牙髓炎的活髓保存及再生治疗新进展:从基础到临床  

New advances in vital pulp therapy and pulp regeneration for the treatment of pulpitis:from basic to clinical application

作　　者：何文喜[1] 余擎[1] He Wenxi;Yu Qing(Department of Operative Dentistry and Endodontics,School of Stomatology,The Fourth Military Medical University&State Key Laboratory of Military Stomatology&National Clinical Research Center for Oral Diseases&Shaanxi Key Laboratory of Stomatology,Xi′an 710032,China)

机构地区：[1]第四军医大学口腔医学院牙体牙髓病科,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,陕西省口腔医学重点实验室,西安710032

出　　处：《中华口腔医学杂志》2022年第1期16-22,共7页Chinese Journal of Stomatology

基　　金：国家自然科学基金(81771060);国家口腔疾病临床医学研究中心2020年度专项课题(LCA202006)。

摘　　要：近年关于牙髓炎治疗的研究取得了较大进展,这主要得益于牙髓炎治疗的基础和临床研究的飞速进展,一些基础研究已转化为临床实践。牙髓炎检测方法的研究进展可以帮助临床医师更准确地诊断牙髓炎的状态,并采取相应的治疗手段,包括间接或直接盖髓术、牙髓切断术、牙髓再生术和根管治疗术等。针对牙髓炎的诊断理念、牙髓免疫防御和修复功能研究以及新型盖髓剂材料研究均有了较大进展,牙髓炎的活髓保存治疗成功率显著提高。对于难以实现活髓保存治疗的弥漫性冠髓炎或根髓炎,除根管治疗术外,牙髓血运重建、细胞归巢和牙髓干细胞移植牙髓再生等牙髓再生术也可作为一种治疗选择。本文重点阐述牙髓炎治疗研究进展和相关的临床转化实践,旨在为牙髓炎的活髓保存和牙髓再生治疗提供参考。In recent years,great progress has been made in research on the treatment of pulpitis,mainly due to the rapid development of basic and clinical researches in this field,and some achievement from basic research has been applied in clinical practice.Advances in the diagnostic methods for pulpitis can help the clinicians to recognize the true state of pulpitis more accurately and to adopt the corresponding treatment methods including indirect/direct pulp capping,pulpotomy,pulp regeneration and root canal therapy.The new theory of pulpitis diagnosis and the studies on immune defense,repair function of dental pulp and new pulp capping materials have significantly improved the success rate of vital pulp therapy.For diffuse coronary pulpitis or radicular pulpitis,which is difficult to achieve vital pulp therapy successfully,methods of pulp revascularization,cell homing and pulp stem cells-mediated pulp regeneration can also be used as treatment options in addition to root canal therapy.The present article focuses on the research progress on pulpitis treatments and related clinical transformation practices,in order to provide reference on vital pulp therapy and pulp regeneration for clinicians.

关 键 词：牙髓炎 牙髓切断术 盖髓术 细胞归巢 牙髓干细胞移植牙髓再生 

分 类 号：R781.31[医药卫生—口腔医学]