ランダム化臨床試験の5年間の追跡調査
Ankita Ramani1, Pankaj Sangwan1
1Department of Conservative Dentistry and Endodontics, Post Graduate Institute of Dental Sciences (PGIDS), Rohtak, Haryana, India.
International endodontic journal
|September 3, 2025
まとめ
完全なパルポトミー (CP) と部分的なパルポトミー (PP) は,不可逆的なパルピティスの成熟した歯の5年後の成功率に類似しています. パーチアル・パルポトミーは,パルプの感度が高く,パルプ運河の消去が少ないため,優れた修復性シールの必要性を強調することができます.
科学分野:
- エンドドンティクス
- 歯科 トラウマ
- 再生性エンドドント
背景:
- 成熟した永久歯の完全なパルポトミー (CP) と部分的なパルポトミー (PP) の長期的なアウトカムについては,十分に文書化されていません.
- 以前の研究では,CPとPPの1年経過で好ましい結果が出ています.
- プロフェッショナルな歯科協会は プルポトミーを決定的な治療法として確立する前に 長期的な証拠を推奨します
研究 の 目的:
- 成熟した永久歯におけるCPとPPの5年間の臨床的および放射線学的成功をSIPと比較する.
- 硬組織障壁 (HTB) 形成,パルプ運河消去 (PCO),パルプ感受性を含む二次的アウトカムを評価する.
- 長期的な成功に影響を与える予測要因を特定する.
主な方法:
- ランダム化制御試験 (NCT04397315) の参加者の見通しによるフォローアップ
- 93人の参加者 (CP=49, PP=44) は割り当てられた介入を受け,88人が1年間の追跡調査に参加し,5年間の評価のために呼び戻されました.
- 臨床とX線検査の成功が主なアウトカムであり,HTB,PCO,復元整体性,二次性下痢,歯周病状態,およびパルプの感受性は二次的なアウトカムであった.
主要な成果:
- 5年後の全体的な成功率は83. 05%で,CPとPPの有意な差は認められませんでした (p=0. 494).
- 比較可能な硬組織障壁 (HTB) の形成が観察された (p=0. 581).
- パルプ・カナル・オブリテレーション (PCO) は,CP群で有意に多く見られた (p=0. 003),PP群では,パルプの感受性反応が有意に良く見られた (p=0. 015). 二次性カリアスは全体的な成功に影響を及ぼしました (p<0. 05).
結論:
- CPとPPは,SIPで成熟した歯の管理において,比較可能な5年間の成功率を示しています.
- パーシャル・パルポトミー (PP) は,保守的な性質,PCOの減少,パルプの感度回復の強化により有利である可能性があります.
- パルポトミー手術の長期的成功には 十分な修復性シールが不可欠です
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