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目的评估波特兰水门汀(Portland cement,PC)直接修复磨牙髓室底穿孔的效果,并与无机三氧化聚合物(mineral trioxide aggregate,MTA)作比较。方法选取人新鲜拔除的恒磨牙53颗,按随机数字表法分为PC、MTA2个实验组(n=24)和1个对照组(n=5)。实验组在髓室底中央制备直径2 mm的穿孔模型,分别用PC和MTA修复穿孔。对照组只开髓不制备穿孔模型。利用体视显微镜观察修复后样本的根分叉形态。扫描电子显微镜(SEM)观察材料和牙体组织的结合界面,并测量结合界面间隙宽度。采用葡萄糖定量法分析模型检测微渗漏值。结果体视显微镜下两实验组对根分叉外形修复均达到了良好效果。SEM观察显示PC和MTA与牙体组织之间均可见不连续的微间隙存在,PC与牙体组织间隙宽度为(7.363±2.159)μm,MTA与牙体组织间隙宽度为(8.693±3.551)μm,两者无明显差异(P>0.05)。在观察期内,虽然PC组的微渗漏值小于MTA组,但无统计学差异(P>0.05)。结论 PC与MTA修复髓室底穿孔的封闭效果相当,且PC价格低廉,不易使牙体变色,可以考虑作为MTA替代材料进一步研究。
Objective To evaluate the efficacy of Portland cement (PC) in directly repairing perforation of pulp floor and compare it with inorganic trioxide aggregate (MTA). Methods 53 permanent fresh molars extracted from human were randomly divided into two groups: experimental group (n = 24) and control group (n = 5). In the experimental group, perforation models with a diameter of 2 mm were prepared in the middle of the medullary cavity, and the perforation was repaired by PC and MTA respectively. Control group only open the perforation without perforation model. The root bifurcation morphology of the repaired samples was observed with stereomicroscope. Scanning electron microscopy (SEM) was used to observe the binding interface between the material and dental tissue, and the bonding interface gap width was measured. Glucose quantitative analysis model was used to detect microleakage. Results The two experimental groups under the stereomicroscope achieved good results on root bifurcation contour repair. SEM observation showed that there was discontinuous micro-gap between PC and MTA and tooth tissue, the gap width between PC and tooth tissue was (7.363 ± 2.159) μm, the gap width between MTA and tooth tissue was (8.693 ± 3.551) μm , No significant difference between the two (P> 0.05). During the observation period, although the microleakage value of PC group was less than that of MTA group, there was no significant difference (P> 0.05). Conclusion PC and MTA have the same sealing effect in repairing perforation of medullary cavity, and the price of PC is low and the color of tooth is not easy to be discolored. Therefore, it can be considered as an alternative material for MTA.