Vitapex、MTA联合氢氧化钙糊剂在年轻恒牙牙髓坏死牙髓血运重建中的效果  

Effects of Vitapex and MTA combined with calcium hydroxide paste in pulp revascularization of necrotic pulps in young permanent teeth

作　　者：郝志庭 高水仙 曹溪溪 Hao Zhi-ting;Gao Shui-xian;Cao Xi-xi(Department of Stomatology,Yulin First Hospital,Yulin,Shaanxi 719000,China)

机构地区：[1]榆林市第一医院口腔科,陕西榆林719000

出　　处：《中国现代医学杂志》2024年第24期75-80,共6页China Journal of Modern Medicine

基　　金：陕西省重点研发计划(No:2021SF-051)。

摘　　要：目的评估Vitapex、矿物三氧化物聚合物(MTA)联合氢氧化钙糊剂在年轻恒牙牙髓坏死牙髓血运重建中效果。方法选取2021年1月—2023年1月在榆林市第一医院接受治疗的123例牙髓坏死患儿。所有患儿行牙髓血运重建术,根据不同填充方式分为A组、B组和C组,每组41例。A组采用Vitapex联合氢氧化钙糊剂;B组采用MTA联合氢氧化钙糊剂;C组采用MTA联合三联抗生素糊剂。比较3组治疗次数、治疗周期和直接成本。通过儿童疼痛行为量表(FLACC)比较3组患儿术后1 d、1周、1个月的疼痛情况。比较患儿术后1 d和1周的血清炎症因子水平,术前和术后6个月龈沟液碱性成纤维细胞生长因子(bFGF)和血管内皮生长因子(VEGF)水平,以及牙根发育情况、咀嚼能力。结果与B、C组比较,A组平均治疗次数和治疗周期更高,但直接成本更低(P<0.05)。A、B、C组术后1 d、1周和1个月的VAS评分比较,结果:①不同时间点VAS评分比较,差异有统计学意义(P<0.05);②3组VAS评分比较,差异有统计学意义(P<0.05),C组VAS评分较低,相对镇痛效果较好;③3组VAS评分变化趋势比较,差异有统计学意义(P<0.05)。C组术后1 d与术后1周CRP、IL-6、IL-8的差值均高于A、B组(P<0.05)。B组治疗前后龈沟液bFGF和VEGF的差值均高于A、C组(P<0.05)。B组治疗前后牙根发育指标和咀嚼效率的差值均高于A、C组(P<0.05)。结论相比氢氧化钙糊剂,三联抗生素糊剂在降低患儿术后炎症水平方面更具优势,而氢氧化钙糊剂在促进牙根发育、改善咀嚼和咬合等方面优于三联抗生素糊剂。Objective To evaluate the effect of Vitapex and mineral trioxide aggregate(MTA)combined with calcium hydroxide paste in pulp revascularization of necrotic pulps in young permanent teeth.Methods A total of 123 children who received treatment for pulp necrosis from January 2021 to January 2023 in our hospital were selected.All patients underwent pulp revascularization surgery and were divided into group A,group B,and group C based on the treatment,with 41 cases in each group.The group A was treated with Vitapex combined with calcium hydroxide paste,the group B with MTA combined with calcium hydroxide paste,and the group C with MTA combined with triple antibiotic paste.The treatment frequency,treatment duration,and direct costs were compared among the three groups.The postoperative pain levels of the three groups of children at 1 day,1 week,and 1 month after surgery were compared using the Face,Legs,Activity,Cry,Consolability(FLACC)scale.Serum levels of inflammatory factors at 1 day and 1 week after surgery,levels of basic fibroblast growth factor(bFGF)and vascular endothelial growth factor(VEGF)in gingival crevicular fluid before and 6 months after surgery,and the root development and masticatory ability were compared.Results Compared to treatment groups B and C,group A had a higher average treatment frequency and longer treatment duration,but lower direct costs(P<0.05).Comparisons of VAS scores at 1 day,1 week,and 1 month after surgery in the three groups revealed that there were significant differences among these time points(P<0.05)and the groups(P<0.05),with lower VAS scores in the group C suggestive of a better analgesic effect(P<0.05).The change trends of VAS scores were different among the three groups(P<0.05).The differences of levels of CRP,IL-6 and IL-8 at 1 day and 1 week after surgery in the group C were greater than those in the groups A and B(P<0.05).The differences of levels of bFGF and VFGF in gingival crevicular fluid before and after treatment in the group B were greater than those in groups A and

关 键 词：牙髓坏死 牙髓血运重建术 氢氧化钙糊剂 三联抗生素糊剂 矿物三氧化物聚合物 

分 类 号：R781.3[医药卫生—口腔医学]