深龋治疗中龋坏去除程度的循证病案讨论  

Evidence-based case discussion of excavation of deep caries

作　　者：薛晶[1] 张凌琳[1] 邹玲[1] 李伟[1] 

机构地区：[1]口腔疾病研究国家重点实验室,四川大学,四川成都610041

出　　处：《国际口腔医学杂志》2008年第6期615-616,623,共3页International Journal of Stomatology

摘　　要：目的针对深龋治疗中龋坏去除程度检索其当前最佳证据,为深龋的临床合理治疗提供依据。方法计算机检索OVID-All EBM Reviews-Cochrane DSR,ACP Journal Club,DARE,CCTR (4th Quarter 2006),以龋病(dental caries)和龋坏去除(excavation)为检索关键词。结果临床证据表明,部分去除龋坏可降低露髓的风险,对以后的牙髓炎症的发生无不利影响,部分去除龋坏后是否需2次去龋还需要进一步的长期临床试验研究。结论对于无牙髓症状的乳牙和恒牙,部分去除龋坏可降低牙髓暴露的风险,部分去除龋坏不会对患者的牙髓症状产生不利影响。Objective To analyze and explain how to treat a patient with deep caries based on best evidence. Methods Used dental caries and excavation as key words to search OVID-All EBM reviews-cochrane DSR, ACP journal club, DARE, and CCTR （4th Quarter 2006） to find the best clinical evidence and evaluated the quality of evidence. Results According to the evidence, we found that partial caries removal would appear to be preferable to complete caries removal in the deep lesion, in order to reduce the risk of carious exposure. We found no evi- dence that partial caries removal is deleterious in terms of signs and symptoms of pulpitis or necrosis in the immediate to long term. It needs further clinical trial to decide whether cavity need re-entered at a second visit to allow the remaining decay to be removed. Conclusion Partial caries removal in symptomless, primary or permanent teeth reduces the risk of pulp exposure. We found no detriment to the patient in terms of pulpal symptoms in this procedure.

关 键 词：龋病 治疗 循证医学 

分 类 号：R781.1[医药卫生—口腔医学]