| Objective: To collect PBF blood flow values of the normal first molars,and to analyze and calculate the "clinical reference range" of PBF blood flow values in physiological state.IRoot BP Plus and Mineral Trioxide Aggregate(MTA)were used to preserve the mature permanent teeth of caries-derived pulp.Laser Doppler Flowmetry(LDF)was used to preserve the mature permanent teeth of caries-derived pulp.LDF was used to detect pulp blood flow and evaluate pulp activity of mature permanent teeth after caries exposure and pulp preservation.Methods:(1)According to the working principle and operational precautions of LDF,the PBF values of the four mature first molars in the upper and lower mandibles that met the inclusion criteria were detected by laser Doppler blood flow,and the clinical reference value range under the physiological state was analyzed and calculated.SPSS 20.0 interval estimation,correlation analysis and T test were used to analyze the differences of PBF values among different ages,genders,dental positions and mandible.(2)According to American Association of Endodontists(AAE)diagnostic criteria and inclusion and exclusion criteria,a total of 60 asymptomatic mature permanent teeth with deep caries or secondary caries were collected from the department of Dentistry and Endodontics,Affiliated Hospital of Youjiang Medical College for Nationalities from January 2020 to January 2021.The PBF values of affected teeth and healthy control teeth were detected preoperatively according to the standard operating procedures of LDF,and randomly divided into iRoot BP Plus observation group(n=30)and MTA control group(n=30)according to different materials selection.During the operation,under the rubber barrier,with the use of microscope,the pulp exposed teeth were judged to be bleeding bright red and gently pressed with 3% sodium hypochlorite for 5min to stop the blood,then the corresponding pulp capping agent was placed on the pulp section,and the crown repair was completed immediately.(3)After 1,3,6 and 12 months,the clinical efficacy was evaluated by clinical symptoms,general clinical examination,X-ray root tip film,pulp cold and heat test,electrical activity test and LDF test.Kaplan-Meier survival analysis was used to calculate the success rate of Vital Pulp Therapy(VPT),expressed as percentage(%).Repeated measures design ANOVA was used for the changes of blood flow values before and after each group.Paired T test was used for the comparison of PBF blood flow values between the affected teeth and their control teeth at the same time point.Two independent samples T test was used for statistical analysis of blood flow values between the two groups at the same time point.The mean PBF value of the iRoot BP Plus group and the MTA group were analyzed by the broken line graph.SPSS20.0 was used for statistical analysis of all data,and P<0.05 was statistically significant.Results:(1)A total of 200 healthy and mature first molars were enrolled,with an average age of(22.76±3.26)years.There were 95 males and 105 females,with a total of 800 first molars.By calculating the reference range of healthy mature first molars in this study,it can be concluded that male 16 teeth were 8.67±3.70 PU,male 26 teeth were 8.44±3.25 PU,male36 teeth were 8.49±2.92 PU,male 46 teeth were 8.63±3.12 PU.Female 16 teeth were9.29±3.70 PU,26 teeth were 9.60±3.68 PU,36 teeth were 9.54±3.53 PU,46 teeth were9.62±3.57 PU.The PBF blood flow value of female was slightly higher than that of male.The clinical reference value of male PBF was 8.56±3.25 PU,and that of female PBF was9.51±3.47 PU.There was no statistically significant correlation between PBF and age in male or female samples(P > 0.05).There was no statistically significant difference between PBF test values of the four first molars of both male and female samples(P > 0.05),and there was no statistically significant difference between PBF test values of upper and lower first molars(P > 0.05).(2)60 patients(30 males and 30 females,11～43 years old,mean age 20.65±7.39 years old).Postoperative reaction observation report of iRoot BP Plus group: there were 30 affected teeth in this group,including 2 failure and 28 success.Postoperative reaction observation report of MTA group: there were 30 affected teeth in this group,including 3 failed teeth and 27 successful teeth.Kaplan-Meier survival analysis showed no significant difference in success rate between the two groups.For the iRoot BP Plus group,the differences were statistically significant(P < 0.05)between the preoperative blood flow and the comparison between 1month,3 months,6 months,12 months,between the postoperative blood flow and 6 months,and between the preoperative blood flow and the self-control tooth,except for the comparison between 1 month and the postoperative blood flow and the comparison between 3 months,6months,12 months,which was statistically significant(P < 0.05)except for the comparison between the postoperative blood flow and,Blood flow was not significantly different between any two groups at 1,3,6,and 12 months after surgery when compared with self control teeth,respectively(P > 0.05).For the MTA group,the blood flow before operation was compared with that of the self control tooth at 1,3,6,and 12 months after operation,the blood flow before operation was compared with that of the self control tooth at 1,3,6,and 12 months after operation,and the blood flow at 1,3,6,and 12 months after operation was compared with that of the self control tooth at 1,3,6,and 12 months after operation,respectively,and the difference was not statistically significant(P > 0.05).Conclusion:(1)The PBF values of mature first molars in healthy people showed differently between different genders.The PBF blood flow value of female was slightly higher than that of male,and the clinical reference value of male PBF was 8.56±3.25 PU and that of female PBF was 9.51±3.47 PU.(2)For mature permanent teeth with caries exposure,the clinical effect of VPT with iRoot BP Plus or MTA can be better by accurately grasping the indications and strictly combining with aseptic operation.(3)After VPT treatment,the PBF blood flow of the iRoot BP Plus group and the MTA group returned to the normal clinical reference range after 1-year follow-up observation.(4)LDF was used to detect the blood flow of VPT in caries exposed permanent teeth.The blood flow of both iRoot BP Plus group and MTA group showed a trend of decreasing first and then increasing,but the blood flow of MTA group remained stable after decreasing. |
PDF Full Text Request