华西口腔医学杂志 ›› 2017, Vol. 35 ›› Issue (3): 227-231.doi: 10.7518/hxkq.2017.03.001

• •    下一篇

活髓保存治疗之惑及解决之道

黄定明(), 陆倩, 廖茜, 叶玲, 周学东()   

  1. 口腔疾病研究国家重点实验室,国家口腔疾病临床研究中心,四川大学华西口腔医院牙体牙髓病科,成都 610041
  • 收稿日期:2017-02-27 修回日期:2017-04-09 出版日期:2017-06-05 发布日期:2017-06-01
  • 作者简介:

    黄定明,教授,博士,E-mail:dingminghuang@163.com

Confusion and solution for vital pulp therapy

Dingming Huang(), Qian Lu, Qian Liao, Ling Ye, Xuedong. Zhou()   

  1. State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Dept. of Conservative Dentistry and Endo-dontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
  • Received:2017-02-27 Revised:2017-04-09 Online:2017-06-05 Published:2017-06-01

摘要:

牙髓组织具有形成牙本质、提供营养、传导痛觉和对外界刺激产生保护性反应的功能。牙髓组织病理学改变性质是决定牙齿治疗方案的选择和治疗效果评估的组织学基础。当牙髓病变可逆或局限时,应消除感染,保存活髓,维护牙髓的功能。长久以来,活髓保存治疗的临床诊治,特别是其适应证和预后因素,一直是临床医生争论的热点话题,且常常给很多医生造成困惑。本文从适应证、牙髓状态评估、感染消除、盖髓材料选择等方面对活髓保存治疗中存在的困惑以及解决方法进行介绍,同时提出了活髓保存治疗的临床路径和操作规范,以便临床上更好地开展活髓保存治疗。

关键词: 活髓保存治疗, 适应证, 预后因素, 激光多普勒血流检测仪

Abstract:

Dental pulp tissue plays a role in forming dentin, providing nutrition, conducting pain, and generating protective responses to environmental stimuli. Bacterial infection is the main cause of pulp disease, where histopathological changes are the histological basis for determining the choice of treatment and the evaluation of therapeutic effect. Thus, particular attention should be given to eliminate infection, as well as preserve and maintain pulpal health in teeth that show reversible or limited pulpal injuries. Vital pulp therapy, especially its indications and prognostic factors, has been a research hotspot that often causes confusion among clinicians. In this paper, we briefly introduce the confusion and solution for vital pulp therapy in terms of indications, pulp condition assessment, infection elimination, and capping material selection. In addition, we develop a clinical pathway and an operation normalization of vital pulp therapy to better perform the therapy.

Key words: vital pulp therapy, indication, prognostic factor, laser Doppler flowmetry

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