再生牙髓学：失败病例的系统分析。

Regenerative Endodontics: A Systematic Analysis of the Failed Cases.

机构信息

Department of Endodontics, School of Dental Medicine, Case Western Reserve University, Cleveland, Ohio; Department of Endodontics, College of Dentistry, Qassim University, Qassim, Saudi Arabia.

Department of Endodontics, School of Dental Medicine, Case Western Reserve University, Cleveland, Ohio.

出版信息

J Endod. 2019 May;45(5):567-577. doi: 10.1016/j.joen.2019.02.004. Epub 2019 Mar 22.

DOI:10.1016/j.joen.2019.02.004

PMID:30905573

Abstract

INTRODUCTION

The aim of this systematic review was to analyze failed cases of regenerative endodontic treatment (RET) reported in the literature in terms of etiology, diagnosis, treatment protocols, signs of failure, and additional endodontic interventions.

METHODS

Electronic searches were performed in PubMed, Web of Science, and ProQuest Dissertations & Theses databases. All in vivo publications in humans that reported at least 1 failed case of RET were included in this systematic review. Failed RET cases were defined in the current study as any case that required an additional endodontic intervention or extraction after the completion of the initial RET.

RESULTS

A total of 28 studies that reported 67 failed cases of RET were included in this review. A total of 37 failed RET cases reported the etiology that resulted in the initiation of RET; 59% of these cases were caused by dental trauma, and 30% were caused by dens evaginatus. A total of 26 (39%) failed RET cases were detected at least 2 years after the initiation of RET. A total of 53 (79%) failed RET cases were presented with signs and/or symptoms of persistent infection.

CONCLUSIONS

Persistent infection was the main presentation in 79% of failed RET cases. Furthermore, 39% of failed RET cases were identified after more than 2 years of follow-up. Future studies should include a detailed description of the etiology, preoperative variables, intraoperative protocols, and postoperative follow-up to provide a better understanding of failed cases after RET.

摘要

简介

本系统评价的目的是分析文献中报道的再生牙髓治疗（RET）失败病例，从病因、诊断、治疗方案、失败迹象和额外的牙髓介入等方面进行分析。

方法

在 PubMed、Web of Science 和 ProQuest Dissertations & Theses 数据库中进行电子检索。本系统评价纳入了所有报告至少 1 例 RET 失败病例的人体体内研究。本研究中，RET 失败病例被定义为在初始 RET 完成后需要额外的牙髓介入或拔牙的任何病例。

结果

本综述共纳入 28 项研究，报告了 67 例 RET 失败病例。共有 37 例 RET 失败病例报告了导致 RET 开始的病因；其中 59%的病例是由牙外伤引起的，30%的病例是由牙内陷引起的。共有 26 例（39%）RET 失败病例是在 RET 开始后至少 2 年后发现的。共有 53 例（79%）RET 失败病例表现出持续感染的迹象和/或症状。