Swaikat Mohamad, Faus-Matoses Ignacio, Zubizarreta-Macho Álvaro, Ashkar Israa, Faus-Matoses Vicente, Bellot-Arcís Carlos, Iranzo-Cortés José Enrique, Montiel-Company José María
Department of Stomatology, Faculty of Medicine and Dentistry, University of Valencia, 46010 Valencia, Spain.
Department of Surgery, Faculty of Medicine and Dentistry, University of Salamanca, 37008 Salamanca, Spain.
J Clin Med. 2023 Apr 2;12(7):2656. doi: 10.3390/jcm12072656.
Regenerative endodontic treatment (RET) has been considered a reliable procedure to treat immature necrotic teeth; however, the effect of dental trauma on the prognosis of RET is questionable. This systematic review aimed to evaluate the current level of evidence for revascularization techniques (the RET) in the management of traumatized necrotic immature permanent teeth with or without periapical radiolucent areas. Four electronic databases-PubMed, Web of Science, Scopus, and Embase-were searched until November 2022. Only randomized clinical trials, cohort studies, and case-control studies with a minimum of 10 cases and 12 months of follow-ups were included. The search identified 363 preliminary results. After discarding the duplicates and screening the titles, abstracts, and full texts, 13 articles were considered eligible. The results showed that RET techniques seemed to have high survival and success rates, 93.8% and 88.3%, respectively, in the treatment of traumatized necrotic immature permanent teeth. Root maturation with RET techniques seemed to be lower in traumatized teeth. Future studies are needed to evaluate root maturation in traumatized teeth using 3-dimensional radiographic evaluations. In addition, the lack of literature on the studies comparing RET and apexification (calcium hydroxide or an MTA) in the treatment of traumatized necrotic immature teeth highlights the necessity for high-level clinical studies comparing these treatment modalities.
再生牙髓治疗（RET）已被认为是治疗未成熟坏死牙齿的可靠方法；然而，牙齿外伤对RET预后的影响尚存在疑问。本系统评价旨在评估血管再生技术（RET）在治疗有或无根尖透射区的外伤坏死未成熟恒牙方面的现有证据水平。检索了四个电子数据库——PubMed、Web of Science、Scopus和Embase，检索截至2022年11月。仅纳入至少10例病例且随访12个月的随机临床试验、队列研究和病例对照研究。检索共得到363条初步结果。在剔除重复项并筛选标题、摘要和全文后，13篇文章被认为符合要求。结果显示，RET技术在治疗外伤坏死未成熟恒牙方面似乎具有较高的生存率和成功率，分别为93.8%和88.3%。外伤牙齿采用RET技术实现牙根发育成熟的比例似乎较低。未来需要通过三维影像学评估来评价外伤牙齿的牙根发育成熟情况。此外，缺乏关于比较RET与根尖诱导成形术（氢氧化钙或MTA）治疗外伤坏死未成熟牙齿的研究文献，这凸显了开展比较这些治疗方式的高水平临床研究的必要性。
