目的:观察不同年龄患者牙髓切断术的临床疗效,探讨牙髓钙化发生的情况和特点.方法:选择2019年10月到2022年8月就诊于北京大学口腔医院综合科龋源性露髓的成年恒前磨牙、恒磨牙行牙髓切断术的患者共77例,使用iRoot BP Plus生物陶瓷类材料作为盖髓剂,一次法完成牙髓切断术.将患者按年龄分为3组,青少年组(11～20岁)25例,平均年龄(15.88±2.19)岁;中年组(21～50岁)27例,平均年龄(34.59±8.67)岁;老年组(51～83岁)25例,平均年龄(63.84±7.40)岁.术后1年复查,评价临床疗效,记录钙化桥形成、钙化桥厚度,以及牙髓钙化指数(pulp calcification index,PCI).结果:3组患者在性别、牙列及牙位分布上差异均无统计学意义(P＞0.05).术后1年随访率为85.71％(66/77),其中青少年组随访率为88.00％(22/25),中年组随访率为85.19％(23/27),老年组随访率为84.00％(21/25).3组病例1年复查临床成功率分别为95.45％(21/22)、91.30％(21/23)、95.24％(20/21),差异无统计学意义(P＞0.05).临床成功病例中,钙化桥出现率青少年组12例(57.14％,12/21),中年组8例(38.10％,8/21),老年组3例(15.00％,3/20),差异有统计学意义(x2=7.810,P=0.020＜0.05).3组间钙化桥厚度比较差异有统计学意义(F=4.434,P=0.020＜0.05).钙化桥厚度与年龄呈负相关(r=-0.516,P＜0.05).3组间PCI变化(ΔPCI)分别为0.67±0.58、0.43±0.51、0.25±0.52,差异有统计学意义(F=3.404,P=0.040＜0.05).结论:老年患者龋源性露髓牙髓切断术同样能够获得较高的成功率;牙髓切断术后钙化桥的发生率以及牙髓钙化的加速程度与年龄相关;青少年组更易形成钙化桥,同时也出现更明显的根管钙化加速现象.
Abstract
Objective:To observe the clinical efficacy of pulpotomy in patients of different ages and to explore the occurrence and characteristics of pulpal calcification.Methods:A total of 77 patients who underwent pulpotomy for mature permanent premolars and molars with caries-derived pulp exposure in the Department of General Dentistry,Peking University School and Hospital of Stomatology from October 2019 to August 2022 were selected.Pulpotomies were performed in a single visit using iRoot BP Plus bioceramic material as pulp capping agent.The patients were divided into three groups according to age:25 cases in the adolescent group(11-20 years old)with a mean age of(15.88±2.19)years;27 cases in the middle-aged group(21-50 years old)with a mean age of(34.59±8.67)years;and 25 cases in the elder-aged group(51-83 years old)with a mean age of(63.84±7.40)years.The patients were reviewed 1 year after the operation to evaluate the clinical efficacy and to record the formation of calcified bridge,thickness of calcified bridge,and pulp calcification index(PCI).Results:There was no statisti-cally significant difference between the three groups in terms of gender,dentition,and tooth position(P＞0.05).The 1-year postoperative follow-up rate was 85.71％(66/77),including 88.00％(22/25)in the adolescent group,85.19％(23/27)in the middle-aged group,and 84.00％(21/25)in the elder-aged group.The 1-year follow-up clinical success rates of the three groups were 95.45％(21/22),91.30％(21/23),and 95.24％(20/21),respectively,with no statistically significant difference(P＞0.05).Among the clinical success cases,calcified bridges appeared in 12 cases(57.14％,12/21)in the adolescent group,8 cases(38.10％,8/21)in the middle-aged group,and 3 cases(15.00％,3/20)in the elder-aged group,with statistically significant differences(x2=7.810,P=0.020＜0.05).The difference was statistically significant(F=4.434,P=0.020＜0.05)when comparing the thickness of calcified bridges among the three groups.Calcified bridge thickness was negatively corre-lated with age(r=-0.516,P＜0.05).The changes in pulpal calcification index ΔPCI were 0.67±0.58,0.43±0.51,and 0.25±0.52,respectively,with statistically significant differences among the three groups(F=3.404,P=0.040＜0.05).Conclusion:Pulpotomy for caries-derived pulp exposure in elderly patients could also achieve a high success rate.The incidence of calcified bri-dges after pulpotomy and the acceleration of pulpal calcification were age-related.The adolescent group was more likely to form calcified bridges and also showed more pronounced accelerated root canal calcifi-cation.
维普
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