两种生物陶瓷材料在全麻下乳牙冠髓切断术中的应用效果

Clinical efficacy of two bioceramic materials in full pulpotomy of primary teeth under general anesthesia

摘要

目的：比较生物陶瓷材料iRoot BP Plus和三氧化矿物凝聚体（mineral trioxide aggregate，MTA）在乳牙不可复性牙髓炎冠髓切断术（full pulpotomy，FP）中的应用效果。方法：回顾性分析2020年7月至2022年12月在广西医科大学附属口腔医院接受乳牙FP的43例不可复性牙髓炎患儿（98颗患牙）的临床资料。根据盖髓剂的不同将患牙分为MTA组（42颗牙）和iRoot BP Plus组（56颗牙）。术后随访≥24个月，通过对患牙术后的临床检查（叩诊、松动度，有无疼痛、牙龈肿胀或瘘管）及影像学检查（有无牙根内吸收或异常外吸收、有无根尖周或根分叉阴影），评价其临床及影像学疗效。结果：两组性别、年龄和牙位等基线资料比较，差异无统计学意义（P＞0.05）。术后24个月，两组患牙均未出现疼痛、松动、牙龈肿胀或瘘管，亦未见牙根内或外吸收及根尖周或根分叉阴影，总成功率均为100%。结论：MTA和iRoot BP Plus作为乳牙不可复性牙髓炎FP的盖髓剂，均可有效保留乳牙根髓，获得良好的临床疗效。

Abstract

Objective: To compare the clinical efficacy of iRoot BP Plus bioceramic material and mineral trioxide aggregate (MTA) in full pulpotomy (FP) of primary teeth with irreversible pulpitis. Methods: A retrospective analysis was performed on the clinical data of 43 children (98 affected teeth) with irreversible pulpitis who underwent FP of primary teeth at Hospital of Stomatology, Guangxi Medical University from July 2020 to December 2022. The affected teeth were divided into the MTA group (42 teeth) and the iRoot BP Plus group (56 teeth) according to different pulp capping agents. All patients were followed up for at least 24 months after surgery. Clinical efficacy and radiographic outcomes were evaluated through postoperative clinical examination of affected teeth (percussion, tooth mobility, presence or absence of pain, gingival swelling or fistula) and radiographic examination (presence or absence of internal root resorption, abnormal external root resorption, periapical or furcation radiolucency). Results: No statistically significant differences were observed in baseline characteristics such as gender, age and tooth position between the two groups (P＞0.05). At 24 months postoperatively, none of the affected teeth in both groups developed pain, tooth mobility, gingival swelling or fistula. No internal or external root resorption, periapical or furcation radiolucency was observed, and the overall success rates in both groups were 100%. Conclusion: Both MTA and iRoot BP Plus, used as pulp capping agents in FP for primary teeth with irreversible pulpitis, can effectively preserve radicular pulp and yield good clinical outcomes.

关键词

生物陶瓷材料 / 三氧化矿物凝聚体 / 乳牙 / 不可复性牙髓炎 / 冠髓切断术 / 全身麻醉 / 活髓保存术 / 盖髓剂

Key words

bioceramic material / mineral trioxide aggregate / primary teeth / irreversible pulpitis / full pulpotomy / general anesthesia / pulp preservation therapy / pulp capping agent

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基金资助

广西卫生健康委员会自筹经费科研项目(Z20211077)