METHODS: This two-armed, parallel-group, randomized, superiority trial included vital mature permanent teeth with deep primary or secondary caries diagnosed radiographically as being at least 75% into the thickness of dentine, without clinical signs of symptomatic irreversible pulpitis or radiographic evidence of a periapical lesion. Carious teeth were blindly allocated to receive either SCR or Pulpotomy using computer-generated randomized patient codes concealed in opaque envelopes. All teeth were reviewed clinically and radiographically at 6 months and 1 year post-treatment. Using a significance level of p < .05, the log rank test and Cox proportional hazards regression were used to compare the outcome of SCR and Pulpotomy and to identify potential prognostic factors, respectively.
RESULTS: In all, 58 teeth in the SCR group and 55 teeth in the pulpotomy group completed treatment, after excluding 6 teeth because they did not complete the allocated treatment and another due to severe periodontal disease. At one year, 57/58 (98.3%) teeth from the SCR group and 48/55 (87.3%) teeth from the Pulpotomy group were available for analysis. One tooth in the Pulpotomy group (2.1%) and eight teeth in the SCR group (14.0%) required the further intervention of root canal treatment (p < .05). There were no other significant prognostic factors for survival. Overall, 91.4% of teeth treated with either SCR or Pulpotomy survived without requiring further intervention over a period of one year. No other adverse events occurred over the review period.
CONCLUSIONS: Within the limitations of this study, Pulpotomy fares better than SCR in preserving the remaining pulp and periapical health. As a treatment modality, Pulpotomy carries greater cost outlay to patient and takes a longer time to complete treatment than SCR. Long-term follow-up is needed to study the pulpal and restorative outcomes of Pulpotomy and SCR.
方法:这种双臂,平行组,随机化,优势试验包括至关重要的成熟恒牙,在影像学上诊断为深度原发性或继发性龋齿至少75%进入牙本质厚度,没有症状性不可逆牙髓炎的临床症状或根尖周病变的影像学证据。使用隐藏在不透明信封中的计算机生成的随机患者代码,盲目地分配不活动的牙齿以接受SCR或牙髓切除术。所有牙齿在治疗后6个月和1年进行临床和影像学检查。使用p<0.05的显著性水平,使用对数秩检验和Cox比例风险回归比较SCR和牙髓切除术的结果,并确定潜在的预后因素。分别。
结果:总而言之,SCR组58颗牙齿和牙髓切除组55颗牙齿完成治疗,在排除6颗牙齿后,因为它们没有完成分配的治疗,另一颗由于严重的牙周病。一年,SCR组的57/58(98.3%)牙齿和牙髓切除术组的48/55(87.3%)牙齿可用于分析。牙髓切除术组的一颗牙齿(2.1%)和SCR组的八颗牙齿(14.0%)需要进一步干预根管治疗(p<0.05)。没有其他重要的生存预后因素。总的来说,在一年的时间内,接受SCR或牙髓切除术治疗的牙齿中有91.4%存活,无需进一步干预。在审查期间没有发生其他不良事件。
结论:在本研究的局限性内,牙髓切除术在保存剩余牙髓和根尖周健康方面优于SCR。作为一种治疗方式,牙髓切除术对患者带来更大的成本支出,并且比SCR花费更长的时间来完成治疗。需要长期随访以研究牙髓切除术和SCR的修复结果。