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VertaisarvioituKruunupulpotomia ­lopullisena hoitomuotona pysyvissä hampaissa

8.12.2023Edita Koronen, Leo Tjäderhane

Pulpan vitaalihoidot, kuten vaiheittainen karioituneen kudoksen poisto, välitön pulpan kattaminen ja osittainen tai kruunupulpotomia, ovat saaneet viime vuosikymmenellä laajalti tutkijoiden ja kliinikoiden huomiota.

Tässä katsauksessa kootaan yhteen tutkimustieto pysyvien hampaiden pulpotomiasta lopullisena hoitomuotona. Uusien biokeraamisten materiaalien ansiosta pulpotomia ei enää ole vain avojuuristen ja maitohampaiden hoitomenetelmä, vaan pulpotomian onnistumisprosentti on erittäin suuri myös aikuisten pysyvissä hampaissa.

The European Society of Endodontology (ESE) (2019) ja American Association of Endodontists (AAE) (2021) ovat julkaisseet syvän karieksen hoidon suositukset, joissa pulpotomia on yksi palautumattoman pulpiitin hoitomenetelmistä. Oikea toimenpidetekniikka ja aseptiikka, tiivis restauraatio ja riittävä seuranta ovat pulpotomian onnistumisen kulmakiviä.

Tässä artikkelissa esitetty tutkimustieto toivottavasti auttaa kliinikoita arvioimaan pulpotomian oikeita indikaatioita ja kontraindikaatioita ja ymmärtämään oikean diagnostiikan, toimenpiteen toteuttamisen ja muiden onnistumiseen vaikuttavien tekijöiden merkitystä.

Kirjoittajat

Edita Koronen, erikoistuva HLL1 ­(kariologia ja endodontia)

Leo Tjäderhane, dosentti, EHL (kariologia ja endodontia), professori, tutkimusjohtaja1, 2, 3

1Helsingin yliopisto
2Suu- ja leukasairauksien osasto,­ ­­Helsingin yliopisto ja Helsingin ­yliopistollinen sairaala
3Suun terveyden tutkimusyksikkö, Oulun yliopisto ja Medical Research Center, Oulun yliopistosairaala ja Oulun yliopisto. Helsingin yliopisto, HUS; ­Oulun yliopisto

 

Pulpotomy in permanent teeth as a definitive treatment modality

Over the last decade, pulp vital treatments have received widespread attention from researchers and clinicians. This review summarizes current research data about pulpotomy in permanent teeth as a definitive treatment modality. Traditionally, pulpotomies were recommended for the treatment of deep caries in immature or deciduous teeth. However, the introduction of new biologically active calcium silicate-based materials has also led to a good clinical outcome of pulpotomy in adult permanent teeth with closed apices.

The European Society of Endodontology (ESE) (2019) and the American Association of Endodontists (AAE) (2021) have recently published recommendations for the treatment of deep caries, where pulpotomy is one of the treatment methods for irreversible pulpitis. The correct procedure technique and asepsis, high quality tooth restoration and adequate follow-ups are the cornerstones of pulpotomy success. This review, based on current research data, will hopefully help clinicians to evaluate the correct indications and contraindications for pulpotomy, and to understand the importance of correct diagnostics, procedure performance and other factors affecting success.

 

Suom Hammaslääkäril 2023; 14: 22–29.
Kirjoitukset julkaistaan kokonaisuudessaan digilehdessä noin kuukauden kuluttua ensijulkaisusta.

 

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