成熟恒牙龋源性不可复性牙髓炎活髓保存治疗的临床疗效观察  

Clinical efficacy observation of vital pulp therapy for mature permanent teeth with carious irreversible pulpitis

作　　者：秦志明 李佳洋 徐华兴 马智菲 韦晓玲 QIN Zhi-ming;LI Jia-yang;XU Hua-xing;MA Zhi-fei;WEI Xiao-ling(Department of Operative Dentistry and Endodontics,Shanghai Stomatological Hospital,Fudan University,Shanghai 201102,China;Shanghai Key Laboratory of Craniomaxillofacial Development and Diseases,Shanghai 201102,China)

机构地区：[1]上海市口腔医院·复旦大学附属口腔医院牙体牙髓病科,上海201102 [2]上海市颅颌面发育与疾病重点实验室,上海201102

出　　处：《复旦学报(医学版)》2025年第2期263-269,共7页Fudan University Journal of Medical Sciences

基　　金：上海市卫健委卫生行业临床研究专项(202140503);上海市口腔医院人才专项(SHH-2022-YJ-07)。

摘　　要：目的比较成熟恒牙龋源性不可复性牙髓炎的活髓保存治疗与根管治疗术之间的疼痛缓解程度和临床疗效。方法收集2021年1月至2022年6月就诊于上海市口腔医院的被诊断为成熟恒牙龋源性不可复性牙髓炎的患者共90例,随机分为2组,试验组(n=45)进行活髓保存治疗,对照组(n=45)进行根管治疗。记录术前、术后24 h及术后7天患者疼痛得分,并在术后1、6、12个月进行临床评价及影像学分析,比较两组疼痛得分情况及治疗成功率。结果81例患者接受了1年以上的随访,其中试验组39人,平均年龄(31.00±1.43)岁,对照组42人,平均年龄(30.60±1.54)岁,试验组和对照组成功率分别为97.44%和95.24%。两组在术后24 h和术后7天疼痛程度均减轻且存在显著差异(P<0.05),术后7天试验组疼痛评分较对照组降低(P<0.01)。结论与根管治疗术相比,采用活髓保存治疗龋源性不可复性牙髓炎的成熟恒牙,在短期疼痛缓解和长期临床疗效方面均可取得良好效果。Objective To compare the pain relief and long-term clinical success rate of vital pulp therapy and root canal treatment in mature permanent teeth with carious irreversible pulpitis.Methods A total of 90 patients diagnosed with carious irreversible pulpitis in mature permanent teeth were collected at Shanghai Stomatological Hospital from Jan 2021 to Jun 2022.They were randomly divided into two groups:test group(n=45)undergoing vital pulp therapy(VPT)and control group(n=45)undergoing root canal treatment(RCT).Pain scores were recorded before treatment,24 hours after operation and 7 days after operation.We conducted clinical evaluation and imaging analysis at 1,6,and 12 months after the surgery,then compared the pain scores and treatment success rates between the two groups.Results Eighty-one patients,including 39 patients in group VPT aged(31.00±1.43)years old and 42 patients in group RCT aged(30.60±1.54)years old,received follow-up for more than 1 year,and the success rate of the test group and control was 97.44%and 95.24%.The pain degree of the two groups was reduced at 24 hours and 7 days after operation(P<0.05),and the pain score of the test group was reduced compared with that in the control group 7 days after operation(P<0.01).Conclusion Compared with root canal treatment,vital pulp therapy for mature permanent teeth with carious irreversible pulpitis can achieve good results in short-term pain evolution and long-term clinical success.

关 键 词：不可复性牙髓炎 成熟恒牙 活髓保存治疗 根管治疗 

分 类 号：R781.3[医药卫生—口腔医学]