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坏死未成熟恒牙长期再生牙髓治疗结果的前瞻性研究:8年随访

A Prospective Study of Long-Term Regenerative Endodontics Outcomes of Necrotic Immature Permanent Teeth: An 8-Year Follow-Up.

作者信息

Abu Zeid Sawsan T, Alamoudi Ruaa A, Alothmani Osama S, Mokeem Saleh Abeer A, Siddiqui Amna Y

机构信息

Department of Endodontics, King Abdulaziz University, Jeddah 21589, Saudi Arabia.

Department of Endodontics, Cairo University, Cairo 12613, Egypt.

出版信息

Healthcare (Basel). 2021 Dec 2;9(12):1670. doi: 10.3390/healthcare9121670.

Abstract

For the management of necrotic immature teeth, regenerative endodontics offers the advantage of further root lengthening, thickening of dentin wall, and apical closure. This prospective study aimed to evaluate the long-term outcome of regenerative endodontics in immature necrotic permanent teeth. A total of 23 immature roots were medicated by triple antibiotic paste. After 21 days, bleeding was induced by over-instrumentation, and then mineral trioxide aggregate and coronal restoration were applied. Patients were scheduled for clinical and radiographic follow-up for 8 years. The radiographic changes of root dimensions were assessed using the ImageJ Plugin and statistically analyzed by Kruskal-Wallis test at a 95% confidence level. For qualitative evaluation, images were overlapped and analyzed using Photoshop software. All teeth were asymptomatic one month after the treatment. All teeth ( = 18) with preoperative periapical radiolucency showed complete resolution within 6-9 months. Recall rate at two, three, and eight years was 69.6%, 56.5%, and 34.8%, respectively. Continuous root development with a significant increase in root length and thickening of dentin wall accompanied by a significant decrease in apical canal diameter was seen at the end of the observation period ( < 0.001). In conclusion, the long-term outcome of regenerative endodontics revealed successful clinical and radiographic results with appropriate case selection.

摘要

对于坏死未成熟恒牙的治疗,再生性牙髓治疗具有进一步延长牙根、增厚牙本质壁和根尖闭合的优势。本前瞻性研究旨在评估再生性牙髓治疗在未成熟坏死恒牙中的长期疗效。共有23颗未成熟牙根用三联抗生素糊剂进行药物治疗。21天后,通过过度预备诱导出血,然后应用三氧化矿物凝聚体和冠部修复。患者计划进行8年的临床和影像学随访。使用ImageJ插件评估牙根尺寸的影像学变化,并在95%置信水平下通过Kruskal-Wallis检验进行统计分析。为进行定性评估,使用Photoshop软件对图像进行重叠和分析。所有牙齿在治疗后1个月均无症状。所有术前有根尖周透射影的牙齿(n = 18)在6 - 9个月内均显示完全消退。2年、3年和8年的回访率分别为69.6%、56.5%和34.8%。在观察期结束时,可见牙根持续发育,牙根长度显著增加,牙本质壁增厚,根尖管直径显著减小(P < 0.001)。总之,再生性牙髓治疗的长期疗效显示,在适当的病例选择下,临床和影像学结果均成功。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5a4a/8701996/b52f53918dcf/healthcare-09-01670-g001.jpg

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