急性不可逆性歯髄炎に対する単回根管治療におけるVitapexペーストの短期有効性：後ろ向きコホート研究
Jia Liu1, Fangfei Li2, Xiaolong Liang1
1Department of Stomatology, Shijiazhuang Second Hospital, Shijiazhuang, 050000, People's Republic of China.
Background:
The selection of root canal obturation material is critical for the successful management of acute irreversible pulpitis. Vitapex, an iodoform-calcium hydroxide-based paste, possesses recognized antimicrobial and biocompatible properties. However, comprehensive evidence comparing its efficacy in single-visit root canal treatment against the conventional gutta-percha/zinc oxide-eugenol (ZOE) sealer combination remains relatively limited.
Objective:
To compare the clinical efficacy of Vitapex paste versus gutta-percha/ZOE sealer in single-visit root canal treatment for acute irreversible pulpitis.
Methods:
In this single-center retrospective cohort study, clinical data from 112 patients with acute irreversible pulpitis who underwent single-visit root canal therapy between April 2022 and August 2024 were analyzed. Patients were allocated into two groups based on the obturation material: the Vitapex group (n=56), obturated with Vitapex paste, and the gutta-percha/ZOE group (n=56), obturated using the cold lateral compaction technique with gutta-percha points and ZOE sealer. Key outcome measures included time to pain relief, time to swelling resolution, time to return to normal masticatory function, Visual Analogue Scale (VAS) scores, bite force, chewing efficiency, levels of inflammatory factors (hs-CRP, IL-6, TNF-α), periodontal health indices (Bleeding Index-BI, Plaque Index-PLI, Probing Depth-PD), and the incidence of adverse reactions.
Results:
The Vitapex group showed significantly shorter recovery times for pain relief, swelling resolution, and return to normal function (all P<0.001), significantly lower VAS scores at 1 and 4 weeks (P<0.05), and greater improvements in masticatory function at 4 weeks (P<0.05). Inflammatory markers and periodontal health indices improved more significantly with Vitapex (all P<0.001). The adverse reaction rate was lower with Vitapex (5.4% vs 12.5%), though not statistically significant (P=0.325).
Conclusion:
Vitapex demonstrates superior outcomes in single-visit treatment for irreversible pulpitis, offering faster recovery, better pain control, improved function, and reduced inflammation compared to gutta-percha/ZOE, making it a valuable clinical alternative.
