不同活髓保存材料在磨牙深龋患者活髓切断术中的治疗效果  

Therapeutic effect of different vital pulp preservation materials during vital pulpotomy on patients with deep molar caries

作　　者：吴超娟 陈怀丽[1] 孟翔峰[1] WU Chaojuan;CHEN Huaili;MENG Xiangfeng(Nanjing Stomatological Hospital,Medical School of Nanjing University,Jiangsu,Nanjing 210000,China)

机构地区：[1]南京大学医学院附属口腔医院,南京市210000

出　　处：《河北医药》2025年第2期242-245,共4页Hebei Medical Journal

基　　金：国家自然科学基金(编号:81470781)。

摘　　要：目的比较2种不同活髓保存材料[三氧化矿物聚合物(MTA)和氢氧化钙]在活髓切断术中对磨牙深龋患者的影响。方法选取2022年我院牙科收治的60例磨牙深龋患者(患牙85颗)进行活髓切断术治疗研究,并随机分为2组,研究组(30例,44颗)与对照组(30例,41颗),对照组使用氢氧化钙活髓保存材料,研究组使用MTA活髓保存材料。治疗后对2组患者进行术后回访,比较2组患者治疗后1个月手术成功率、牙髓电活力、咀嚼功能(咀嚼效率、咬合力)、牙髓刺激程度差异,对比2组治疗后6个月满意度差异,分析治疗前及治疗后1、3、6个月时的疼痛度变化,观察治疗前及治疗后1个月时龈沟液炎性因子[C-反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)、白介素-6(IL-6)]变化。结果治疗后1个月,研究组治疗成功率和牙髓电活力检测优良率高于对照组(P<0.05),与对照组比较,研究组咀嚼效率和咬合力略高,但组间比较差异无统计学意义(P>0.05),研究组牙髓刺激程度低于对照组(P<0.05)。治疗后1、3和6个月时,2组患者VAS评分均较治疗前降低(P<0.05),且研究组低于同期对照组(P<0.05)。治疗后1个月时,2组患者血清CRP、TNF-α、IL-6均较治疗前降低(P<0.05),且研究组低于同期对照组(P<0.05)。治疗后6个月时,研究组总满意度高于对照组(P<0.05)。结论应用活髓保存材料MTA对磨牙深龋患者活髓切断术的治疗效果及预后影响均优于使用氢氧化钙,因该方法能够提高手术成功率及牙髓电活力,减少局部炎症浸润、缓解牙髓刺激程度及疼痛症状,具有较高应用价值。Objective To compare the influence of two vital pulp preservation materials used in vital pulpotomy,namely mineral trioxide aggregate(MTA)and calcium hydroxide,on patients with deep molar caries.Methods A total of 60 patients with deep molar caries(85 affected teeth)admitted to the Department of Dentistry of our hospital for vital pulpotomy in 2022 were selected.They were randomly assigned into the study group(44 teeth,30 cases)and control group(41 teeth,30 cases).Patients in the control group were given vital pulp preservation material of calcium hydroxide,and those in the study group were treated with vital pulp preservation material of MTA.Postoperative follow-up was performed.Success rate of surgery,electric pulp testing,masticatory function(masticatory efficiency,occlusal force)and degree of dental pulp stimulation at 1 month postoperatively were compared between the two groups.Satisfaction at 6 months postoperatively was compared.The changes in pain degree before treatment and at 1 month,3 months and 6 months after treatment were compared.The changes in inflammatory factors,including C-reactive protein(CRP),tumor necrosis factor-α(TNF-α),and interleukin-6(IL-6)in gingival crevicular fluid were observed before treatment and 1 month after treatment.Results At 1 month after treatment,the success rate of treatment and excellent and good rate of electric pulp testing were significantly higher in the study group than those of control group(P<0.05).Compared with those of control group,the masticatory efficiency and occlusal force were slightly higher in the study group,but without significant differences(P>0.05).The degree of dental pulp stimulation was significantly milder in the study group than that of control group(P<0.05).At 1 month,3 months and 6 months after treatment,the Visual Analogue Scale(VAS)score in both groups was significantly reduced compared with that before treatment,and it was significantly lower in the study group than control group(all P<0.05).At 1 month after treatment,serum CRP,TNF-αand

关 键 词：深龋 活髓切断术 三氧化矿物聚合物 氢氧化钙 

分 类 号：R781.31[医药卫生—口腔医学]