背景:基质金属蛋白酶(MMPs)是参与牙髓组织重塑和防御机制的关键酶。虽然它们在恒牙中的作用已被广泛研究,针对乳牙MMPs的研究仍然有限。这种差距凸显了需要进一步研究以了解MMP对乳牙牙髓防御的具体贡献。此外,Biodentine作为乳牙牙髓切开术材料的临床疗效值得通过精心设计的研究进一步探索,以确定其在儿科牙科的成功和长期结局.
目的:本研究旨在比较可逆性和不可逆性牙髓炎患者中MMP-2,MMP-8和MMP-9的表达水平。此外,它旨在评估三氧化二矿聚集体(MTA)和生物牙本质在原发性磨牙中用作牙髓切除术剂的临床成功。通过分析这些MMPs的差异表达,这项研究将有助于更好地了解它们在牙髓炎症中的作用以及MTA和Biodentine在原发性磨牙中的潜在治疗结果.
方法:在这项平行随机对照试验中,将63颗下颌初级第二磨牙分为两个主要组:第1组,由42颗诊断为可逆性牙髓炎的牙齿组成,和第2组,由21颗诊断为不可逆性牙髓炎的牙齿组成。第1组进一步分为两个随机亚组,每个包含21颗牙齿。在所有样品中评估MMP-2、MMP-8和MMP-9的表达水平。在第1组中使用MTA和Biodentine进行牙髓切除术治疗。在18个月的随访期内进行临床和影像学评估。使用Kolmogorov-Smirnov检验进行统计分析,t检验和Fisher精确检验(p<0.05)。
结果:研究显示,在不可逆性牙髓炎标本中,MMP-2和MMP-9表达水平显著升高(p=0.01),表明这些基质金属蛋白酶与牙髓炎症的严重程度之间存在潜在的相关性。然而,用MTA和Biodentine进行牙髓切除术的临床成功率没有显着差异,这表明两种材料在治疗可逆性牙髓炎的原发性磨牙方面同样有效。
结论:牙髓血中MMP-2和MMP-9的表达为评估乳牙牙髓炎症程度提供了一个有希望的生物标志物。提供潜在有价值的诊断工具。此外,Biodentine在牙髓切除术中的临床成功支持其作为MTA的有效替代品的可行性,提供可靠的选择。
■研究方案已注册ID:NCT05145686。注册日期:2021年11月9日。
BACKGROUND: Matrix metalloproteinases (MMPs) are critical enzymes involved in the remodeling and defense mechanisms of dental pulp tissue. While their role in permanent teeth has been extensively studied, research focusing on MMPs in primary teeth remains limited. This gap highlights the need for further investigations to understand the specific contributions of MMPs to pulpal defense in primary teeth. Moreover, the clinical efficacy of Biodentine as a pulpotomy material in primary teeth warrants further exploration through well-designed studies to establish its success and long-term outcomes in pediatric dentistry.
OBJECTIVE: This study aims to compare the expression levels of MMP-2, MMP-8, and MMP-9 in cases of reversible and irreversible pulpitis. Additionally, it seeks to evaluate the clinical success of Mineral Trioxide Aggregate (MTA) and Biodentine when used as pulpotomy agents in primary molars. By analyzing the differential expression of these MMPs, the study will contribute to a better understanding of their role in pulpal inflammation and the potential therapeutic outcomes of MTA and Biodentine in primary molars.
METHODS: In this parallel randomized controlled trial, 63 mandibular primary second molars were assigned to two main groups: Group 1, consisting of 42 teeth diagnosed with reversible pulpitis, and Group 2, consisting of 21 teeth diagnosed with irreversible pulpitis. Group 1 was further divided into two randomized subgroups, each containing 21 teeth. The expression levels of MMP-2, MMP-8, and MMP-9 were evaluated in all samples. Pulpotomy treatments were performed using MTA and Biodentine in Group 1. Clinical and radiographic evaluations were conducted over an 18-month follow-up period. Statistical analyses were carried out using The Kolmogorov-Smirnov test, t-test and Fisher\'s exact test (p < 0.05).
RESULTS: The study revealed that MMP-2 and MMP-9 expression levels were significantly elevated in specimens with irreversible pulpitis (p = 0.01), indicating a potential correlation between these matrix metalloproteinases and the severity of pulpal inflammation. However, no significant difference was observed in the clinical success rates of pulpotomies performed with MTA and Biodentine, suggesting that both materials are equally effective in the treatment of primary molars with reversible pulpitis.
CONCLUSIONS: The expression of MMP-2 and MMP-9 in pulpal blood presents a promising biomarker for assessing the degree of pulpal inflammation in primary teeth, offering a potentially valuable diagnostic tool. Additionally, the clinical success of Biodentine in pulpotomy procedures supports its viability as an effective alternative to MTA, providing a reliable option.
UNASSIGNED: The study protocol has been registered with an ID: NCT05145686. Registration Date: 9th November 2021.