Department of Conservative Dentistry and Endodontics, Sinhgad Dental College and Hospital, Pune, India.
Department of Conservative Dentistry and Endodontics, Meenakshi Ammal Dental College and Hospital, Chennai, India.
Eur Endod J. 2023 May;8(3):170-186. doi: 10.14744/eej.2023.77486.
The purpose of this systematic review was to critically evaluate the available clinical literature on the use of regenerative endodontic therapy (RET) for the treatment of root resorption. All case reports, case series and clinical studies documenting the management of root resorption in mature or immature permanent teeth using RET were included. Review articles, animal studies, and RET in teeth showing developmental anomalies were excluded. A literature search was conducted in electronic databases MEDLINE, Scopus, Cochrane, and Google Scholar from 2001 to January 2022. The JBI Critical Appraisal Checklist Quality was used to appraise the included case reports and case series. The Methodological item for non-randomised studies (MINORS) tool was used to appraise the clinical study critically. After applying the inclusion and exclusion criteria, the search resulted in 14 studies (12 case reports, 1 case series, and 1 clinical study) accounting for root resorption in 34 teeth from 29 patients treated with RET. Despite the wide variation in RET protocols, the arrest of root resorption and resolution of symptoms was seen in all teeth except one (failure after 27 months). The clinical study's cone beam computed tomography (CBCT) imaging evalu- ation documented a significant volumetric decrease in resorptive and periapical lesions after RET. The clinical study was deemed as good quality using the MINORS scale. The JBI critical appraisal tool showed that the case series was of poor quality; 11 of the case reports were of good quality, while 1 case report was of fair quality. This systematic review revealed a low-to-moderate level of evidence for the use of RET in resorption cases. However, further well-designed, long-term clinical studies are required to recommend it as an alternative treatment option for root resorption management. Funding: None. The systematic review was registered in PROSPERO (CRD42021274569). (EEJ-2022-11-136).
本系统评价的目的是批判性地评估再生牙髓治疗(RET)治疗牙本质吸收的现有临床文献。所有病例报告、病例系列和临床研究均记录了使用 RET 治疗成熟或未成熟恒牙牙本质吸收的情况。综述文章、动物研究以及在表现出发育异常的牙齿中使用 RET 的研究被排除在外。从 2001 年至 2022 年 1 月,在电子数据库 MEDLINE、Scopus、Cochrane 和 Google Scholar 中进行了文献检索。使用 JBI 批判性评价清单质量评估纳入的病例报告和病例系列。非随机研究的方法学项目 (MINORS) 工具用于批判性评估临床研究。应用纳入和排除标准后,搜索结果显示,有 14 项研究(12 项病例报告、1 项病例系列和 1 项临床研究)涉及 29 名患者的 34 颗牙齿的牙本质吸收,这些患者接受了 RET 治疗。尽管 RET 方案差异很大,但所有牙齿(1 颗牙齿在 27 个月后失败)均观察到牙本质吸收的停止和症状的缓解。临床研究的锥形束计算机断层扫描(CBCT)成像评估显示,在 RET 后,吸收性和根尖病变的体积显著减少。根据 MINORS 量表,该临床研究被认为是高质量的。JBI 批判性评价工具显示,病例系列质量较差;11 项病例报告质量良好,1 项病例报告质量中等。本系统评价为 RET 在吸收病例中的应用提供了低至中等水平的证据。然而,需要进一步进行设计良好、长期的临床研究,以推荐其作为牙本质吸收管理的替代治疗选择。资金来源:无。本系统评价已在 PROSPERO(CRD42021274569)中注册。(EEJ-2022-11-136)。