中华老年口腔医学杂志2024,Vol.22Issue(1) :15-20.DOI:10.19749/j.cn.cjgd.1672-2973.2024.01.003

老年人不可复性牙髓炎行活髓切断术的临床疗效观察

Clinical effects of pulpotomy in the treatment of teeth with irreversible pulpitis in elderly patients

朱丽娜 郑幼洋 邓学韬 陈震 钱文昊
中华老年口腔医学杂志2024,Vol.22Issue(1) :15-20.DOI:10.19749/j.cn.cjgd.1672-2973.2024.01.003

老年人不可复性牙髓炎行活髓切断术的临床疗效观察

Clinical effects of pulpotomy in the treatment of teeth with irreversible pulpitis in elderly patients

朱丽娜 1郑幼洋 2邓学韬 1陈震 1钱文昊1
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作者信息

  • 1. 200032,上海市徐汇区牙病防治所
  • 2. 310009 杭州,浙江大学医学院附属第二医院口腔内科
  • 折叠

摘要

目的 观察老年人不可复性牙髓炎行活髓切断术的临床疗效.方法 在 60~80 岁的老年患者中选取 60 例因龋露髓引起不可复性牙髓炎,且去除部分或全部冠髓后 5 min内可止血的患牙,将 60 颗患牙随机分到活髓切断组或根管治疗组,其中活髓切断组 30 颗患牙使用iRoot BP Plus作为盖髓材料行活髓切断术,根管治疗组30颗患牙行根管治疗术.比较两组术后1~7 d的视觉模拟评分(VAS),比较两组治疗所需时间,术后 3、6、12 个月对患者进行临床及影像学检查,评价2 组的临床疗效.结果 活髓切断组有 2 颗患牙出现牙髓感染,5 颗疗效不确定,总成功率为 75.0%,根管治疗组有 1 颗患牙出现牙体折裂,2 颗继发根尖周炎,总成功率为 89.7%,两组之间成功率的差异无统计学意义(P>0.05).活髓切断组术后 1~7 d的VAS评分均低于根管治疗组(P>0.05),活髓切断组的平均治疗时间为46.4 min,显著低于根管治疗组的112.5 min(P<0.05).结论 活髓切断术用于老年人不可复性牙髓炎具有良好的短期疗效,可有效减轻术后疼痛、缩短治疗时间,可能成为根管治疗术的替代方法.

Abstract

Objective To observe the clinical effects of pulpotomy in the treatment of teeth with irreversible pulpitis in elderly patients.Methods A total of 60 patients aged 60-80 years who had irreversible pulpitis caused by caries and could stop bleeding within 5 minutes after partial or total removal of crown pulp were selected.60 teeth were randomly divided into pulpotomy group and root canal therapy group respectively.The teeth in pulpotomy group were treated with pulpotomy using iRoot BP Plus as pulp capping material,and the teeth in root canal group were treated with root canal therapy.The visual analogue scale(VAS)score after 1 day to 7 days,the average treatment time,the clinical effects after 3 months,6 months,12 months were compared between groups.Results In pulptomy group,2 teeth had pulp infection,the clinical effects of 5 teeth was uncertain,the total success rate was 75.0%,while in root canal therapy group,1 teeth had fracture and 2 teeth had periapical periodontitis,the total success rate was 89.7%.The VAS scores of pulpotomy group were lower than root canal therapy group after 1 day to 7 days.There was no significant difference in success rate and VAS score between two groups(P>0.05).The average treatment time of pulpotomy group was 46.4 min,which was significantly shorter than time of root canal therapy group 112.5min(P<0.05).Conclusions Pulpotomy has a good short-term clinical effect on teeth with irreversible pulpitis in elderly patients,which can effectively reduce the postoperative pain and shorten the treatment time.Pulpotomy may become an alternative method for root canal therapy.

关键词

活髓切断/活髓保存/不可复性牙髓炎/老年人

Key words

Pulpotomy/Vital pulp therapy/Irreversible pulpitis/Elderly patients

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基金项目

上海市徐汇区医学科研项目(SHXH202109)

徐汇区卫生健康系统尖峰学科建设项目(SHXHZDXK202302)

出版年

2024
中华老年口腔医学杂志
解放军总医院 口腔医学教研室

中华老年口腔医学杂志

CSTPCD
影响因子:1.169
ISSN:1672-2973
参考文献量20
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