METHODS: In this prospective randomized clinical trial, n = 50 children with deeply carious young PFM affected with MIH, and diagnosed with reversible or irreversible pulpitis were randomized into 2 groups: indirect pulp treatment (IPT) and pulpotomy (partial or complete). Teeth were followed up clinically and radiographically for 24 months. Statistical analysis was done using Chi-square test; P ≤ 0.05 was considered significant.
RESULTS: A total of n = 50 teeth/patients (n = 26 females (52%), n = 24 males (48%)) were included, and 14 upper and 36 lower PFM were treated. Mean age was 11 ± 3.2 years. Clinical and radiographic success rates were: 96% for IPT, 90% for PP and 82% for CP (and 86% for both types of pulpotomy combined) over 24 months. There were no significant differences in outcomes between treatment groups. Age, gender and tooth location/jaw were found to have no statistically significant difference in outcomes among treatment groups, nor did pulpal status or root maturity, regardless of type of VPT and follow up period.
CONCLUSIONS: VPT is a valid treatment option in deeply carious young permanent first molars affected with MIH over 24 months. IPT had a higher clinical and radiographic success rate (96%) than partial or cervical pulpotomy (total 86%), but the difference was not statistically significant. Future randomized clinical trials on VPT for teeth affected with MIH are recommended with larger sample size and longer follow-up.
方法:在这项前瞻性随机临床试验中,n=50名患有严重龋齿的年轻PFM的儿童受到MIH的影响,被诊断为可逆性或不可逆性牙髓炎的患者被随机分为2组:间接牙髓治疗(IPT)和牙髓切除术(部分或完全)。对牙齿进行24个月的临床和影像学随访。统计学分析采用卡方检验;P≤0.05被认为是显著的。
结果:总共n=50颗牙齿/患者(n=26名女性(52%),n=24名男性(48%)包括在内,治疗14个上PFM和36个下PFM。平均年龄为11±3.2岁。IPT的临床和影像学成功率为:96%,在24个月内,PP占90%,CP占82%(两种类型的联合牙髓切除术占86%)。治疗组之间的结果没有显着差异。年龄,发现性别和牙齿位置/颌骨在治疗组之间的结局没有统计学上的显着差异,牙髓状态或根成熟度也没有,无论VPT类型和随访期。
结论:VPT是一种有效的治疗方案,适用于24个月以上患有MIH的深度龋齿的年轻永久性第一磨牙。IPT的临床和影像学成功率(96%)高于部分或宫颈髓切除术(总计86%),但差异无统计学意义。建议对患有MIH的牙齿进行VPT的未来随机临床试验,样本量更大,随访时间更长。