The Israeli National Center for Trauma & Emergency Medicine Research, Gertner Institute, Tel Hashomer, Israel.
Department of Endodontics, Rambam Health Care Campus, Haifa, Israel.
Int Endod J. 2022 Nov;55(11):1165-1176. doi: 10.1111/iej.13811. Epub 2022 Sep 27.
External inflammatory lateral resorption (EILR) following dental trauma is a severe complication that can lead to significant root loss and tooth extraction.
The aim of this project was to review current evidence in the literature on regenerative endodontic therapy (RET) for EILR following traumatic injuries and assess the best treatment practices.
Publications appearing in PubMed, from January 1, 2001 to January 9, 2022 were studied. Inclusion criteria were: (a) Publications in English; (b) Publications on RET and EILR; (c) Teeth subjected to dental trauma; and (d) Presence of intracanal bleeding and blood clots. Exclusion criteria were: (a) Conference proceedings; (b) Lectures; (c) Abstracts; and (d) Letters to editor; (e) Non-English publications.
355 publications were analysed. Nine met all inclusion criteria. In 10 (58.8%) teeth, triple antibiotic paste was used for an average of 26 days. Double antibiotic paste was used in 3 (17.6%) teeth for an average of 14 days. In 3 (17.6%) cases, calcium hydroxide (Ca(OH) ) was used for 14 days and negative pressure irrigation was applied once on 1 (6%) tooth.
Using RET to treat EILR has some advantages compared to long term CA(OH) dressing. RET requires shorter dressing time compared to CA(OH) . This can significantly improve patient compliance. Additionally, in immature teeth, RET helps to arrest root resorption leading to continued root maturogenesis and revascularization. It is recommended that a meticulous follow-up should be conducted when RET is performed to assure early detection of treatment failure.
RET appears to be a good treatment modality producing biologic repair and improving prognosis in cases of EILR in post-traumatic tooth/pulp injuries. The key limitation of this study is that all publications included were either case reports or case series that usually tend to report successful outcome.
牙外伤后发生的外部炎症性侧方吸收（EILR）是一种严重的并发症，可导致严重的牙根丧失和拔牙。
本项目旨在回顾牙外伤后 EILR 再生牙髓治疗（RET）的文献中的现有证据，并评估最佳治疗方法。
研究了 2001 年 1 月 1 日至 2022 年 1 月 9 日期间在 PubMed 上发表的出版物。纳入标准为：（a）英文出版物；（b）关于 RET 和 EILR 的出版物；（c）接受过牙外伤的牙齿；（d）存在根管内出血和血。排除标准为：（a）会议记录；（b）讲座；（c）摘要；（d）给编辑的信；（e）非英文出版物。
分析了 355 篇出版物。9 篇符合所有纳入标准。在 10 颗（58.8%）牙齿中，平均使用三联抗生素糊剂 26 天。在 3 颗（17.6%）牙齿中使用双抗生素糊剂 14 天。在 3 例（17.6%）中，使用氢氧化钙（Ca(OH)）14 天，对 1 例（6%）牙齿进行一次负压冲洗。
与长期使用 CA(OH)相比，使用 RET 治疗 EILR 具有一些优势。与 CA(OH)相比，RET 需要更短的敷药时间。这可以显著提高患者的依从性。此外，在未成熟的牙齿中，RET 有助于阻止牙根吸收，从而导致根继续成熟和再血管化。建议在进行 RET 时进行仔细的随访，以确保及早发现治疗失败。
RET 似乎是一种很好的治疗方式，可在牙外伤后牙髓/牙本质损伤引起的 EILR 中产生生物修复并改善预后。本研究的主要局限性在于，所有纳入的出版物均为病例报告或病例系列，通常倾向于报告成功的结果。
