目的:这项随机临床试验旨在评估和比较三氧化二矿(MTA)为基础的生物酰胺和树脂为基础的密封剂对无症状的重要磨牙在一次根管治疗中闭塞后疼痛的发生率和强度以及治疗结果的影响。
方法:根据使用的密封剂,将一百颗无症状的具有重要牙髓的下颌磨牙随机分为两组:MTAFillapex或AHPlus密封剂。WaveOneGold仪器用于根管准备。根管用WaveOneGoldgutta-percha锥体封闭,其大小和锥度与所用的最后一种仪器相对应。第一组使用MTAFillapex,第二组使用AHPlus作为根管封闭剂。年龄的影响,性别,1年和2年后评估牙型和根管充填水平对治疗结果的影响。术后疼痛6,12,24,48,72h,用数值评定量表测量根管治疗后4、5、6、7和30天。治疗结果采用卡方检验,Mann-WhitneyU,卡方和Spearman相关性分析用于术后疼痛。α=.05是显著性水平。
结果:12例患者未完成2年随访,88例患者完成研究。在MTAFillapex组41中正确,一个短,两个挤压,在AHPlus组40中正确,检测到一个短的和三个挤压的根管填充物。两组之间的第一年和第二年治疗结果没有显着差异(p>0.05)。年龄之间没有关联,性别,齿数,所有评估牙齿的根管充填长度和治疗成功率(p>.05)。两组之间在术后疼痛发生率和强度方面在所有时间点的差异均无统计学意义(p>0.05)。年龄与术后疼痛无相关性(p>0.05),但女性疼痛在统计学上较高(p<0.05)。
结论:矿物三氧化物聚集体Fillapex显示出与AHPlus封闭剂相似的成功率和闭塞后疼痛发生率和强度,可用作无症状下颌磨牙伴不可逆牙髓炎的根管封闭剂。
OBJECTIVE: This randomized clinical trial aimed to evaluate and compare the effect of mineral trioxide aggregate (MTA)-based bioceramic- and resin-based sealers on the incidence and intensity of post-obturation pain and treatment outcome in asymptomatic vital molar teeth in single-visit root canal treatment.
METHODS: One hundred asymptomatic mandibular molar teeth with vital pulp were randomly assigned into two groups according to the sealer used: MTA Fillapex or AH Plus sealer. WaveOne Gold instruments were used for root canal preparations. Root canals were obturated with WaveOne Gold gutta-percha cones corresponding in size and taper to the last instrument used. MTA Fillapex was used in the first group and AH Plus was used in the second group as the root canal sealer. The effects of age, gender, tooth types and the level of root canal filling on the treatment outcome were evaluated after 1 and 2 years. Postoperative pain at 6, 12, 24, 48, 72 h, 4, 5, 6, 7 and 30 days after root canal treatment was measured with the Numerical Rating Scale. Chi-square test was used for the treatment outcome and Mann-Whitney U, chi-Square and Spearman correlation analyses were used for postoperative pain. α = .05 was the level of significance.
RESULTS: Twelve patients did not complete the 2-year follow-up and the study finished with 88 patients. In the MTA Fillapex group 41 correct, one short, two extruded, and in the AH Plus group 40 correct, one short and three extruded root canal fillings were detected. No significant differences were observed between the first- and second-year treatment outcomes between the groups (p > .05).There was no association between age, gender, tooth number, root canal filling length and the treatment success in all evaluated teeth (p > .05). The differences between the groups in terms of postoperative pain incidence and intensity at all time-points were not significant (p > .05). There was no correlation between the age and postoperative pain (p > .05), but pain was statistically higher in women (p < .05).
CONCLUSIONS: Mineral trioxide aggregate Fillapex showed similar success rate and post-obturation pain incidence and intensity as AH Plus sealer and can be used as a root canal sealer in asymptomatic mandibular molars with irreversible pulpitis.