Gerodontology and Special Care Dentistry Unit, Morales Meseguer Hospital, Faculty of Medicine, IMIB-Arrixaca, University of Murcia, 30008 Murcia, Spain.
Gerodontology and Special Care Dentistry Unit, Morales Meseguer Hospital, Faculty of Medicine, IMIB-Arrixaca, University of Murcia, 30008 Murcia, Spain.
Ann Anat. 2022 Aug;243:151936. doi: 10.1016/j.aanat.2022.151936. Epub 2022 Mar 30.
The main objective of this systematic review is to carry out a qualitative synthesis of the available bibliography on the use of scaffolds used in dentistry for the revitalisation treatment of immature teeth with open apex.
The search was carried out in the MEDLINE, Scopus and Cochrane databases. The search included the terms 'Pulp regeneration' OR 'Pulp revitalisation' AND 'scaffold'. The inclusion criteria were articles published in English, which carry out revitalisation treatments, with analysis of the results obtained and comparison of them, carried out in humans, in immature permanent teeth with open apex, and randomised clinical trials. The risk of bias assessment was performed with the RoB2 guideline.
Of 769 studies, 10 met the inclusion criteria. The scaffolds used were blood clot, platelet-rich plasma, platelet-rich fibrin, and blood clots combined with different membranes such as collagen membrane, collagen membrane and placentrex, chitosan membrane and hydrogel with basic growth factor for fibroblasts. The clinical success rate is excellent for all scaffolds used. The best scaffold for root development is platelet-rich plasma and it is the scaffold with the highest percentage of response to vitality test.
Our results suggested that platelet-rich plasma is the preferred scaffold of choice, although all the scaffolds analysed have acceptable results.
本系统评价的主要目的是对牙科中用于治疗根尖未闭合的年轻恒牙的支架的应用进行定性综合分析。
在 MEDLINE、Scopus 和 Cochrane 数据库中进行了检索。检索词为“牙髓再生”或“牙髓活力恢复”和“支架”。纳入标准为发表于英文期刊、进行活力恢复治疗、分析并比较结果、在人类中进行、涉及根尖未闭合的年轻恒牙的随机临床试验。使用 RoB2 指南进行偏倚风险评估。
在 769 项研究中，有 10 项符合纳入标准。使用的支架有血凝块、富含血小板的血浆、富含血小板的纤维蛋白和富含血小板的纤维蛋白与不同的膜（如胶原膜、胶原膜和胎盘素、壳聚糖膜和含基本成纤维细胞生长因子的水凝胶）结合。所有使用的支架的临床成功率都非常高。对于根发育最好的支架是富含血小板的血浆，也是活力测试反应率最高的支架。
我们的结果表明，富含血小板的血浆是首选的支架，尽管所有分析的支架都有可接受的结果。
