老年人不可复性牙髓炎行活髓切断术的临床疗效观察  

Clinical effects of pulpotomy in the treatment of teeth with irreversible pulpitis in elderly patients

作　　者：朱丽娜 郑幼洋[2] 邓学韬 陈震 钱文昊[1] ZHU Li-na;ZHENG You-yang;DENG Xue-tao;CHEN Zhen;QIAN Wen-hao(Dental Disease Control Institute,Xuhui District,Shanghai 200032,China)

机构地区：[1]上海市徐汇区牙病防治所,200032 [2]浙江大学医学院附属第二医院口腔内科,杭州310009

出　　处：《中华老年口腔医学杂志》2024年第1期15-20,共6页Chinese Journal of Geriatric Dentistry

基　　金：上海市徐汇区医学科研项目(SHXH202109);徐汇区卫生健康系统尖峰学科建设资助项目(SHXHZDXK202302)。

摘　　要：目的 观察老年人不可复性牙髓炎行活髓切断术的临床疗效。方法 在60~80岁的老年患者中选取60例因龋露髓引起不可复性牙髓炎,且去除部分或全部冠髓后5 min内可止血的患牙,将60颗患牙随机分到活髓切断组或根管治疗组,其中活髓切断组30颗患牙使用i Root BP Plus作为盖髓材料行活髓切断术,根管治疗组30颗患牙行根管治疗术。比较两组术后1~7 d的视觉模拟评分(VAS),比较两组治疗所需时间,术后3、6、12个月对患者进行临床及影像学检查,评价2组的临床疗效。结果 活髓切断组有2颗患牙出现牙髓感染,5颗疗效不确定,总成功率为75.0%,根管治疗组有1颗患牙出现牙体折裂,2颗继发根尖周炎,总成功率为89.7%,两组之间成功率的差异无统计学意义(P> 0.05)。活髓切断组术后1~7 d的VAS评分均低于根管治疗组(P> 0.05),活髓切断组的平均治疗时间为46.4 min,显著低于根管治疗组的112.5 min(P <0.05)。结论 活髓切断术用于老年人不可复性牙髓炎具有良好的短期疗效,可有效减轻术后疼痛、缩短治疗时间,可能成为根管治疗术的替代方法。Objective To observe the clinical effects of pulpotomy in the treatment of teeth with irreversible pulpitis in elderly patients.Methods A total of 60 patients aged 60-80 years who had irreversible pulpitis caused by caries and could stop bleeding within 5 minutes after partial or total removal of crown pulp were selected.60 teeth were randomly divided into pulpotomy group and root canal therapy group respectively.The teeth in pulpotomy group were treated with pulpotomy using iRoot BP Plus as pulp capping material,and the teeth in root canal group were treated with root canal therapy.The visual analogue scale(VAS)score after 1 day to 7 days,the average treatment time,the clinical effects after 3 months,6 months,12 months were compared between groups.Results In pulptomy group,2 teeth had pulp infection,the clinical effects of 5 teeth was uncertain,the total success rate was 75.0%,while in root canal therapy group,1 teeth had fracture and 2 teeth had periapical periodontitis,the total success rate was 89.7%.The VAS scores of pulpotomy group were lower than root canal therapy group after 1 day to 7 days.There was no significant difference in success rate and VAS score between two groups(P>0.05).The average treatment time of pulpotomy group was 46.4 min,which was significantly shorter than time of root canal therapy group 112.5min(P<0.05).Conclusions Pulpotomy has a good short-term clinical effect on teeth with irreversible pulpitis in elderly patients,which can effectively reduce the postoperative pain and shorten the treatment time.Pulpotomy may become an alternative method for root canal therapy.

关 键 词：活髓切断 活髓保存 不可复性牙髓炎 老年人 

分 类 号：R781.31[医药卫生—口腔医学]