本文選題：深齲　切入點(diǎn)：活髓切斷術(shù)　出處：《安徽醫(yī)科大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：隨著生活水平的提高,人們對口腔健康越發(fā)重視,口腔健康明顯影響著人們的生活質(zhì)量。在臨床上,我們發(fā)現(xiàn)越來越多的患者具有強(qiáng)烈的保存活髓、保留患牙的意識,尤其對很常見的齲源性露髓患牙。但是對于這種齲源性露髓的牙根發(fā)育完成恒牙,根管治療被認(rèn)為是治療的金標(biāo)準(zhǔn)。根據(jù)文獻(xiàn)報道我們知道牙髓組織具有形成、營養(yǎng)、感覺、防御的能力,活髓患牙的保存率明顯高于無髓患牙。因此,活髓切斷術(shù)用于成熟恒牙的研究,便成為我們本次研究的主要內(nèi)容。目的觀察活髓切斷術(shù)應(yīng)用于牙根發(fā)育已完成、齲源性露髓的恒牙臨床效果,為其在臨床應(yīng)用,提供一定的理論基礎(chǔ)和臨床指導(dǎo)。方法收集齲源性露髓且牙根發(fā)育完成的患牙(62例),行活髓切斷術(shù)的患牙為實驗組A(32例),行根管治療的患牙為對照組B(30例)。A組患牙利用阿替卡因腎上腺素注射液(必蘭)進(jìn)行局麻,上橡皮障,利用無菌球鉆去齲壞組織、去齲未凈,探及穿髓孔,更換使用活切包器械,揭凈髓室頂,充分暴露髓腔,利用銳利的挖匙或球鉆切斷冠部炎癥牙髓組織,斷面整齊,無菌生理鹽水沖洗牙髓斷面,去除組織碎屑,無菌濕棉球壓迫止血。將按照說明書調(diào)置的MTA糊劑覆蓋于斷面上約2mm厚,勿向根方施力,之后將無菌生理鹽水濕棉球輕輕置于MTA上,暫封24小時后,去暫封物,觀察MTA凝固情況,3M樹脂充填,調(diào)牙合,拋光,拍攝術(shù)后X線片。B組患牙局麻,上橡皮障,無菌球鉆去凈齲壞組織、揭凈髓室頂,拔髓,根尖定位儀測定工作長度,根向技術(shù)進(jìn)行根管預(yù)備,5.25%次氯酸鈉溶液及大量生理鹽水沖洗根管,吸潮紙尖干燥根管、試主尖、最后進(jìn)行根管充填,流動樹脂封根管口,3M樹脂充填、調(diào)牙合,拋光,拍攝術(shù)后X線片。分別1、3、6、12個月進(jìn)行復(fù)診,通過臨床評估及影像學(xué)評估來評價治療效果,并進(jìn)行比較,采SPSS18.0軟件包進(jìn)行統(tǒng)計分析。結(jié)果觀察一年活髓切斷術(shù)的成功率為93.75%,根管治療的成功率為93.10%,兩組成功率無顯著差異(χ2=0.010,P=0.665)。結(jié)論活髓切斷術(shù)應(yīng)用于齲源性露髓的牙根發(fā)育完成恒牙,既保留了部分牙髓組織,也避免了牙體組織預(yù)備,適合臨床推廣,具有一定可行性。
[Abstract]:With the improvement of living standard, people pay more and more attention to oral health. Oral health obviously affects people's quality of life. Clinically, we find that more and more patients have a strong sense of preserving the living pulp and keeping the affected teeth. Especially for very common cariogenic exposed teeth. But root canal therapy is considered to be the gold standard for permanent teeth. According to the literature, we know that dental pulp tissue is formed, nutritious, and felt. The defense ability of living pulp teeth is significantly higher than that of unmyelinated teeth. Therefore, the study of active pulp incision for mature permanent teeth has become the main content of our study. Objective to observe that the application of living pulp incision in root development has been completed. The clinical effect of cariogenic pulp exposed permanent teeth, for its clinical application, Methods A total of 62 patients with caries exposed pulp and complete root development were collected, 32 cases of experimental group were treated with active pulp incision, and 30 cases of group A were treated with root canals as control group (n = 30, n = 30, n = 30, n = 30, n = 30, n = 30, n = 30, n = 30, n = 30, n = 30, n = 30, n = 30, n = 30, n = 30). The teeth were treated by local anesthesia with Atevacaine epinephrine injection (Beilan). On rubber barrier, use sterility ball drill to remove decayed tissue, remove caries not clean, probe through pulp hole, replace and use alive wrapping apparatus, clean pulp chamber top, fully expose pulp cavity, use sharp scoop or ball drill to cut off inflammatory pulp tissue of the crown, section is neat, Wash dental pulp section with sterile saline, remove tissue debris, and dry wet cotton ball to stop bleeding. Cover the MTA paste adjusted according to the instructions to the section about 2 mm thick, do not apply force to the root, Then the sterile saline wet cotton ball was placed on the MTA gently, and after 24 hours of temporary sealing, the temporary sealing material was removed, the solidification of MTA was observed by 3M resin filling, the occlusion was adjusted and polished, the local anaesthesia of teeth in group B was photographed after operation, and the rubber barrier was added to the teeth. The sterility ball drilled the clean decayed tissue, removed the top of the pulp chamber, pulled out the pulp, measured the working length of the root tip, prepared the root canal with 5.25% sodium hypochlorite solution and a large amount of normal saline for root canal preparation, and dried the root canal at the top of the hygroscopic paper. Finally, root canal filling, flowing resin sealing root canal orifice and 3M resin filling, adjusting occlusion, polishing, taking X-ray film after operation were carried out respectively. The treatment effect was evaluated by clinical evaluation and imaging evaluation after 12 months, respectively, and compared with each other. Results the success rate of one year active pulp incision was 93.755.The success rate of root canal therapy was 93.100.There was no significant difference between the two groups (蠂 ~ 2 0.010 ~ (10)). Conclusion\\\; It not only preserves some pulp tissues, but also avoids tooth tissue preparation, which is suitable for clinical application and has certain feasibility.
【學(xué)位授予單位】：安徽醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R781.05

【參考文獻(xiàn)】

相關(guān)期刊論文 前1條

1 徐西紅;郭蕾;黃世濤;楊婕;馮穎;吳永梅;劉莉;;CBCT在疑難根管治療中的應(yīng)用分析[J];口腔醫(yī)學(xué);2016年06期

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本文編號：1643433