Outcomes of Vital Pulp Therapy Using Mineral Trioxide Aggregate or Biodentine: A Prospective Randomized Clinical Trial
Outcomes of Vital Pulp Therapy Using Mineral Trioxide Aggregate or Biodentine: A Prospective Randomized Clinical Trial
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DOI：
10.1016/j.joen.2018.08.004
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发表时间：
2018-11-01
影响因子：
4.2
通讯作者：
Chakra, Rosalie Jean
中科院分区：
文献类型：
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作者：
Awawdeh, Lama;Al-Qudah, Aladdin;Chakra, Rosalie Jean
前言：三氧化矿物聚合体(MTA)已用于龋性暴露的成熟恒牙的盖髓治疗，取得了良好的效果。寻找比MTA密封更好、固化速度更快、不会沾染的替代材料正在进行中。Biodentine(Septodon，St Maur-des-Fosses，法国)显示了这些优点，但还没有在成熟牙齿上进行长期试验。本研究旨在评价Biodentine和白色MTA(Angelus，Londrina，巴西)在龋性暴露的成熟恒牙中的临床表现。方法：这是一项前瞻性、纵向、随机对照研究，研究对象为68颗患深龋的活体恒牙。患者被随机分配到2个研究组：Biodentine和MTA。在手术前对牙齿进行临床和X线片评估。在局部麻醉下挖出龋齿；用次氯酸钠暴露牙髓后止血，并用Biodentine或MTA封堵。在6个月、1年、2年和3年后，由盲法校准评估器进行临床和放射学随访。结果：Biodentine和MTA的总成功率无显著差异，6个月时Biodentine和MTA的总成功率分别为93.1%和93.5%。总成功率1年达96.2%(Biodentine=96.0%，MTA=100%)，2年达100%。随访3年后降至93.8%(Biodentine=91.7%，MTA=96.0%)。结论：Biodentine和MTA作为恒牙龋损暴露的直接盖髓或切髓材料具有良好的成功率和可比性。残存的牙体结构和冠状修复体的耐久性可能对活髓治疗的长期成功有重要影响。
Introduction: Mineral trioxide aggregate (MTA) has been used in pulp capping of cariously exposed mature permanent teeth with promising results. The search for alternative materials that seal better and set faster than MTA and do not stain is ongoing. Biodentine (Septodont, St Maur-des-Fosses, France) exhibits these advantages but has not been tested yet for a prolonged duration in mature teeth. This study aimed to evaluate the clinical performance of Biodentine and white MTA (Angelus, Londrina, Brazil) in cariously exposed mature permanent teeth. Methods: This was a prospective longitudinal randomized controlled study of 68 vital permanent teeth with deep caries. Patients were randomly allocated into 2 study arms: Biodentine and MTA. Teeth were assessed clinically and radiographically before the procedure. Caries were excavated under local anesthesia; hemostasis was achieved after pulp exposure using sodium hypochlorite and capped with Biodentine or MTA. Clinical and radiographic follow-ups were performed by a blinded calibrated evaluator after 6 months and 1, 2, and 3 years. Results: There were no significant differences in the overall success rate between Biodentine and MTA; it was 93.3% (Biodentine = 93.1% and MTA = 93.5%) at 6 months. The overall success rate increased to 96.2% (Biodentine = 96.0% and MTA = 100%) at 1 year and to 100% at 2 years. At the 3-year follow-up, it decreased to 93.8% (Biodentine = 91.7% and MTA = 96.0%). Conclusions: Biodentine and MTA have favorable and comparable success rates when used as direct pulp capping or pulpotomy material in permanent mature teeth with carious exposure. The remaining tooth structure and durability of coronal restoration might affect significantly the long-term success of vital pulp therapy.