Comparison of the efficacy of two bioceramic materials in vital pulp preservation of mature permanent teeth with exposed pulp of caries origin
JIA Xiaoling1, ZHANG Hui2
1. Department of Stomatology, Hangzhou Traditional Chinese Medicine Hospital Affiliated to Zhejiang Chinese Medical University, Hangzhou, Zhejiang 310007, China; 2. Zhejiang University, Hangzhou, Zhejiang 310058, China
摘要目的 比较2种生物陶瓷材料iRoot BP Plus 和三氧化矿物凝聚体（MTA）在龋源性露髓成熟恒牙的活髓盖髓效果,为此类患牙选择合适的盖髓剂提供参考。方法 选择浙江中医药大学附属杭州市中医院口腔科就诊的龋源性露髓的成熟恒牙并行活髓保存术的120例患者及其120颗患牙,随机分为两组,分别使用iRoot BP Plus和MTA作为盖髓剂。术后定期复诊,通过临床检查和影像学检查评估盖髓效果。结果 iRoot组60例,其中男性23例,女性37例;年龄M（QR）为41（12）岁;患牙在前磨牙27例,磨牙33例;Ⅰ类洞8例,Ⅱ类洞52例。MTA组60例,其中男性29例,女性31例;年龄M（QR）为39（14）岁;患牙在前磨牙21例,磨牙39例;Ⅰ类洞10例,Ⅱ类洞50例。两组性别、年龄、患牙位置和洞型差异均无统计学意义（P>0.05）。术后12个月,iRoot组和MTA组盖髓成功率分别为91.67%和88.33%,牙髓感染率分别为8.33%和11.67%,差异均无统计学意义（P>0.05）;但MTA组牙冠变色占61.67%,iRoot组无变色。结论 12个月观察期内,iRoot BP Plus和MTA在龋源性露髓成熟恒牙活髓保存中均能取得较好的盖髓效果,无明显差异,但MTA盖髓后存在牙冠变色问题。两种材料的远期临床效果还有待进一步研究。
Abstract：Objective To compare the efficacy of two bioceramic materials, iRoot BP Plus and mineral trioxide aggregate (MTA) in the preservation of vital pulp of mature permanent teeth with exposed pulp of caries origin, so as to provide insights into appropriate selection of pulp capping agents in clinical process. Methods Vital pulp therapy were performed on 120 mature permanent teeth with carious exposure at the Department of Stomatology of Hangzhou Traditional Chinese Medicine Hospital Affiliated to Zhejiang Chinese Medical University. The teeth were randomly divided into two groups which were treated respectively by iRoot BP Plus (iRoot group) and MTA (MTA group). The clinical efficacy was evaluated by clinical examinations and imaging examinations. Results There were 60 cases in iRoot group, including 23 males and 37 females, 27 cases affected premolars and 33 cases affected molars, and 8 cases of Class I and 52 cases of Class II cavity type, with a median age of 41 (interquartile range, 12) years. There were 60 cases in MTA group, including 29 males and 31 females, 21 cases affected premolars and 39 cases affected molars, and 10 cases of Class I and 50 cases of Class II cavity type, with a median age of 39 (interquartile range, 14) years. There were no significant differences in gender, age, affected tooth location and cavity type between the two groups (P>0.05). The success rate of iRoot group at 12 months was 91.67% while the MTA group was 88.33%, and the pulp infection rate of iRoot group at 12 months was 8.33% while the MTA group was 11.67%. There were no significant differences in success rate and pulp infection rate between the two groups (P>0.05). The rate of crown discoloration in MTA group was 61.67%, while there was no discoloration in iRoot group. Conclusions During 12 months, iRoot BP Plus and MTA can both achieve great effects in the treatment of mature permanent teeth with carious pulp exposure, but there is a problem of tooth discoloration after pulp covering using MTA. The long-term clinical effects of the two materials need to be further studied.
贾晓玲, 章慧. 龋源性露髓成熟恒牙活髓保存的2种生物陶瓷材料盖髓效果比较[J]. 预防医学, 2024, 36(3): 224-227.
JIA Xiaoling, ZHANG Hui. Comparison of the efficacy of two bioceramic materials in vital pulp preservation of mature permanent teeth with exposed pulp of caries origin. Preventive Medicine, 2024, 36(3): 224-227.
[1] DUNCAN H F,GALLER K M,TOMSON P L,et al.European society of endodontology position statement:management of deep caries and the exposed pulp[J].Int Endod J,2019,52(7):923-934. [2] LIN L M,RICUCCI D,SAOUD T M,et al.Vital pulp therapy of mature permanent teeth with irreversible pulpitis from the perspective of biology[J].Aust Endod J,2020,46(1):154-166. [3] ASGARY S,HASSANIZADEN R,TORABZADEN H,et al.Treatment outcomes of 4 vital pulp therapies in mature molors[J].J Endod,2018,44(4):529-535. [4] 吴补领,罗奕菲,徐稳安,等.恒牙牙髓炎的活髓保存治疗[J].口腔疾病防治,2021,29(7):433-441. [5] ASGARY S,PARIROKH M,EGHBAL M J,et al.Chemical differences between white and gray mineral trioxide aggregate[J].J Endod,2005,31(2):101-103. [6] CAMILLERI J,MONTESIN F E,PAPAIOANNOU S,et al.Biocompatibility of two commercial forms of mineral trioxide aggregate[J].Int Endod J,2004,37(10):699-704. [7] 钱锟,潘洁,朱文昊,等.两种硅酸钙类材料用于成熟恒牙牙髓切断术的临床效果[J].北京大学学报(医学版),2022,30(4):260-264. [8] 何文喜,余擎.牙髓炎的活髓保存及再生治疗新进展[J].中华口腔医学杂志,2022,57(1):16-22. [9] 陈嘉琪,董艳梅.龋源性露髓成熟恒牙活髓保存治疗的研究进展[J].中华口腔医学杂志,2022,57(1):95-100. [10] ALSUBAIT S,ALJARBOU F.Biodentine or mineral trioxide aggregate as direct pulp capping material in matural permanent teeth with carious exposure? A systematic review and meta-analysis[J].Oper Dent,2021,46(6):631-640. [11] AHLAWAT M,GREWAL M S,GOEL M,et al.Direct pulp capping with mineral trioxide aggregate and biodentine in cariously exposed molar teeth:1-year follow-up-an in vivo study[J].J Pharm Bioallied Sci,2022,14(1):983-985. [12] MOTWANI N,IKHAR A,NIKHADE P,et al.Premixed bioceramics:a novel pulp capping agent[J].J Conserv Dent,2021,24(2):124-129. [13] SHI S,BAO Z F,LIU Y,et al.Comparison of in vivo dental pulp response to capping with iRoot BP Plus and mineral trioxide aggregate[J].Int Endod J,2016,49(2):154-160. [14] MATSUURA T,ZIAUDDIN S M,KAWATA-MATSUURA V,et al.Long-term clinical and radiographic evaluation of the effectiveness of direct pulp capping materials:a meta-analysis[J].Dent Mater J,2021,40(1):1-7. [15] 黄伟曼,张栋杰,胡旭初,等.iRoot BP Plus和MTA用于年轻恒牙直接盖髓的临床疗效观察[J].中华口腔医学研究杂志,2017,11(6):366-370. [16] ElMSMARI F,RUIZ X F,MIRO Q,et al.Outcome of partial pulpotomy in cariously exposed posterior permanent teeth:a systematic review and meta-analysis[J].J Endod,2019,45(11):1296-1306. [17] WILLERSHAUSEN B,WILLERSHAUSEN I,ROSS A,et al.Retrospective study on direct pulp capping with calcium hydroxide[J].Quintessence Int,2011,42(2):165-171.
