CAJ | 학술논문

背景:羟基磷灰石具有良好的生物相容性,可保护牙髓组织,促进骨样牙本质的形成和牙髓组织的愈合,但无抗感染能力.越来越多的学者认为活髓保存治疗时应配伍其他抗菌药物来提高疗效.目的:实验拟观察自凝羟基磷灰石/去甲万古霉素复合物作为盖髓材料的疗效,并与临床应用最广泛的盖髓剂氢氧化钙相比较.设计、时间及地点:随机对照观察实验,于2004-01/2005-06在上海交通大学医学院附属第九人民医院口腔综合科完成.对象及材料:选择能按时复诊且签署知情同意书的深龋或牙髓穿髓患者60例(60颗牙),男28例,女32例,年龄9-40岁.诊断标准:患牙有食物嵌塞痛或冷热刺激痛,去除刺激后疼痛缓解,无自发痛,放射痛及夜间痛.材料:自凝羟基磷灰石/2.5%去甲万古霉素复合物(上海二医口腔材料研究室制);可硬化氧氧化钙(Dycal,美国登士柏公司).方法:将60例患者随机分为实验组和对照组,每组30例(30颗牙).实验组用自凝羟基磷灰石/2.5%去甲万古霉素复合物作为盖髓剂,对照组用可硬化氢氧化钙作为盖髓剂.复查后如无任何不适,则行永久性充填.若盖髓后,患者出现任何不适症状,立刻复诊,改做根管治疗.主要观察指标:观查患者牙髓反应情况.结果:实验组1例患者在盖髓1周后出现隐痛,改做根管治疗,成功率为97%.对照组2例分别在盖髓3 d和1周后出现隐痛,改做根管治疗,成功率为93%.结论:自凝羟基磷灰石复合物盖髓成功率高,效果与氢氧化钙相似,是一种良好的活髓保存盖髓剂.
배경:간기린회석구유량호적생물상용성,가보호아수조직,촉진골양아본질적형성화아수조직적유합,단무항감염능력.월래월다적학자인위활수보존치료시응배오기타항균약물래제고료효.목적:실험의관찰자응간기린회석/거갑만고매소복합물작위개수재료적료효,병여림상응용최엄범적개수제경양화개상비교.설계、시간급지점:수궤대조관찰실험,우2004-01/2005-06재상해교통대학의학원부속제구인민의원구강종합과완성.대상급재료:선택능안시복진차첨서지정동의서적심우혹아수천수환자60례(60과아),남28례,녀32례,년령9-40세.진단표준:환아유식물감새통혹랭열자격통,거제자격후동통완해,무자발통,방사통급야간통.재료:자응간기린회석/2.5%거갑만고매소복합물(상해이의구강재료연구실제);가경화양양화개(Dycal,미국등사백공사).방법:장60례환자수궤분위실험조화대조조,매조30례(30과아).실험조용자응간기린회석/2.5%거갑만고매소복합물작위개수제,대조조용가경화경양화개작위개수제.복사후여무임하불괄,칙행영구성충전.약개수후,환자출현임하불괄증상,립각복진,개주근관치료.주요관찰지표:관사환자아수반응정황.결과:실험조1례환자재개수1주후출현은통,개주근관치료,성공솔위97%.대조조2례분별재개수3 d화1주후출현은통,개주근관치료,성공솔위93%.결론:자응간기린회석복합물개수성공솔고,효과여경양화개상사,시일충량호적활수보존개수제.
BACKGROUND: Hydroxyapatite has favorable biocompatibility, can protect pulp tissue and promote the formation of osteoid dentin and the concrescence of pulp tissue. However, hydroxyapatite has no capability of anti-infection. Increasing scholars deem that antibacterials should be added with the hydroxyapatite during the treatment of vital pulp conservation to elevate curative effects.OBJECTIVE: To observe the curative effects of self-solidifying hydroxyapatite/norvancomycin composite as pulp capping material and to make a comparison with calcium hydroxide.DESIGN, TIME AND SETTING: The present randomized controlled observation experiment was performed at the General Dental Clinic, the Ninth People's Hospital, Shanghai Jiao Tong University Medical College between January 2004 and June 2005.PARTICIPANTS AND MATERIALS: A total of 60 patients (60 teeth) that suffered from deep caries or pulp exposure, could return visit on time, and agreed to sign informed consents were selected for this study. These patients comprised of 28 males and 32 females, aged 9-40 years. Diagnosis criteria: Teeth with food impaction pain and/or caloric stimulation pain which can relieve after stimulation removal; in addition, with no spontaneous pain, radiating pain, and hypnalgia. Self-solidifying hydroxyapatite/2.5% norvancomycin composite were prepared in the Department of Dental Material, Shanghai Second Hospital. Self-hardening calcium hydroxide was provided by Dentsply Company, USA.METHODS: All 60 patients were randomly divided into an experimental group and a control group, with 30 patients (30 teeth) per group. Self-solidifying hydroxyapatite/2.5% norvancomycin composite and self-hardening calcium hydroxide were applied as pulp capping agents in the experimental and control groups, respectively. Pulpal tissue reactions were assessed after 8 weeks. Teeth with normal response were restored permanently, and the others were given root canal treatment.MAIN OUTCOME MEASURES: Pulpal tissue reaction of patients.RESULTS: In the experimental group, one case showed vague pain after 1-week pulp capping and received root canal therapy, with success rate of 97%. In the control group, two cases presented with vague pain after 3-day and 1-week pulp capping, respectively, and also received root canal therapy, with success rate of 93%.CONCLUSION: Self-solidifying hydroxyapatite/norvancomycin composite acquires a high success rate of pulp capping, with curative effects similar to calcium hydroxide, it is a good pulp capping agent for vital pulp preservation.