成熟した永久歯の急性不可逆性歯髄炎の管理に対して，歯髄切開術は有効な治療選択肢となるか？

Is pulpotomy an effective therapeutic option for the management of acute irreversible pulpitis in mature permanent teeth?

抄録

成熟した永久歯の急性不可逆性歯髄炎の管理において、頸部歯髄穿刺は従来の根管治療に代わる有効な治療法か？ データソース 2000年から2021年までのPubMedとCochrane Libraryで、定義した臨床問題を扱う無作為化臨床試験の総合文献検索を行った。研究選択 頸部歯髄摘出術と非外科的根管治療を比較した無作為化対照試験研究のみをこのシステマティックレビューに含めることとした。データの抽出と統合 臨床的およびX線写真の成功率を報告し、最低6ヶ月のフォローアップが行われた研究を対象とした。結果は、包含/除外基準を満たした研究は4件のみであった。結論 成人期永久歯の急性不可逆性歯髄炎の治療において，パルポトミーは従来の根管治療と比較して劣るものではない．

Clinical question Is cervical pulpotomy a viable treatment alternative to conventional root canal treatment for management of acute irreversible pulpitis in mature permanent teeth?Data sources A comprehensive literature search was performed on PubMed and Cochrane Library covering the years 2000-2021 for randomised clinical trials addressing the defined clinical question. The title and abstract were reviewed by two authors independently and any conflict was resolved by discussion with the third author.Study selection Only randomised controlled trials studies that compared cervical pulpotomy against non-surgical root canal treatment were included in this systematic review. Studies dealing with primary teeth or immature permanent teeth were excluded.Data extraction and synthesis Studies that reported clinical and radiographic success rate with a minimum follow-up of six months were included. The authors tabulated the data from primary sources without any synthesis.Results Only four studies fulfilled the inclusion/exclusion criteria. The results indicate that the clinical success rate of pulpotomy was comparable to root canal treatment while the radiographic success rate was higher in pulpotomy.Conclusions Pulpotomy is not inferior to the conventional root canal treatment for the management of acute irreversible pulpitis in mature permanent teeth in adults.