Al-Qudah Aladdin, Almomani Mohammad, Hassoneh Layla, Awawdeh Lama
Department of Conservative Dentistry, Jordan University of Science and Technology, Irbid, Jordan.
Department of Conservative Dentistry, Jordan University of Science and Technology, Irbid, Jordan.
J Endod. 2023 Jul;49(7):776-785. doi: 10.1016/j.joen.2023.05.009. Epub 2023 May 22.
INTRODUCTION: This randomized clinical trial aimed to assess and compare the long-term clinical and radiographic outcomes of regenerative endodontic procedures (REPs) in treating nonvital immature permanent teeth using 2 intracanal medicaments. METHODS: Forty-five patients yielding a total of 50 anterior and posterior nonvital immature teeth were randomly divided into 2 groups. REPs using either nonsetting calcium hydroxide (Ca[OH]) (n = 25) or modified triple antibiotic paste (TAP) (n = 25) as intracanal medicaments were performed. NeoMTA Plus (Avalon Biomed Inc) was applied for coronal sealing. Cases were followed up clinically and radiographically for 36 months. The survival rate, success rate, and clinical outcome measures were analyzed. Preoperative and recall radiographs were evaluated for dimensional changes in root length, dentin thickness, apical diameter, and periapical radiolucency. RESULTS: At the 36-month follow-up, the success and survival rates were 81.6% and 100%, respectively, in which 79.4% of cases showed complete resolution of periapical radiolucency with no significant difference between the nonsetting Ca(OH) and modified TAP groups (P > .050). The cumulative changes in root length, root dentin thickness, and apical diameter throughout the study period were observed in 47.9%, 77.1%, and 89.6% of cases, respectively, with no significant differences between groups (P ≥ .39). Intracanal calcifications were detected in 60% of cases with no significant difference between groups (P = .77). CONCLUSIONS: REPs, using either nonsetting Ca(OH) or modified TAP as the intracanal medicament, exhibited high success and survival rates over a follow-up period of 36 months with equally favorable clinical and radiographic outcome data.
引言:本随机临床试验旨在评估和比较使用两种根管内药物的再生牙髓治疗术(REP)治疗非活髓未成熟恒牙的长期临床和影像学结果。 方法:45例患者共有50颗前牙和后牙非活髓未成熟牙,随机分为两组。分别使用非凝固性氢氧化钙(Ca[OH])(n = 25)或改良三联抗生素糊剂(TAP)(n = 25)作为根管内药物进行REP治疗。采用NeoMTA Plus(Avalon Biomed Inc)进行冠部封闭。对病例进行36个月的临床和影像学随访。分析存活率、成功率和临床结果指标。评估术前和复诊X线片的根长、牙本质厚度、根尖直径和根尖周透影区的尺寸变化。 结果:在36个月的随访中,成功率和存活率分别为81.6%和100%,其中79.4%的病例根尖周透影区完全消失,非凝固性Ca(OH)组和改良TAP组之间无显著差异(P >.050)。在整个研究期间,分别有47.9%、77.1%和89.6%的病例观察到根长、牙根牙本质厚度和根尖直径的累积变化,组间无显著差异(P≥.39)。60%的病例检测到根管内钙化,组间无显著差异(P =.77)。 结论:使用非凝固性Ca(OH)或改良TAP作为根管内药物的REP在36个月的随访期内显示出高成功率和存活率,临床和影像学结果数据同样良好。