Indirect pulp therapy

间接牙髓疗法
  • 文章类型: Journal Article
    氟化银二胺(SDF)已被证明可有效阻止龋齿病变,最近,临床试验评估了SDF作为乳牙间接牙髓治疗(IPT)药物的有效性.这篇综述旨在总结与使用SDF相关的文献,并找出SDF是否可以用作IPT的有效材料。对包括PubMed在内的电子数据库进行了文献检索,MEDLINE,ScienceDirect,和谷歌学者,这引发了50项研究,在初级磨牙的IPT中使用不同的材料;然而,其中,只有4项临床试验使用SDF作为间接盖髓(IPC)材料。SDF有可能成为乳牙中IPT的有用材料。由于其最小的侵入性,它是儿科牙医的方便选择,易于应用,以及阻止龋齿发展的能力。然而,需要更多的研究来确定SDF是否可以常规用于IPT,以及它是否可以取代目前可用的材料,以及充分发挥其潜力,并为其在IPT程序中的理想应用建立标准。
    Silver diamine fluoride (SDF) has been demonstrated to be effective in arresting caries lesions and, recently, clinical trials have assessed the effectiveness of SDF as a medicament for indirect pulp therapy (IPT) in primary teeth. This review aims to summarize the literature related to the use of SDF and find out if SDF can be used as an effective material for IPT. A literature search was undertaken on electronic databases including PubMed, MEDLINE, ScienceDirect, and Google Scholar, which elicited 50 studies employing different materials in the IPT of primary molars; however, of them, only four clinical trials used SDF as indirect pulp capping (IPC) material. SDF has the potential to be a useful material for IPT in primary teeth. It is a handy choice for pediatric dentists due to its minimum invasiveness, ease of application, and ability to stop the progression of caries. However, more studies are needed to determine whether SDF can be used routinely for IPT and whether it can even replace the currently available materials, as well as to fully realize its potential and establish criteria for its ideal application in IPT procedures.
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  • 文章类型: Journal Article
    儿童早期龋病(ECC)是儿童最常见的慢性口腔疾病,是全球范围内急需解决的公共卫生问题之一。ECC会影响儿童的牙齿,牙列,颅颌面,以及总体健康和发展。因此,通过龋齿病因和龋齿风险评估,以病人为中心,在ECC的临床管理中,应实行个性化规划和防治相结合。周期性和连续的循环管理只有在医务人员的配合下才能完成,孩子们,和他们的监护人。本专家共识将从以下几个方面阐述ECC的临床管理:龋病风险评估、早期临床预防,治疗策略,和术后管理。
    Early childhood caries (ECC) is the most prevalent chronic oral disease and one of the worldwide public health problems of great urgency for children. ECC can affect children\'s teeth, dentition, craniomaxillofacial, and general health and development. Therefore, through dental caries etiologies and caries risk assessment, patient-centered, personalized planning and a combination of prevention and treatment should be implemented in the clinical management for ECC. Periodic and continuous cycle management can only be accomplished with the cooperation of medical staff, children, and their guardians. This expert consensus will expound the clinical management of ECC in the following aspects: caries risk assessment, early clinical prevention, treatment strategies, and postoperative management.
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  • 文章类型: Journal Article
    在本科教学环境中,有关重要牙髓治疗结果的信息很少。这项研究旨在确定哪种类型的落叶磨牙,拱门位置,活髓疗法的类型,当本科牙科学生进行时,所涉及的龋齿表面的数量具有更好的预后。使用的方法是回顾590例600颗乳磨牙患者的临床记录,他们访问了门诊本科牙科诊所进行重要的牙髓治疗。用于确定牙齿类型关联的统计分析,拱门位置,治疗类型,与成功结局相关的龋齿表面数量进行了logistic回归分析,显著性设置为p<0.05.根据回归分析模型的结果,根据牙齿类型(p<0.05)和牙弓位置(p=0.003),存在显着相关性。此外,根据所进行的治疗类型存在显著关联(p=0.036).然而,根据所涉及的龋齿表面的数量,成功率没有显著关联(p=0.873).总之,第二乳磨牙和上颌乳磨牙的总体预后较好,在我们的设置中,与硫酸铁牙髓切除术相比,间接牙髓治疗与成功治疗结果的相关性更高.
    There is a paucity of information concerning vital pulp treatment outcomes in the undergraduate teaching setting. This study aimed to determine which type of deciduous molar, arch location, type of vital pulp therapy, and the number of carious surfaces involved had a better prognosis when carried out by undergraduate dental students. The method used was the review of clinical records of 590 patients with 600 deciduous molars, that visited the outpatient undergraduate dental clinics for vital pulp therapy. Statistical analysis used to determine the associations of tooth type, arch location, treatment type, and the number of carious surfaces involved in successful outcomes was logistic regression analysis with significance set at p < 0.05. According to the regression analysis model results, there was a significant association based on tooth type (p < 0.05) and arch location (p = 0.003). In addition, there was a significant association based on the type of treatment performed (p = 0.036). However, there was no significant association in success rates based on the number of carious surfaces involved (p = 0.873). In conclusion, second deciduous molars and maxillary deciduous molars had a better overall prognosis, and indirect pulp therapy was revealed to be more highly associated with successful treatment outcomes in comparison to ferric sulfate pulpotomy in our setting.
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  • 文章类型: Journal Article
    目的:目前尚无关于原发性磨牙的间接牙髓疗法与硫酸铁牙髓切除术的长期比较研究。这项回顾性研究旨在比较硫酸铁牙髓切除术与间接牙髓治疗在4年随访期间的成功率。
    方法:从38例儿童(女16例,男22例)中选择114颗原发性磨牙。在这些磨牙中,根据两名高级儿科牙医的标准协议,在全身麻醉下治疗了71例用于硫酸铁髓切除术和43例用于间接牙髓治疗。用于确定成功率的临床和影像学评估在初始时使用既定标准进行,术后,24个月和48个月。使用Fisher精确检验对数据进行分析,以比较硫酸铁牙髓切除术和间接牙髓治疗在24个月和48个月随访时的成功率。
    结果:间接牙髓治疗和硫酸铁牙髓切除术的总体成功率分别为100%(43/43)和91.5%(65/71),分别,在24个月随访时;差异无统计学意义(P=0.08)。然而,间接牙髓治疗的成功率(93.0%,40/43)在48个月的随访中明显高于硫酸铁切除术(70.4%,50/71)(P=0.008)。
    结论:在4年的随访中,间接牙髓疗法治疗原发性磨牙深部龋病变的成功率明显高于硫酸铁牙髓切除术。与间接牙髓疗法相比,用硫酸铁牙髓切除术治疗后观察到较早的剥脱。
    OBJECTIVE: There is no long-term study on the comparison of indirect pulp therapy with ferric sulfate pulpotomy in primary molars. This retrospective study aimed to compare the success rates of ferric sulfate pulpotomy with those of indirect pulp therapy in primary molars during a 4-year follow-up.
    METHODS: A total of 114 primary molars from 38 children (16 females and 22 males) with deep carious lesions were selected. Among these molars, 71 indicated for ferric sulfate pulpotomy and 43 indicated for indirect pulp therapy were treated under general anesthesia according to a standard protocol by two senior pediatric dentists. Clinical and radiographic assessments for determining success rates were performed using established criteria at initial, post-operatively, and at 24 and 48 months. Data were analyzed using Fisher\'s exact test to compare success rates of ferric sulfate pulpotomy and indirect pulp therapy at the 24- and 48-month follow-ups.
    RESULTS: The overall success rates for indirect pulp therapy and ferric sulfate pulpotomy were 100% (43/43) and 91.5% (65/71), respectively, at the 24-month follow-up; the difference was not significant (P = 0.08). However, the success rate for indirect pulp therapy (93.0%, 40/43) at the 48-month follow-up was significantly higher than that for ferric sulfate pulpotomy (70.4%, 50/71) (P = 0.008).
    CONCLUSIONS: Indirect pulp therapy showed a significantly higher success rate at the 4-year follow-up than did ferric sulfate pulpotomy for treating deep carious lesions in primary molars. Earlier exfoliation was observed after treatment with ferric sulfate pulpotomy compared to indirect pulp therapy.
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  • 文章类型: Journal Article
    Deciduous teeth are the first dentition of humans and play an important role in children\'s physical and mental development. Dental caries are one of the most common oral diseases in children. According to the data of the World Health Organization, 60%-90% of school children worldwide develop dental caries. In China, dental caries of primary teeth feature high incidence and low rate of visits. Without timely treatment, the deep caries lesions of primary teeth can lead to teeth defect, pulpitis, apical periodontitis, and maxillofacial space infection. Moreover, the premature loss of deciduous teeth can cause malocclusion and eruption disorder of subsequent permanent teeth. These conditions all cause considerable effects on children\'s oral health and physical and mental development. Performing active and effective measures to treat deciduous teeth with deep caries lesions is important to maintain the integrity and normal physiological function of dentition and facilitate normal eruption of permanent teeth. The current situation of indirect pulp therapy in China was studied in this paper. Basic concepts, including indirect pulp capping, interim therapeutic restoration, partial caries removal, stepwise caries removal, and atraumatic restorative therapy, have been defined by consulting domestic and foreign literature. A theoretical basis for improving the clinical pathway of deciduous teeth with deep caries lesions is provided by explaining the technical connotation and therapeutic importance of indirect pulp therapy in primary teeth.
    乳牙是人类的第一副牙齿,其正常萌出建并行使生理功能对儿童的身心发育具有重要意义。乳牙龋病是儿童慢性疾病之首,是儿童口腔医学临床最常见的疾病之一。根据世界卫生组织调查数据显示,世界范围内60%~
90%的学龄儿童患有龋病。乳牙龋病在我国具有患龋率高,就诊率低下的特点,如不及时治疗,可导致牙体组织缺损、生理间隙丢失、牙髓和根尖周病变及颌面间隙感染,严重者可致乳牙早失并伴发牙列畸形及后续恒牙萌出障碍等不良结果,影响儿童口腔健康及身心发育。因此,对深龋乳牙采取积极有效的治疗措施对保存必要乳牙及其牙髓活力,恢复正常生理功能,维持牙列完整性,诱导后续恒牙正常萌出建具有重要意义。本文从目前深龋乳牙间接牙髓治疗的研究认识现状出发,通过文献资料收集整理,对间接牙髓治疗、间接盖髓术、暂时性保髓充填、部分去龋法、分步去龋法和非创伤性修复治疗等相关概念进行了对比分析,阐明了乳牙间接牙髓治疗的技术内涵和治疗意义,对乳牙深龋的临床治疗路径完善提供了理论依据。.
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