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非活髓未成熟恒牙根尖诱导成形术或牙髓血管再生术的治疗结果:一项回顾性研究

Treatment Outcomes of Apexification or Revascularization in Nonvital Immature Permanent Teeth: A Retrospective Study.

作者信息

Silujjai Jidapa, Linsuwanont Pairoj

机构信息

Faculty of Dentistry, Department of Restorative Dentistry, Chulalongkorn University, Bangkok, Thailand.

Faculty of Dentistry, Department of Restorative Dentistry, Chulalongkorn University, Bangkok, Thailand.

出版信息

J Endod. 2017 Feb;43(2):238-245. doi: 10.1016/j.joen.2016.10.030.

Abstract

INTRODUCTION

The purposes of this retrospective study were to evaluate the clinical and radiographic outcomes of mineral trioxide aggregate apexification and revascularization in nonvital immature permanent teeth and to analyze factors influencing treatment outcome.

METHODS

Forty-six cases (29 cases of apexification and 17 cases of revascularization) were recruited into this study. Patients' preoperative and postoperative information was analyzed. Treatment outcomes were categorized as a success or failure and functional retention. Further root development was assessed in terms of the percentage changes in root length and root width.

RESULTS

The success rates of mineral trioxide aggregate apexification and revascularization were 80.77% and 76.47% and functional retention was 82.76% and 88.24%, respectively. Revascularization provided significantly greater percentage changes in root width (13.75%) in comparison with mineral trioxide aggregate (MTA) apexification (-3.30%). The mean percentage change of increased root length was 9.51% in the revascularization group and 8.55% in the MTA apexification group. Interestingly, revascularization showed various degrees of increased root length ranging from -4% to 58%. Fracture was the main cause of failure in MTA apexified teeth. All failed revascularized teeth presented with signs and symptoms of apical periodontitis caused by persistent infection.

CONCLUSIONS

MTA apexification and revascularization provide a reliable outcome in the aspects of resolution of the disease and tooth functional retention. None of these treatments provides satisfactory predictable further root development.

摘要

引言

本回顾性研究的目的是评估无机三氧化物凝聚体根尖诱导成形术和牙髓血管再生术治疗非活髓未成熟恒牙的临床和影像学结果,并分析影响治疗效果的因素。

方法

本研究纳入46例患者(29例行根尖诱导成形术,17例行牙髓血管再生术)。分析患者术前和术后信息。治疗结果分为成功、失败和功能保留。根据牙根长度和牙根宽度的百分比变化评估进一步的牙根发育情况。

结果

无机三氧化物凝聚体根尖诱导成形术和牙髓血管再生术的成功率分别为80.77%和76.47%,功能保留率分别为82.76%和88.24%。与无机三氧化物凝聚体(MTA)根尖诱导成形术(-3.30%)相比,牙髓血管再生术使牙根宽度的百分比变化显著更大(13.75%)。牙髓血管再生术组牙根长度增加的平均百分比变化为9.51%,MTA根尖诱导成形术组为8.55%。有趣的是,牙髓血管再生术显示牙根长度有不同程度的增加,范围从-4%到58%。折断是MTA根尖诱导成形术治疗牙齿失败的主要原因。所有牙髓血管再生术失败的牙齿均出现由持续感染引起的根尖周炎的体征和症状。

结论

MTA根尖诱导成形术和牙髓血管再生术在疾病解决和牙齿功能保留方面提供了可靠的结果。这些治疗方法均未提供令人满意的可预测的进一步牙根发育。

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