, 牙髓切断术, 牙髓摘除术

Abstract: Objective　To compare the clinical effect of mineral trioxide aggragate（MTA）pulpotomy and Vitapex pulpectomy in treating mechanically pulp exposed primary teeth with deep caries. Methods　A total of 108 children with deep caries who met the inclusion criteria，including 224 teeth，were selected from Department of Pediatric Dentistry，School of Stomatology，the Fourth Military Medical University，from June to December 2014. All children were randomly divided into pulpotomy group（119 affected teeth）and pulpectomy group（105 affected teeth）. MTA pulpotomy and Vitapex pulpectomy were performed，respectively. At 6，12 and 18 months after the operation，the therapeutic effect of the two groups was followed up，and the therapeutic success rate was evaluated. Results　A total of 92 patients were followed up，with a total of 192 teeth. Among them，there were 101 affected teeth in pulpotomy group and 91 affected teeth in pulpectomy group. The treatment results of pulpotomy group at 6，12 and 18 months after the operation were all better than those of the pulpectomy group，and the treatment success rate of the pulpotomy group was higher（90.10%）than that of the pulpectomy group（79.12%），the difference being statistically significant（χ2 = 4.50，P = 0.04）. Conclusion　Compared with Vitapex pulpectomy，MTA pulpotomy has a better short-term efficacy in the treatment of mechanically pulp exposed primary teeth with deep caries and is recommended for clinicians.

Key words: deep caries；deciduous molars；mineral trioxide aggragate, MTA；pulpotomy；pulpectomy