Outcome of full pulpotomy using Biodentine in adult patients with symptoms indicative of irreversible pulpitis
Outcome of full pulpotomy using Biodentine in adult patients with symptoms indicative of irreversible pulpitis
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DOI：
10.1111/iej.12903
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发表时间：
2018-08-01
影响因子：
5
通讯作者：
Abdelkhader, S. Z.
中科院分区：
文献类型：
--
作者：
Taha, N. A.;Abdelkhader, S. Z.
目的评价Biodentine全切牙术治疗恒牙不可逆性牙髓炎的疗效。方法对52例19~69岁患者64颗有牙髓症状的恒磨牙进行全切髓治疗。建立了术前牙髓和根尖周部的诊断。在知情同意后，将牙齿麻醉，用橡胶垫隔离，然后用5%NaOCl液消毒，然后将牙髓截断到根管口的水平。止血被实现，并放置3 mm层的生物牙本质(Septodon，Saint-Maur-des-Fosses，法国)作为切髓剂。放置树脂修饰的玻璃离子衬里，用树脂复合体或银汞合金修复牙齿，并暴露术后根尖周X线片。分别于术后6个月和1年进行临床和放射学评估。结果所有患牙均出现不可逆性牙髓炎的临床症状和体征，9颗患牙出现根尖周稀疏。2d后，93.8%的患者报告疼痛完全缓解。6个月时，有63人参加了Recall，临床和放射学成功率为98.4%。1年时，63人中有59人参加了Recall，临床成功率为100%，放射学成功率为98.4%。在参加Recall的8例根尖周稀疏者中，7例根尖周指数(PAI)评分有改善。结论对于有不可逆性牙髓炎临床症状和体征的恒磨牙，使用Biodentine行全髓切断术是一种成功的治疗方法。
AimTo assess the outcome of full pulpotomy using Biodentine in permanent teeth with carious exposures and symptoms indicative of irreversible pulpitis.MethodologySixty-four permanent molar teeth with symptomatic vital pulps in 52 patients aged 19-69years were included. Preoperative pulpal and periapical diagnosis was established. After informed consent, the tooth was anaesthetized, isolated using rubber dam and disinfected with 5% NaOCl before caries excavation; subsequently, the pulp was amputated to the level of the canal orifices. Haemostasis was achieved, and a 3-mm layer of Biodentine (Septodont, Saint-Maur-des-Fosses, France) was placed as the pulpotomy agent. Resin-modified glass-ionomer liner was placed and the tooth restored with either resin composite or amalgam, and a postoperative periapical radiograph exposed. Clinical and radiographic evaluation was completed at 6months and 1year postoperatively. Pain levels were scored preoperatively and 2days post-treatment.ResultsClinical signs and symptoms indicative of irreversible pulpitis were established in all teeth, and periapical rarefaction was present in nine teeth. After 2days, 93.8% reported complete relief of pain. At 6months, 63 of 64 attended recall with 98.4% clinical and radiographic success. At 1year, 59 of 63 attended recall, with 100% clinical and 98.4 radiographic success. Seven of eight cases with periapical rarefaction who attended recall had improvement in the periapical index (PAI) score. A hard tissue barrier was detected radiographically in four cases.ConclusionFull pulpotomy using Biodentine was a successful treatment option for cariously exposed pulps in mature permanent molar teeth with clinical signs and symptoms indicative of irreversible pulpitis, up to 1year.