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坏死性乳磨牙再生牙髓治疗的1年临床和影像学评估:一项随机对照试验

A 1-year Clinical and Radiographic Assessment of Regenerative Endodontic Therapy for Necrotic Primary Molars: A Randomized controlled Trial.

作者信息

Abdelmoneim Dina D, Abdelaziz Amr M, Allam Gehan G, Badran Amira S

机构信息

Department of Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Ain Shams University, AlWaili, Cairo, Egypt.

出版信息

Int J Clin Pediatr Dent. 2023 Mar-Apr;16(2):295-301. doi: 10.5005/jp-journals-10005-2536.

Abstract

BACKGROUND

Preservation of necrotic primary teeth is important. Pulpectomy is the gold standard treatment in this situation. Reinfection is the main cause of failure in pulpectomy. The application of regenerative endodontic therapy in mature teeth has the rationale of restoring dental-pulp-like tissue and preventing reinfection.

AIMS AND OBJECTIVES

The current study was designed to clinically and radiographically assess regenerative endodontics therapy in necrotic primary molars in comparison to zinc oxide eugenol (ZOE) pulpectomy.

MATERIALS AND METHODS

A double-blinded randomized controlled trial with three parallel arms and a 1:1:1 allocation ratio was conducted. A total of 54 necrotic primary molars in 39 healthy children aged 4-7 years old were randomly allocated as follows group I-control group, in which ZOE pulpectomy was performed. Group II and III-experimental groups, in which regenerative endodontic therapy (RET) was performed. Modified triple antibiotic paste (mTAP) and Metapex™ were used as intracanal medicaments in groups II and III, respectively. Clinical and radiographic assessments were recorded at baseline, 6 and 12 months. Chi-squared and Fisher's exact tests were used to compare the qualitative data, while Friedman's test was used to study the changes by time within each group.

RESULTS

Nonstatistically significant differences were reported between the three groups at the 6 and 12 months follow-ups regarding the clinical or radiographic assessment (-value = 0.327 and effect size = 0.22), (-value = 0.055 and effect size = 0.118), respectively.

CONCLUSION

Regenerative endodontic therapy (RET) yielded comparable results to pulpectomy. However, the use of 5 mg/mL mTAP in RET represented the highest level of clinical as well as radiographic insignificant failure.

CLINICAL SIGNIFICANCE

Regenerative endodontic therapy (RET) provides an acceptable biological alternative to pulpectomy.

TRIAL REGISTRATION

The protocol was registered at ClinicalTrial.gov with the registration number (NCT04190914). 12/5/2019.

HOW TO CITE THIS ARTICLE

Abdelmoneim DD, Abdelaziz AM, Allam GG, et A 1-year Clinical and Radiographic Assessment of Regenerative Endodontic Therapy for Necrotic Primary Molars: A Randomized controlled Trial. Int J Clin Pediatr Dent 2023;16(2):295-301.

摘要

背景

保留坏死的乳牙很重要。牙髓摘除术是这种情况下的金标准治疗方法。再感染是牙髓摘除术失败的主要原因。再生性牙髓治疗在恒牙中的应用具有恢复牙髓样组织并防止再感染的理论依据。

目的

本研究旨在通过临床和影像学评估,比较坏死乳磨牙的再生性牙髓治疗与氧化锌丁香油(ZOE)牙髓摘除术的效果。

材料与方法

进行了一项双盲随机对照试验,分为三个平行组,分配比例为1:1:1。将39名4至7岁健康儿童的54颗坏死乳磨牙随机分配如下:第一组为对照组,进行ZOE牙髓摘除术。第二组和第三组为试验组,进行再生性牙髓治疗(RET)。第二组和第三组分别使用改良三联抗生素糊剂(mTAP)和Metapex™作为根管内药物。在基线、6个月和12个月时进行临床和影像学评估。使用卡方检验和Fisher精确检验比较定性数据,使用Friedman检验研究每组随时间的变化。

结果

在6个月和12个月的随访中,三组在临床或影像学评估方面均未报告有统计学意义的差异(P值 = 0.327,效应量 = 0.22),(P值 = 0.055,效应量 = 0.118)。

结论

再生性牙髓治疗(RET)产生的结果与牙髓摘除术相当。然而,在RET中使用5 mg/mL的mTAP代表了临床和影像学上无显著失败的最高水平。

临床意义

再生性牙髓治疗(RET)为牙髓摘除术提供了一种可接受的生物学替代方法。

试验注册

该方案已在ClinicalTrial.gov上注册,注册号为(NCT04190914)。2019年12月5日。

如何引用本文

Abdelmoneim DD, Abdelaziz AM, Allam GG等。坏死乳磨牙再生性牙髓治疗的1年临床和影像学评估:一项随机对照试验。《国际临床儿科牙科学杂志》2023;16(2):295 - 3

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3d0f/10373785/145dac37ba4d/ijcpd-16-295-g001.jpg

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