恒牙活髓保存治疗的研究进展

Research Progress on Vital Pulp Therapy for Permanent Teeth

摘要: 活髓保存治疗(Vital Pulp Therapy, VPT)是以保存全部或部分健康牙髓组织、维持牙髓活力及其生理功能为目标的治疗方法，近年来已成为牙髓病学领域的研究热点。其应用范围已从深龋和年轻恒牙可复性牙髓炎，逐步延伸至部分成熟恒牙不可逆性牙髓炎。年轻恒牙因根尖孔开放、血供丰富、牙髓干细胞含量高，具有更强的修复与再生潜能，可实现牙根继续发育；而成熟恒牙在感染控制良好、炎症局限的条件下同样可获得满意疗效。本文系统综述了恒牙活髓保存治疗的生物学基础、主要术式、材料研究进展、疗效评价指标及影响预后的关键因素，并结合近年来的实验研究与临床数据加以分析，重点探讨牙髓炎症精确诊断、长期疗效评估等尚待解决的问题，以期为临床精准决策及后续研究方向提供理论参考。

Abstract: Vital Pulp Therapy (VPT) is a treatment method aimed at preserving all or part of the healthy dental pulp tissue, maintaining the vitality and physiological functions of the pulp. In recent years, it has become a research hotspot in the field of endodontics. Its application has gradually expanded from traditional deep caries and reversible pulpitis in young permanent teeth to the treatment of irreversible pulpitis in some mature permanent teeth. Young permanent teeth have a stronger potential for repair and regeneration due to the open root canals, rich blood supply, and high content of dental pulp stem cells, allowing for continued root development. While mature permanent teeth can also achieve satisfactory results under conditions of good infection control and limited inflammation. This article systematically reviews the biological basis, main procedures, material research progress, efficacy evaluation indicators, and key factors affecting prognosis of endodontic vital pulp therapy for permanent teeth. It also analyzes these based on recent experimental studies and clinical data, focusing on issues such as precise diagnosis of pulp inflammation and long-term efficacy assessment, with the aim of providing theoretical references for clinical precise decision-making and subsequent research directions.