在永久牙中使用生命脉治疗的指南
James A Coll1, Vineet Dhar2, Marcio Guelmann3
1Clinical Professor, Department of Pediatric Dentistry University of Maryland School of Dentistry, Baltimore, Md, USA.
Pediatric dentistry
|October 22, 2025
概括
新的指导方针建议选择性去除永久牙中常见或可逆的牙腔的深腔. 建议使用酸水泥进行生命脉治疗,并使用二酸盐进行血液静止.
科学领域:
- 牙科 牙科是指牙科的专业.
- 牙周内科医院 牙周内科医院 牙周内科医院
- 卡里斯管理 卡里斯管理
背景情况:
- 生命脉治疗 (VPT) 旨在保持永久牙中的脉活力.
- 需要基于证据的建议,以实现最佳的VPT程序.
- 深度腐烂和肉质暴露带来了复杂的治疗挑战.
研究的目的:
- 建立基于证据的建议,用于永久牙的重要脉治疗.
- 为了指导临床医生管理深层虫和脉暴露.
主要方法:
- 在2024年6月30日之前对永久牙VPT文献进行系统审查.
- 应用GRADE (推评估,开发和评价的分级) 框架.
- 基于证据的确定性,制定有条件和强有力的建议.
主要成果:
- 对于带有正常脉/可逆脉 (NP/RP) 的深层,间接脉治疗 (IPT),直接脉盖 (DPC),部分脉切除 (PP) 或全脉切除 (FP) 是可选的;强烈建议针对IPT进行选择性除.
- 对于纸暴露,建议使用DPC,PP或FP与酸水泥 (CS),以及低化 (NaOCl) 进行血液静止.
- 对于极其深层的牙或有症状的牙,建议完全去除牙以评估肉质;如果至关重要,则优先使用CS进行全肉质切除,而不是部分肉质切除.
结论:
- 对于NP/RP牙的深层虫,建议选择性虫去除.
- 酸水泥 (CS) 是DPC,PP和FP的推材料,其中NaOCl用于止血.
- 对于有症状的牙来说,完全去除牙和脉评估至关重要;如果至关重要,则优先进行全脉切除.
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