Dai Y F, Liu H, Peng C F, Jiang X J
Department of Paediatric Dentistry, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing 100081, China.
Beijing Da Xue Xue Bao Yi Xue Ban. 2023 Aug 18;55(4):729-735. doi: 10.19723/j.issn.1671-167X.2023.04.026.
To evaluate the clinical outcomes of immature teeth treated with regenerative endodontic procedures with an over-36-month review, to identify potential contributing factors of root deve-lopment, and to provide new reference for long-time prognosis of regenerative endodontic procedures.
We recruited teeth that had undergone regenerative endodontic procedures at the Department of Pediatric Dentistry in Peking University School and Hospital of Stomatology from January 2013 to June 2017 and had a follow-up period of more than 36 months.Clinical and radiographic records were collected.We evaluated the treatment outcomes and summarized different patterns of root development.Changes in root length, root canal wall thickness were compared between preoperative and recall radiographs.A statistical analysis was performed using software SPSS 22.0 to identify potential contributing factors of root development.
In this study, 84 teeth were recruited and the mean follow-up period was (44.7±19.3) months.The longest follow-up period was 81 months.Sixty-eight teeth (81.0%) were clinical success with bony healing, and 55 teeth (80.9%) gained the continued root development.Forty teeth completed root development with apical closure.The rate of the apical closure reached 58.8%.Twenty-four teeth gained normal root morphology with the increasing of root length and canal wall thickness and apical closure.The rate of continued root development was 92.5% in teeth with broken central cusp and 58.3% in teeth with trauma, which was statistically significant ( < 0.05).There was a statistically significant difference ( < 0.05) between the root development rates of teeth with different induced bleeding heights (orifice/middle/tip of the root)(92.9%/81.0%/63.2%).
Most of the teeth treated with regenerative endodontic procedures achieved continued root development with an over 36-month follow-up.However, the patterns of root development were different.The morphology of some teeth were close to the physiological state.Etiology and the height of induced bleeding are two factors significantly associated with the rate of the continued development root.
通过超过36个月的随访评估采用再生性牙髓治疗术治疗的未成熟恒牙的临床疗效，确定牙根发育的潜在影响因素，并为再生性牙髓治疗术的长期预后提供新的参考依据。
选取2013年1月至2017年6月于北京大学口腔医学院儿童口腔科接受再生性牙髓治疗术且随访时间超过36个月的患牙。收集临床及影像学资料。评估治疗效果并总结牙根发育的不同模式。比较术前与复查时X线片牙根长度、根管壁厚度的变化。使用SPSS 22.0软件进行统计学分析，以确定牙根发育的潜在影响因素。
本研究共纳入84颗患牙，平均随访时间为（44.7±19.3）个月，最长随访时间为81个月。68颗牙（81.0%）临床成功且有骨质愈合，55颗牙（80.9%）实现牙根继续发育。40颗牙完成牙根发育并根尖闭合，根尖闭合率达58.8%。24颗牙随着牙根长度、根管壁厚度增加及根尖闭合获得正常牙根形态。中央尖折断患牙牙根继续发育率为92.5%，外伤患牙为58.3%，差异有统计学意义（P<0.05）。不同诱导出血高度（根管口/根管中部/根尖）患牙的牙根发育率比较，差异有统计学意义（P<0.05）（92.9%/81.0%/63.2%）。
多数采用再生性牙髓治疗术治疗的患牙在超过36个月的随访中实现了牙根继续发育。然而，牙根发育模式各异。部分患牙形态接近生理状态。病因及诱导出血高度是与牙根继续发育率显著相关的两个因素。
