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中华口腔医学研究杂志(电子版) ›› 2026, Vol. 20 ›› Issue (02) : 93 -97. doi: 10.3877/cma.j.issn.1674-1366.2026.02.002

所属专题: 经典病例

活髓保存专栏·病例分析

牙髓切断术在慢性增生性牙髓炎治疗中的应用:2例病例报告及文献回顾
戴萱怡1, 聂宇芳2, 陶祎伟1, 罗薇1, 潘娱1, 夏卓玙1, 何飞1,()   
  1. 1深圳市人民医院(南方科技大学第一附属医院,暨南大学第二临床医学院)口腔医学中心,深圳 518020
    2暨南大学口腔医学院,广州 510632
  • 收稿日期:2026-01-28 出版日期:2026-04-01
  • 通信作者: 何飞

Application of pulpotomy in chronic hyperplastic pulpitis of young permanent teeth: Two case reports and literature review

Xuanyi Dai1, Yufang Nie2, Yiwei Tao1, Wei Luo1, Yu Pan1, Zhuoyu Xia1, Fei He1,()   

  1. 1Stomatology Center, Shenzhen People's Hospital (The First Affiliated Hospital, Southern University of Science and Technology; The Second Clinical Medical College, Jinan University), Shenzhen 518020, China
    2School of Stomatology, Jinan University, Guangzhou 510632, China
  • Received:2026-01-28 Published:2026-04-01
  • Corresponding author: Fei He
  • Supported by:
    Sanming Project of Medicine in Shenzhen(SZSM202311009)
引用本文:

戴萱怡, 聂宇芳, 陶祎伟, 罗薇, 潘娱, 夏卓玙, 何飞. 牙髓切断术在慢性增生性牙髓炎治疗中的应用:2例病例报告及文献回顾[J/OL]. 中华口腔医学研究杂志(电子版), 2026, 20(02): 93-97.

Xuanyi Dai, Yufang Nie, Yiwei Tao, Wei Luo, Yu Pan, Zhuoyu Xia, Fei He. Application of pulpotomy in chronic hyperplastic pulpitis of young permanent teeth: Two case reports and literature review[J/OL]. Chinese Journal of Stomatological Research(Electronic Edition), 2026, 20(02): 93-97.

目的

探讨牙髓切断术在年轻恒牙慢性增生性牙髓炎治疗中的可行性及应用价值。

方法

分析2例年轻恒牙慢性增生性牙髓炎患者的活髓保存治疗过程,结合文献综述,探讨其病理基础、适应证、操作要点及修复策略。

结果

2例患牙随访12 ~ 30个月,牙髓活力良好,影像学显示根尖周无异常,病例2可见牙根继续发育。

结论

在严格把握适应证的前提下,活髓保存治疗可为年轻恒牙慢性增生性牙髓炎提供一种微创有效的治疗方式,有助于保存牙髓活力、促进牙根发育。

Objective

To evaluate the feasibility and clinical value of vital pulp therapy in the treatment of chronic hyperplastic pulpitis in young permanent teeth.

Methods

The pulpotomy was used in two cases of young permanent teeth with chronic hyperplastic pulpitis. Combined with literature review, the pathological basis, indications, key operational points, and restorative strategies were discussed.

Results

After a follow-up of 12 to 30 months, the two teeth maintained favorable pulp vitality. Radiographic examination revealed no periapical abnormalities, and continued root development was observed in case 2.

Conclusions

Under strict indication control, vital pulp therapy provides a minimally invasive and effective treatment option for chronic hyperplastic pulpitis in young permanent teeth, which helps preserve pulp vitality and promote root development.

图1 左上第一恒磨牙慢性增生性牙髓炎治疗前影像资料 A:口内像示26面牙髓息肉增生,65残冠,25颊侧萌出;B:26根尖片。
图2 左上第一恒磨牙行牙髓切断术及充填治疗过程 A:上橡皮障;B:去除息肉后显露牙髓断面;C:牙髓息肉;D:牙髓断面经处理后止血有效;E:髓室底平铺iRoot SP糊剂;F:覆盖iRoot BP Plus糊剂;G:光固化玻璃离子水门汀垫底;H:选择性酸蚀牙釉质;I:放置双层成型片;J:光固化树脂分层充填塑形。
图3 左上第一恒磨牙治疗后复查口内像及根尖片 A ~ D:术后1、3、6和12个月口内像;E ~ H:术后1、3、6和12个月根尖片。
图4 右上中切牙治疗前影像资料 A:口内像示11远中邻面缺损达龈下;B:根尖片示11牙根未发育完成,牙周膜间隙稍增宽。
图5 右上中切牙牙折治疗后复查根尖片及口内像 A ~ G:术后1、3、6、9、18、24和30个月根尖片;H ~ K:术后1、9、24和30个月口内像。
[1]
周学东.牙体牙髓病学[M]. 5版.北京:人民卫生出版社,2020:169-170.
[2]
万佳铭,谢春,刘加荣.年轻恒牙牙髓疾病的临床治疗进展[J].华中科技大学学报(医学版)202453(1):129-132. DOI:10.3870/j.issn.1672-0741.23.08.009.
[3]
Duncan HFGaller KMTomson PL,et al. European Society of Endodontology position statement:Management of deep caries and the exposed pulp[J]. Int Endod J201952(7):923-934. DOI:10.1111/iej.13080.
[4]
Sriudomdech PSantiwong BLinsuwanont P. Outcomes of vital pulp treatment in permanent teeth with carious pulp exposure with signs and symptoms of irreversible pulpitis[J]. Clin Oral Investig202428(10):551. DOI:10.1007/s00784-024-05923-9.
[5]
Leong DJXYap AU. Vital pulp therapy in carious pulp-exposed permanent teeth:An umbrella review[J]. Clin Oral Investig202125(12):6743-6756. DOI:10.1007/s00784-021-03960-2.
[6]
葛立宏.儿童口腔医学[M]. 5版.北京:人民卫生出版社,2020:124-126.
[7]
Ricucci DLoghin SSiqueira FJ. Correlation between clinical and histologic pulp diagnoses[J]. J Endod201440(12):1932-1939. DOI:10.1016/j.joen.2014.08.010.
[8]
AAE position statement on vital pulp therapy[J]. J Endod202147(9):1340-1344. DOI:10.1016/j.joen.2021.07.015.
[9]
Fasoulas AKeratiotis GSpineli L,et al. Comparative efficacy of materials used in patients undergoing pulpotomy or direct pulp capping in carious teeth:A systematic review and Meta-analysis[J]. Clin Exp Dent Res20239(6):1129-1148. DOI:10.1002/cre2.767.
[10]
蔡贵爱,卢嘉健,梁悦娥,等. iRoot BP Plus与MTA应用于龋源性露髓成熟恒牙直接盖髓术的效果比较[J].口腔疾病防治202331(6):420-425. DOI:10.12016/j.issn.2096-1456.2023.06.006.
[11]
Duncan HFKirkevang LLPeters OA,et al. Treatment of pulpal and apical disease:The European Society of Endodontology (ESE)S3-level clinical practice guideline[J]. Int Endod J202356(3):238-295. DOI:10.1111/iej.13974.
[12]
Calişkan MKOztop FCalişkan G. Histological evaluation of teeth with hyperplastic pulpitis caused by trauma or caries:Case reports[J]. Int Endod J200336(1):64-70. DOI:10.1046/j.1365-2591.2003.00590.x.
[13]
Heide SMjor IA. Pulp reactions to experimental exposures in young permanent monkey teeth[J]. Int Endod J198316(1):11-19. DOI:10.1111/j.1365-2591.1983.tb01288.x.
[14]
汪俊.不可复性牙髓炎恒牙的活髓保存治疗[J].华西口腔医学杂志202341(6):622-627. DOI:10.7518/hxkq.2023.2023193.
[15]
Mahgoub NAlqadasi BAldhorae K,et al. Comparison between iRoot BP Plus(EndoSequence root repair material)and mineral trioxide aggregate as pulp-capping agents:A systematic review[J]. J Int Soc Prev Community Dent20199(6):542-552. DOI:10.4103/jispcd.JISPCD_249_19.
[16]
Ramani ASangwan PTewari S,et al. Comparative evaluation of complete and partial pulpotomy in mature permanent teeth with symptomatic irreversible pulpitis:A randomized clinical trial[J]. Int Endod J202255(5):430-440. DOI:10.1111/iej.13714.
[17]
Demarco FFCollares KCoelho-de-Souza FH,et al. Anterior composite restorations:A systematic review on long-term survival and reasons for failure[J]. Dent Mater201531(10):1214-1224. DOI:10.1016/j.dental.2015.07.005.
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