单次根管治疗与牙髓切开术治疗牙髓炎的比较

Mariam Elsherif, A. Darrag, H. Saudi, N. Shaheen
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摘要

目的评价单次根管治疗和牙髓切开术治疗成熟牙不可逆性牙髓炎的临床及影像学评价。患者与方法选择24例诊断为不可逆牙髓炎的成熟恒磨牙患者,根据治疗方案随机分为单次随机对照试验组和截髓组。单次随访RCT组采用ProTaper NEXT旋转系统预备根管,并采用冷侧凝技术进行封堵。截髓组在冠状髓切除止血后,采用百妥妥定作为截髓剂。实验组在完成治疗后立即(基线)、治疗后3、6、9和12个月进行临床检查。同时在基线和术后12个月使用锥束计算机断层扫描进行影像学检查。临床评价标准采用χ2检验,影像学资料采用t检验进行统计学分析。结果单次随访RCT的临床成功率为91.67%,而截髓组的成功率为83.33%。随访后两组牙周膜间隙宽度正常,骨密度正常。两组间差异无统计学意义(P > 0.05)。结论单次随机对照试验联合截髓术治疗成熟恒牙不可逆性牙髓炎成功率高。髓体切开术可作为另一种治疗选择。
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Single visit root canal treatment versus pulpotomy in management of pulpitis
Aim To clinically and radiographically evaluate single visit root canal treatment (RCT) and pulpotomy in management of mature teeth with irreversible pulpitis. Patients and methods Twenty-four patients diagnosed with irreversible pulpitis in their mature permanent mandibular molars, were selected and randomly divided into two equal groups according to the treatment protocol either single visit RCT or pulpotomy. For single visit RCT group, ProTaper NEXT rotary system was used for canal preparation and obturation was done using cold lateral condensation technique. While in pulpotomy group, after coronal pulp amputation and hemostasis, Biodentine was used as the pulpotomy agent. The clinical examination of tested groups was performed immediately after completing the procedure (baseline), 3, 6, 9, and 12 months posttreatment. While the radiographic examination using cone-beam computed tomography was carried out at baseline and 12 months postoperatively. Statistical analysis was performed by χ2 test for clinical evaluation criteria and t test for radiographic data. Results Single visit RCT had clinical success rate of 91.67%, while pulpotomy group showed 83.33% success rate. Radiographically, both groups showed normal width of periodontal ligament membrane space and normal bone density after follow-up. There was no statistically significant difference between two groups (P > 0.05). Conclusions Single visit RCT and pulpotomy had high success rate in management of mature permanent teeth diagnosed with irreversible pulpitis. Pulpotomy can be considered as an alternative treatment option.
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