Success of Direct Pulp Capping Using Mineral Trioxide Aggregate and Calcium Hydroxide in Mature Permanent Molars with Pulps Exposed during Carious Tissue Removal: 1-year Follow-up
Success of Direct Pulp Capping Using Mineral Trioxide Aggregate and Calcium Hydroxide in Mature Permanent Molars with Pulps Exposed during Carious Tissue Removal: 1-year Follow-up
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DOI：
10.1016/j.joen.2019.02.025
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发表时间：
2019-07-01
影响因子：
4.2
通讯作者：
Sangwan, Pankaj
中科院分区：
文献类型：
--
作者：
Suhag, Komal;Duhan, Jigyasa;Sangwan, Pankaj
简介：本随机临床试验旨在比较氢氧化钙（CH）和三氧化二矿骨料（MTA）直接髓盖（DPC）治疗龋齿暴露和可逆性牙髓炎的成功率和术后疼痛。方法：64颗恒牙开挖后随机分为CH组和MTA组，每组32颗。使用标准化方案对暴露的纸浆进行封盖。采用玻璃离子水门合剂和复合修复体修复牙体。主要观察指标为随访12个月的成功率，次要观察指标为术后7天的疼痛。在3、6和12个月时进行临床和影像学评估。干预后7天，每24小时用视觉模拟量表记录疼痛。结果：56例患者在12个月的随访中进行了分析，其中29例接受CH治疗，27例接受prooroot MTA治疗（Dentsply Tulsa Dental, Tulsa， OK）。CH和prooroot MTA的成功率分别为69%和93% （P < 0.05）。译员间一致性kappa值为0.773。两组间疼痛发生率无显著差异（P < 0.05），但两组术后6小时疼痛均明显减轻。18小时后，MTA组疼痛评分（6.3 +/- 9.5）明显低于CH组（18.5 +/- 20.8）。结论：牙髓外露及可逆性牙髓炎均可采用DPC治疗。MTA在成功率和疼痛强度方面均优于CH。
Introduction: This randomized clinical trial aimed to compare the success rate and postoperative pain of direct pulp capping (DPC) using calcium hydroxide (CH) and mineral trioxide aggregate (MTA) in teeth with carious pulp exposures and reversible pulpitis. Methods: Sixty-four permanent teeth were randomly divided after caries excavation into 2 groups: CH and MTA (n = 32 in each group). Exposed pulps were capped using standardized protocols. The treated teeth were restored with glass ionomer cement and composite restoration. The primary outcome was success rate at the 12-month follow-up, and the secondary outcome was postoperative pain after 7 days. Clinical and radiographic evaluations were performed at 3, 6, and 12 months. Pain was recorded using the visual analog scale every 24 hours for 7 days after intervention. Results: Fifty-six patients were analyzed at the 12-month follow-up, 29 treated with CH and 27 with ProRoot MTA (Dentsply Tulsa Dental, Tulsa, OK). The success rate was 69% for CH and 93% for ProRoot MTA (P < .05). The kappa value of interrater agreement was 0.773.No significant difference in pain incidence was found between the 2 groups (P > .05) although a significant pain reduction was found 6 hours after the procedure in both the groups. Significantly lower pain scores were reported in the MTA group (6.3 +/- 9.5) compared with the CH group (18.5 +/- 20.8) after 18 hours. Conclusions: Teeth with carious pulp exposures and reversible pulpitis can be treated successfully with DPC. MTA proved better than CH in terms of both success rate and pain intensity.