牙髓切开术治疗具有不可逆牙髓炎临床症状的初生磨牙：一项前瞻性单臂先导研究。

IF 5.5 2区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of dentistry Pub Date : 2025-09-28 DOI:10.1016/j.jdent.2025.106140

Nebu Philip , Mawlood Kowash , Thikrayat Bani-Hani , Osama El Shahawy , Ahmad Issa , Hanan Mohamed , Mustafa Abdalla , Suhad Jundi , Sondos Albadri , Mandeep Duggal , Hani Nazzal

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引用次数: 0

摘要

目的：评估临床症状为不可逆牙髓炎的重要磨牙全髓切开术的治疗效果和疼痛缓解效果。方法：本研究设计为一项多中心、单臂、前瞻性临床试验，已在ClinicalTrials.gov注册（NCT06149845）。50例临床症状显示不可逆性牙髓炎且术中评估牙髓至关重要的龋齿，按照标准化的程序方案进行了全冠状牙髓切开术。止血是通过在根状髓残端上适度压缩2% naocl湿润的无菌棉球达6分钟而实现的。放置一层2-3毫米的矿物三氧化物骨料（MTA）作为切髓药物，用预成型的金属冠修复牙齿。术前和术后疼痛评分采用经过验证的五点视觉模拟量表（VAS）进行评估。6个月后评估临床和影像学结果。并分析年龄、性别、牙型、龋位、止血时间、牙形放射率等潜在预后因素对治疗结果的影响。结果：组内VAS疼痛评分分析显示，截髓术后24小时和7天疼痛明显减轻。治疗后6个月，牙髓切除的初生磨牙临床和影像学成功率分别为100%和93.9%。治疗结果与所调查的变量之间没有明显的关联。结论：疼痛的缓解和6个月的临床和影像学结果表明，MTA牙髓切开术是临床诊断为不可逆牙髓炎的重要一磨牙的成功治疗选择。临床意义：本研究加强了目前可用的证据，认为牙髓切开术可以作为一种替代治疗方式来治疗严重暴露的重要乳牙，并出现症状性不可逆牙髓炎。

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Pulpotomy for treating primary molars with clinical symptoms indicative of irreversible pulpitis: A prospective single-arm pilot study

Objectives

Assess the treatment outcomes and pain relief afforded by full pulpotomy in vital primary molars with clinical symptoms indicative of irreversible pulpitis.

Methodology

This study was designed as a multi-centre, single-arm, prospective clinical trial registered under ClinicalTrials.gov (NCT06149845). Fifty carious primary molars with clinical symptoms indicative of irreversible pulpitis and pulp intra-operatively assessed to be vital, underwent full coronal pulpotomy following a standardized procedural protocol. Haemostasis was achieved by moderately compressing a 2 % NaOCl-moistened sterile cotton pellet over the radicular pulp stumps for up to 6-minutes. A 2–3 mm layer of mineral trioxide aggregate (MTA) was placed as the pulpotomy medicament and the tooth restored with a pre-formed metal crown. Pre- and post-operative pain scores were evaluated using a validated five-point visual analogue scale (VAS). Clinical and radiographic outcomes were assessed after 6-months. Treatment outcome effects of potential prognostic factors like age, gender, tooth type, site of caries, haemostasis time, and furcal radiolucency were also analysed.

Results

Intra-group analysis of VAS pain scores revealed significant pain reduction 24-h and 7-d after the pulpotomy treatment procedure. The 6-month post-treatment clinical and radiographic success rates of the pulpotomised primary molars were 100 % and 93.9 %, respectively. No significant association was evident between treatment outcomes and the investigated variables.

Conclusions

The pain relief afforded and the 6-month clinical and radiographic outcomes indicate that MTA pulpotomy is a successful treatment option for vital primary molars clinically diagnosed with irreversible pulpitis.

Clinical Significance

This study strengthens the currently available evidence for pulpotomy to be considered as an alternate treatment modality for cariously exposed vital primary molars presenting with symptomatic irreversible pulpitis.

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来源期刊

Journal of dentistry 医学-牙科与口腔外科

CiteScore

7.30

自引率

11.40%

发文量

349

审稿时长

35 days

期刊介绍： The Journal of Dentistry has an open access mirror journal The Journal of Dentistry: X, sharing the same aims and scope, editorial team, submission system and rigorous peer review. The Journal of Dentistry is the leading international dental journal within the field of Restorative Dentistry. Placing an emphasis on publishing novel and high-quality research papers, the Journal aims to influence the practice of dentistry at clinician, research, industry and policy-maker level on an international basis. Topics covered include the management of dental disease, periodontology, endodontology, operative dentistry, fixed and removable prosthodontics, dental biomaterials science, long-term clinical trials including epidemiology and oral health, technology transfer of new scientific instrumentation or procedures, as well as clinically relevant oral biology and translational research. The Journal of Dentistry will publish original scientific research papers including short communications. It is also interested in publishing review articles and leaders in themed areas which will be linked to new scientific research. Conference proceedings are also welcome and expressions of interest should be communicated to the Editor.