| Objective: To study the effect of direct pulp capping with iroot BP plus on carious pulp exposure of mature permanent teeth.To provide a theoretical basis for the clinical application of iroot BP plus.Method:60 adult patients with asymptomatic caries and pulp exposed were collected from September 2019 to September 2020 in the Department of Stomatology of Affiliated Hospital of Youjiang College,and 60 mature permanent teeth were teeth.All cases were diagnosed as deep caries,no self pain,nocturnal pain and percussion pain symptoms,and the electrical activity,cold and hot test were normal,the color of crown was normal,and the root tip had no low density shadow.According to the materials of pulp capping,30 patients were randomly divided into the iRoot BP Plus observation group and the control group of mineral trioxide aggregate(MTA).After lidocaine was anesthetized locally(without adrenaline),the rubber barrier was kept wet.If there was leakage,it was closed with a sealer.The crown was washed with 3% sodium hypochlorite(sodium hypochlorite),the microscope was adjusted,the decayed tissue was completely removed,and the tissue debris was removed by pressing the pulp penetrating point with 3% sodium hypochlorite cotton ball.According to the instructions,iRoot BP Plus in observation group was closely closed to the puncture point,with a thickness of 1-1.5mm.The base was filled with light cured glass ion,filled with composite resin permanently,and then the jaw was adjusted and polished.Then cone beam computer tomography(CBCT)was taken;the control group was treated with MTA,and the operation method was the same.All the above operations were performed by the same doctor.The patients were not well after operation and they were called back at any time.The postoperative response and the success rate of 1、3、6、12 months after operation and the volume of calcification were observed in 2 groups.The statistical analysis was carried out with SPSS 26.0 statistical software.Result:After one year follow-up,the postoperative response of iRoot BP Plus group was observed.30 teeth were found in this group,29 cases were successful and 1 case failed.The clinical symptoms of the successful patients were not any,the gingiva was normal,the electrical activity was normal,the cold and hot test was normal,and the root tip of CBCT did not have low density shadow.The software of MIMIS observed that there was neocalcification between the pulp at the point where the teeth were penetrated and the root BP plus pulp covering material.One case had a bite discomfort one month after operation,the gingiva around the crown was normal,percussion(+),no pathological loosening.CBCT showed that the root tip showed low density shadow.After communicating with the patient,the root canal therapy was changed.The postoperative response of MTA group was observed.30 cases of teeth were developed in this group,27 cases were successful and 3 failed.The clinical symptoms of the successful patients were not any,the gingiva was normal,the electrical activity was normal,the cold and hot test was normal,and the root tip of CBCT did not have low density shadow.The software of MIMIS observed that there was neocalcification between the pulp at the point where the teeth were penetrated and the root BP plus pulp covering material.One case had irregular dull pain one month after operation,which could be relieved for a long time after the stimulation of cold and hot.The tooth was sensitive to temperature test.After communicating with the patient,the root canal therapy was changed.One case had nocturnal pain one month after operation,spontaneous paroxysmal pain,and the tooth was extremely sensitive to the heat test.The pain symptoms after stimulation removal lasted for a while.After communicating with the patient,we performed root canal therapy.One case of tooth occurred spontaneous and persistent pain at 3 months after operation.The teeth were not able to bite,the gingiva around the crown was normal,and the percussion was(+++).After communicating with the patient,root canal treatment was carried out.1.success rate:The success rate of iRoot BP Plus group and MTA control group was96.67%,90% respectively,and the success rate of the experimental group was 96.67%,96.67%,96.67%,96.67% and 96% in 1、3、6、12 months after operation.The success rate of MTA control group was 93.33%,90%,90%,90% and 90% in 1、3、6、12 months.and there was no statistical significance in 1、3、6、12 months after operation(P> 0.05).2.Postoperative calcification volume results: The two groups of data had statistical significance for calcification volume in terms of time(P<0.001),the two materials at the same time point had no statistically significant effect on the formation of calcification(P>0.05).Conclusion:1.The iRoot BP Plus can be applied to mature permanent teeth with carial-derived pulp exposure,which can achieve a high success rate.The one-year efficacy is less different from that of MTA,which can be used for long-term clinical follow-up.2.When iRoot BP Plus was applied to the direct pulp capping of mature permanent teeth with carial-derived pulp exposure,the formation of calcifications increased with time,and the ability of pulp tissue to form calcifications was not significantly different from that of MTA. |
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