Department of Surgical Sciences, Division of Endodontics, Marquette University School of Dentistry, Milwaukee, Wisconsin.
Department of Restorative Dentistry, Faculty of Dentistry, University of Malaya, Kuala Lumpur, Malaysia.
J Endod. 2020 Dec;46(12):1856-1866.e2. doi: 10.1016/j.joen.2020.08.016. Epub 2020 Aug 20.
The purposes of this review were to appraise the level of evidence of the existing regenerative endodontic therapy (RET) publications, perform a meta-analysis on the survival and healing rates of necrotic immature permanent teeth treated with RET, and run a meta-analysis on the quantitative assessment of the root development of those teeth.
Electronic searches were performed in Web of Science, PubMed, CINAHL (Cumulative Index to Nursing and Allied Health Literature), and Cochrane Library databases. Two authors independently screened the titles and abstracts for eligibility. The analyses were performed on the clinical outcomes (ie, survival, healing, and root development) of the procedure.
Eleven articles were included in the qualitative and quantitative syntheses. Three studies were randomized controlled trials, 6 were prospective cohort studies, and 2 were retrospective cohort studies. The pooled survival and healing rates were 97.3% and 93.0%, respectively. The pooled rates of root lengthening, root thickening, and apical closure were 77.3%, 90.6%, and 79.1%, respectively. However, if 20% radiographic changes were used as a cutoff point, there were only 16.1% root lengthening and 39.8% root thickening.
Within the limitations of the present study, it can be concluded that RET yielded high survival and healing rates with a good root development rate. However, clinical meaningful root development after RET was unpredictable.
本综述的目的是评估现有的再生性牙髓治疗(RET)文献的证据水平,对采用 RET 治疗的坏死性未成熟恒牙的存活率和愈合率进行荟萃分析,并对这些牙齿的根管发育进行定量评估。
在 Web of Science、PubMed、CINAHL(护理与联合健康文献累积索引)和 Cochrane 图书馆数据库中进行电子检索。两位作者独立筛选标题和摘要以确定其是否符合纳入标准。对该程序的临床结果(即存活率、愈合率和根管发育)进行分析。
11 篇文章纳入定性和定量综合分析。3 项研究为随机对照试验,6 项为前瞻性队列研究,2 项为回顾性队列研究。荟萃分析的总体存活率和愈合率分别为 97.3%和 93.0%。根管延长、根管增厚和根尖封闭的总体比率分别为 77.3%、90.6%和 79.1%。然而,如果将 20%的影像学变化作为截断点,则仅有 16.1%的根管延长和 39.8%的根管增厚。
在本研究的限制范围内,可以得出结论,RET 具有较高的存活率和愈合率,并且根管发育良好。然而,RET 后临床意义上的根管发育是不可预测的。