炎性活髓保存在年轻恒牙不可逆性牙髓炎及根尖周炎治疗中的应用  

Study of vital inflamed pulp therapy in immature permanent teeth with irreversible pulpitis and apical periodontitis2

作　　者：肖文[1] 史文涛 汪俊[1] Xiao Wen;Shi Wentao;Wang Jun(Department of Pediatric Dentistry,Shanghai Ninth People′s Hospital,Shanghai Jiao Tong University School of Medicine&College of Stomatology,Shanghai Jiao Tong University&National Center for Stomatology&National Clinical Research Center for Oral Diseases&Shanghai Key Laboratory of Stomatology,Shanghai 200011,China;Clinical Research Center,Shanghai Ninth People′s Hospital,Shanghai Jiao Tong University School of Medicine&College of Stomatology,Shanghai Jiao Tong University&National Center for Stomatology&National Clinical Research Center for Oral Diseases&Shanghai Key Laboratory of Stomatology,Shanghai 200011,China)

机构地区：[1]上海交通大学医学院附属第九人民医院儿童口腔科上海交通大学口腔医学院国家口腔医学中心国家口腔疾病临床医学研究中心上海市口腔医学重点实验室,上海200011 [2]上海交通大学医学院附属第九人民医院临床研究中心上海交通大学口腔医学院国家口腔医学中心国家口腔疾病临床医学研究中心上海市口腔医学重点实验室,上海200011

出　　处：《中华口腔医学杂志》2022年第3期287-291,共5页Chinese Journal of Stomatology

基　　金：上海交通大学医学院附属第九人民医院临床研究助推计划(JYLJ010);上海市口腔医学研究所院级基金(院2016-8)。

摘　　要：为评价炎性活髓保存治疗年轻恒牙不可逆性牙髓炎及根尖周炎的疗效,本研究征集上海交通大学医学院附属第九人民医院儿童口腔科2015年6月至2016年6月收治,并随访1年以上的炎性活髓保存治疗病例进行回顾性分析。得出该技术对改善患牙临床症状及根尖周骨组织愈合的影响,并对患牙根尖孔直径及牙根长度改变数值进行统计,进行重复测量方差分析。本研究共收集符合纳入标准的病例13例(男性6例,女性7例),年龄(9.9±1.4)岁,随访时间(26.5±6.8)个月(17~37个月)。在术后12个月随访时,全部病例均实现临床症状改善,9例初诊时根尖阴影的患牙实现根尖阴影消退。术后3、6、12个月根尖孔直径缩小分别为(8.0±5.1)%、(24.1±9.1)%及(70.3±10.7)%,牙根长度增加分别为(11.4±9.8)%、(14.5±9.8)%及(27.4±14.2)%。术前与术后各随访时间点根尖孔直径及牙根长度改变的重复测量方差分析显示,随着时间的变化,根尖孔直径(F=18.80,P<0.001)及牙根长度(F=4.64,P=0.047)改变差异均有统计学意义。炎性活髓保存技术可有效实现临床症状改善及促进牙根发育,可作为年轻恒牙不可逆性牙髓炎及根尖周炎的治疗方法。To assess the treatment effectiveness of vital inflamed pulp therapy(VIPT)in immature permanent teeth with irreversible pulpitis and apical periodontitis.The faculty members in the Department of Pediatric Dentistry,the Ninth People′s Hospital were invited to submit consecutive VIPT cases from June 2015 to June 2016(follow-up periods>12 months).The cases were retrospectively reviewed,clinical symptoms and radiographic changes in periapical radiolucency were evaluated,meanwhile,the data of radiographic changes such as apical diameter and root length were calculated and analyzed with ANOVA.Totally thirteen submitted patients/cases were included(6 males and 7 females)in the present study,.The average age of patients was(9.9±1.4)years old.The average follow-up time was(26.5±6.8)months(17-37 months).At the 12-month visit,all 13 treated teeth survived,9 out of 11 teeth with apical periodontitis showed normal radiographic manifestation.At the 3,6 and 12 months visits,the within-case percentage changes in apical diameter were(8.0±5.1)%,(24.1±9.1)%and(70.3±10.7)%,respectively,while the within-case percentage changes in root length were(11.4±9.8)%,(14.5±9.8)%and(27.4±14.2)%,respectively.There were statistically significant differences in the changes of apical diameter(F=18.80,P<0.001)and root length(F=4.64,P=0.047)from the preoperative time to the postoperative follow-ups.VIPT might improve clinical outcomes,even achieve continued root development.VIPT can be an option in treating immature teeth with irreversible pulpitis and apical periodontitis.

关 键 词：牙髓炎 根尖周炎 年轻恒牙 活髓保存 影像学表现 

分 类 号：R781.3[医药卫生—口腔医学]