Sự hình thành mô khoáng hóa trên phim CBCT trong điều trị che tủy với MTA=Formation of mineralized tissue on CBCT film in pulp capping treatment with MTA

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Tác giả: Huỳnh Anh Bùi

Ngôn ngữ: vie

Ký hiệu phân loại:

Thông tin xuất bản: Tạp chí Y học Việt Nam (Tổng hội Y học Việt Nam), 2024

Mô tả vật lý: tr.118-124

Bộ sưu tập: Metadata

ID: 243674

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Nghiên cứu nhằm đánh giá hiệu quả ứng dụng chất khoáng trioxide tổng hợp (MTA) trong điều trị che tủy trực tiếp trên răng vĩnh viễn người về hình thành mô khoáng hóa trên phim CBCT (cone - beam computed tomography). Phương pháp: Thử nghiệm lâm sàng che tủy trực tiếp với MTA trên 17 răng cối nhỏ vĩnh viễn cần nhổ, chụp CBCT và đánh giá kết quả trên phim sau thời điểm 12 tuần. Các triệu chứng lâm sàng như đau, các thử nghiệm nhạy cảm tủy và thông số X quang được ghi nhận sau khi điều trị. Tiêu chí đánh giá trên X quang bao gồm độ dày ngà chân răng, sự liên tục, kích thước cầu ngà và sự hiện diện của tổn thương quanh chóp trên phim CBCT. Phân tích thống kê bằng SPSS 20.0 với giá trị p ≤ 0,05 làm ngưỡng để coi kết quả có ý nghĩa thống kê. Kết quả: Sự tăng độ dày ngà ngoài trong và gần xa có tăng từ một đến ba vị trí nhưng không khác biệt có ý nghĩa. Độ dày trung bình cầu ngà trước và sau nhổ là 0,32 ± 0,42 mm và 0,53 ± 0,57 mm. Không có khác biệt giữa hai nhóm trước và sau nhổ về độ dày trung bình và sự liên tục cầu ngà. Không hiện diện cầu ngà ở 41,2% và không có hiện tượng viêm, chết tủy và tổn thương quanh chóp sau điều trị ở 100% trường hợp. Kết luận: Sau che tủy trực tiếp, nghiên cứu cho thấy MTA có hiệu quả tốt qua các dấu chứng lâm sàng bình thường và tiềm năng bảo tồn tủy sống. Phim X quang CBCT thể hiện là một phương tiện hữu hiệu để quan sát hình ảnh cầu ngà sớm cho các biểu hiện hình thành mô cứng sửa chữa.This study aimed to assess the efficacy of Mineral Trioxide Aggregate (MTA) in the direct pulp capping treatment of human permanent teeth, particularly in relation to mineralized tissue formation observed on conebeam computed tomography (CBCT) films. Methods: This is a clinical trial of direct pulp capping treatment with MTA involving 17 permanent premolars planned for orthodontic extraction, the results were observed on CBCT film after 12 weeks. Clinical symptoms such as pain, pulp sensitivity tests, and radiological parameters were documented post-treatment. Radiographic assessment criteria involved the measurement of root dentin thickness, continuity of dentinal bridge, and the presence of periapical lesions on CBCT. Statistical analysis was performed using SPSS 20.0, with a threshold p value of ≤ 0.05 signifying statistical significance of the results. Results: Observations revealed a non-significant increase in buccal-lingual and mesio-distal dentin thickness at one to three locations (p >
0.05). The average thickness of the dentinal bridge pre-and post-extraction was recorded as 0.32 ± 0.42 mm và 0.53 ± 0.57 mm, respectively. There was no discernible disparity between the two groups in terms of average thickness and dentinal bridge continuity before and after extraction (p >
0.05). Notably, 41.2% of cases exhibited the absence of dentin bridge, and there were no signs of inflammation, pulp necrosis and periapical lesions post-treatment. Conclusion: Following direct pulp capping, the study findings indicate the favorable efficacy of MTA, as evidenced by standard clinical indicators and its potential in preserving the pulp vitality. Additionally, CBCT radiographs proved to be an effective modality for early detection of dentinal bridge formation, signifying reparative hard tissue manifestations.

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