不同保髓法治疗龋源性有症状不可复性牙髓炎的短期疗效及影响因素分析  

Analysis of the short-term curative effect and prognostic factors of different pulp preservation methods in the treatment of cariogenic and symptomatic irreducible pulpitis

作　　者：景然 邵扬 吴刘中[2] Jing Ran;Shao Yang;Wu Liuzhong(Department of Operative Dentistry&Endodontics,General Hospital of Northern Theater of Chinese People’s Liberation Army,Liaoning Shenyang 110015,China;Department of Oral Medicine,Stomatology Hospital of Shenyang,Liaoning Shenyang 110002,China)

机构地区：[1]中国人民解放军北部战区总医院口腔内科,辽宁沈阳110015 [2]沈阳市口腔医院口腔内科,辽宁沈阳110002

出　　处：《中国医刊》2022年第3期309-312,共4页Chinese Journal of Medicine

基　　金：辽宁省科学技术计划(2020-MS-320);沈阳市重大科技创新研发计划(19-112-4-026)。

摘　　要：目的探讨活髓保存治疗龋源性有症状不可复性牙髓炎的短期疗效,并分析其与人口学指标、临床指标、龋齿深层腐质及微生物的关系。方法选取2018年1月至2020年6月中国人民解放军北部战区总医院收治的因深龋引起的有症状不可复性牙髓炎患者220例,根据术中露髓情况分为直接盖髓术组(73例)、间接盖髓术组(73例)、活髓切断术组(74例)。比较三组患者术后3个月的短期疗效,并分析不可复性牙髓炎保髓治疗预后的影响因素。结果经术后3个月随访,成功202例,失败18例,活髓保存术的总体成功率为91.82%。三组活髓保存术成功率比较差异无显著性(P>0.05)。单因素分析结果显示,不可复性牙髓炎患者的腐质颜色、腐质质地、龋齿微生物与活髓保存治疗预后相关(P<0.05),而性别、牙位、洞形、冷刺激痛、冷刺激延缓痛、热刺激痛、热刺激延缓痛、自发痛、夜间痛、叩痛、牙髓电活力差值、治疗方案与活髓保存术预后无明显相关(P>0.05)。多因素logistic回归分析结果显示,龋源性有症状不可复性牙髓炎患者的腐质颜色(浅黄/黄色)、腐质质地(软)、龋齿微生物(乳酸杆菌属明显增加)是影响活髓保存术成功的独立危险因素(P<0.05)。结论活髓保存治疗龋源性有症状不可复性牙髓炎的短期疗效佳,腐质颜色、腐质质地、龋齿微生物是影响其疗效的独立危险因素。Objective To explore the short-term curative effect of vital pulp preservation in the treatment of cariogenic and symptomatic non-reducible pulpitis,and to analyze the relationship between the prognosis of pulp preservation treatment and demographics,clinical indicators,deep humus,and microorganisms.Method From January 2018 to June 2020,220 patients with symptomatic and irreducible pulpitis caused by deep caries in our hospital were selected as the research objects.According to the intraoperative pulp exposure,they were divided into the direct pulp capping group(73 cases),indirect pulp capping group(73 cases),pulpotomy group(74 cases).The three-month short-term efficacy of the three groups was compared,and the main prognostic factors of the treatment of non-reducible pulpitis were analyzed.Result After 3 months of follow-up,202 cases were successful and 18 cases failed.The overall success rate of vital pulp preservation was 91.82%.There was no significant difference in the success rate of vital pulp preservation among the three groups(P>0.05).Univariate analysis showed that the humus color,humus texture,and caries microorganisms of patients with irreducible pulpitis were related to the prognosis of vital pulp preservation treatment(P<0.05),while gender,tooth position,cavity shape,and cold stimulation pain,cold stimulation delayed pain,thermal stimulation pain,thermal stimulation delayed pain,spontaneous pain,nocturnal pain,percussion pain,the difference in pulp electrical vitality,and treatment plan were not related to the prognosis of vital pulp preservation(P>0.05).Multivariate analysis of logistic regression showed that humus color(light yellow/yellow),humus texture(soft),caries microorganisms(lactobacillus significant increase)was independent risk factors that affected the success of vital pulp preservation(P<0.05).Conclusion Vital pulp preservation had a good short-term curative effect in the treatment of cariogenic symptomatic and irreducible pulpitis.The main factors affecting the prognosis of the pulp pre

关 键 词：龋齿 不可复性牙髓炎 保髓治疗术 短期疗效 预后 

分 类 号：R781.31[医药卫生—口腔医学]