Department of Conservative Dentistry, Dental Research Institute, Seoul National University School of Dentistry, Daehak-ro 101, Jongro-Gu, Seoul, 03080, Republic of Korea.
Department of Conservative Dentistry, Korea University Anam Hospital, Seoul, Republic of Korea.
Odontology. 2021 Apr;109(2):411-421. doi: 10.1007/s10266-020-00556-2. Epub 2020 Sep 27.
This retrospective study investigated the effect of mineral trioxide aggregate (MTA) plug location on treatment outcome and root maturation after regenerative endodontic procedures (REP) in immature permanent teeth. Thirty-three roots (n = 33) in cohort that underwent REP consistently according to AAE guideline were included to trace radiographic changes for the root and canal dimensions. Based on intraoral radiographs, roots were divided into two groups depending on the location of MTA plug within whole root length: coronal group (n = 14), within the upper half; apical group (n = 19), within the lower half. Periapical radiographs were standardized to assess treatment outcomes and root maturation including root development stages and digital measurements on the change ratios of root length, apex width, radiographic root area (RRA), modified RRA (mRRA), and periapical rarefaction area. The data were statistically analysed using the Mann-Whitney test. The patients' average age was 11 years and 10 months, with no significant between-group difference in sex. Premolars were the most prevalent tooth type (62.1%), followed by incisiors and molars. Pre-existing symptoms and signs subsided within 6 months in all cases. The teeth showed similar radiographic root development in both groups (P > 0.05). However, mRRA increase ratio was significantly higher in apical group than that in coronal group at early (< 6 months) and late (< 24 months) periods of follow-up (P < 0.05). Significant changes of root development stage were observed at early period for apical group and at late period for coronal group (P < 0.05). All the observed cases showed continuing root development after REP. Significant changes in root developments occurred at different follow-up periods according to the location of MTA plugs.
本回顾性研究旨在探讨在再生性牙髓治疗（REP）中，矿化三氧化物凝聚体（MTA）的封堵位置对未成熟恒牙的治疗效果和根尖成熟的影响。纳入了 33 个接受 REP 治疗的牙根（n=33），并根据 AAE 指南对这些牙根进行了连续的影像学追踪，以评估牙根和根管尺寸的变化。根据口腔内 X 光片，将牙根分为两组：MTA 封堵位置在上半部的为冠方组（n=14），在下半部的为根尖组（n=19）。通过根尖周 X 光片评估治疗效果和根尖成熟情况，包括根尖发育阶段和牙根长度、根尖宽度、影像学根尖面积（RRA）、改良 RRA（mRRA）和根尖稀疏区面积的数字测量值的变化比值。采用 Mann-Whitney 检验对数据进行统计学分析。患者的平均年龄为 11 岁 10 个月，性别无显著组间差异。前磨牙是最常见的牙位（62.1%），其次是切牙和磨牙。所有病例的原有症状和体征均在 6 个月内消失。两组的影像学牙根发育情况相似（P>0.05）。然而，在早期（<6 个月）和晚期（<24 个月）随访期间，根尖组的 mRRA 增加率明显高于冠方组（P<0.05）。在早期观察到根尖组的根尖发育阶段有显著变化，而在晚期观察到冠方组的根尖发育阶段有显著变化（P<0.05）。所有观察到的病例在 REP 后均有持续的牙根发育。根据 MTA 封堵位置的不同，牙根发育在不同的随访期间发生了显著变化。
