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用于再生性牙髓治疗的血小板浓缩物和血凝块支架的比较结果:一项随机对照临床试验的系统评价

Comparative outcomes of platelet concentrates and blood clot scaffolds for regenerative endodontic procedures: A systematic review of randomized controlled clinical trials.

作者信息

Ríos-Osorio Nestor, Caviedes-Bucheli Javier, Jimenez-Peña Oscar, Orozco-Agudelo Mangriveth, Mosquera-Guevara Lorenzo, Jiménez-Castellanos Fabio-Andrés, Muñoz-Alvear Hernan-Darío

机构信息

DDS, MSc. Research Department COC- CICO, Institución Universitaria Colegios de Colombia UNICOC, Bogotá, Colombia.

DDS, MSc. Centro de Investigaciones Odontológicas Pontificia Universidad Javeriana Bogotá, Colombia.

出版信息

J Clin Exp Dent. 2023 Mar 1;15(3):e239-e249. doi: 10.4317/jced.60150. eCollection 2023 Mar.

Abstract

BACKGROUND

The main objective of this systematic review is to evaluate the effectiveness of platelet concentrates -Platelet-rich plasma (PRP) or Fibrin-rich plasma (PRF)- compared with blood clot (BC) as scaffolds for maturogenesis, in patients with immature permanent teeth with or without AP, in terms of the criteria for pulp revascularization success.

MATERIAL AND METHODS

We reviewed randomized controlled clinical trials comparing regenerative endodontic therapies (maturogenesis) based on PRP or PRF versus the conventional BC approach, in necrotic teeth with or without apical periodontitis (AP) under clinical and radiographic criteria. We performed a strategic search in MEDLINE (PUBMED), EMBASE, and ISI Web of Science from inception to October 2022. This systematic review of the literature was developed following the Cochrane Collaboration and PRISMA statement recommendations. We used the Cochrane risk of bias tool v2 to assess the included studies' quality. We performed a qualitative synthesis of the evidence.

RESULTS

Ten randomized controlled clinical trials were included in this systematic review. Analyses of these studies suggest that maturogenesis is a successful therapy regardless of the method employed. However, further research should be conducted with more suitable research methodologies and more homogenous data for meta-analysis.

CONCLUSIONS

Results from this systematic review suggest that BC maturogenesis approaches yield similar clinical and radiographic outcomes when compared to Platelet-concentrates based therapies (PRP and PRF). Maturogenesis, Revascularization, Platelet-rich plasma, Fibrin-rich plasma, blood clot, systematic review.

摘要

背景

本系统评价的主要目的是,根据牙髓血运重建成功的标准,评估与血凝块(BC)相比,血小板浓缩物——富血小板血浆(PRP)或富纤维蛋白血浆(PRF)——作为成熟诱导支架,在患有或未患有根尖周炎(AP)的未成熟恒牙患者中的有效性。

材料与方法

我们回顾了随机对照临床试验,这些试验根据临床和影像学标准,比较了基于PRP或PRF的再生性牙髓治疗(成熟诱导)与传统BC方法在患有或未患有根尖周炎(AP)的坏死牙中的效果。我们从创刊至2022年10月在MEDLINE(PUBMED)、EMBASE和ISI科学网进行了策略性检索。本系统文献综述是按照Cochrane协作网和PRISMA声明的建议开展的。我们使用Cochrane偏倚风险工具v2评估纳入研究的质量。我们对证据进行了定性综合分析。

结果

本系统评价纳入了10项随机对照临床试验。对这些研究的分析表明,无论采用何种方法,成熟诱导都是一种成功的治疗方法。然而,应该采用更合适的研究方法和更同质的数据进行进一步研究,以进行荟萃分析。

结论

本系统评价的结果表明,与基于血小板浓缩物的治疗方法(PRP和PRF)相比,BC成熟诱导方法产生的临床和影像学结果相似。成熟诱导、血运重建、富血小板血浆、富纤维蛋白血浆、血凝块、系统评价。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/639b/10062460/fc23772b5d7b/jced-15-e239-g001.jpg

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