Al Ansary Mohammad A D, Day Peter F, Duggal Monty S, Brunton Paul A
Paediatric Dentistry Department, Bnied Al Gar Speciality Dental Centre, Kuwait.
Dent Traumatol. 2009 Aug;25(4):367-79. doi: 10.1111/j.1600-9657.2009.00797.x.
Apical barrier formation and root strengthening procedures have been extensively described in the literature. This systematic review attempts to establish where the effects of interventions using multi-visit apexification, single visit apical plug techniques and root strengthening procedures are consistent and where they may vary significantly.
To evaluate the relative effectiveness of apexification and apical plug techniques as well as root strengthening procedures for treating traumatized necrotic immature permanent anterior teeth through a systematic review of randomized controlled trials. Reported immediate and/or long-term adverse events and effects of the materials and techniques are also evaluated.
SEARCH STRATEGY & SELECTION CRITERIA: Structured electronic and hand search was performed with no restriction on the language of publication. Only randomized controlled trials comparing different apical barrier formation techniques and root strengthening procedures in traumatized necrotic immature anterior teeth were assessed.
Two hundred studies were identified but only two were suitable for inclusion. Included studies investigated multi-visit apexification techniques using calcium hydroxide and tricalcium phosphate. There were no eligible studies investigating root strengthening procedures or any other intervention for apical barrier formation in necrotic immature anterior teeth. No reliable information was available on long-term adverse effects of the reported interventions or cost implications.
Based on two included studies, there is weak evidence supporting the use of either calcium hydroxide or tricalcium phosphate for apical barrier formation in necrotic immature anterior teeth employing multi-visit apexification techniques. The evidence is insufficient to provide guidelines for practice. There was no reliable evidence on adverse events or long-term effects after the use of calcium hydroxide or tricalcium phosphate justifying caution in their use in apical barrier formation techniques.
根尖屏障形成术和牙根强化术在文献中已有广泛描述。本系统评价旨在确定采用多次就诊根尖诱导成形术、单次就诊根尖充填技术和牙根强化术的干预效果在哪些方面是一致的，哪些方面可能存在显著差异。
通过对随机对照试验的系统评价，评估根尖诱导成形术和根尖充填技术以及牙根强化术治疗外伤后坏死的未成熟恒前牙的相对有效性。还评估了所报道的材料和技术的即时和/或长期不良事件及效果。
进行结构化电子检索和手工检索，对发表语言无限制。仅评估比较外伤后坏死的未成熟前牙不同根尖屏障形成技术和牙根强化术的随机对照试验。
共识别出200项研究，但仅2项适合纳入。纳入的研究调查了使用氢氧化钙和磷酸三钙的多次就诊根尖诱导成形术技术。没有符合条件的研究调查牙根强化术或坏死未成熟前牙根尖屏障形成的任何其他干预措施。关于所报道干预措施的长期不良影响或成本影响，没有可靠信息。
基于2项纳入研究，有薄弱证据支持在采用多次就诊根尖诱导成形术技术治疗坏死未成熟前牙时使用氢氧化钙或磷酸三钙进行根尖屏障形成。证据不足以提供实践指南。对于在根尖屏障形成技术中使用氢氧化钙或磷酸三钙后的不良事件或长期影响，没有可靠证据，因此在使用时需谨慎。
