Clinical MSc in Endodontics, University of Manchester, Manchester, UK.
Clinical MSc in Prosthetic Dentistry, University of Bristol, Bristol, UK.
Evid Based Dent. 2023 Sep;24(3):125-126. doi: 10.1038/s41432-023-00916-1. Epub 2023 Aug 4.
Five scientific databases were electronically searched: PubMed, EMBASE, OpenGrey, Web of Science and Cochrane Library. The search was conducted until 17 February 2022 without any restriction on date of publication but was restricted to English language. Relevant studies were also screened for related publications. The aim of this systematic review and meta-analysis was to evaluate the effectiveness of regenerative endodontic procedures (REPs) in mature and immature permanent teeth with necrotic pulp and to evaluate if the success rate was affected by the stage of root development.
Types of studies: all of the included studies were randomised controlled trials (RCTs).
people with necrotic permanent teeth (immature or mature) treated with regenerative endodontic procedures. Types of interventions: regenerative endodontic procedures. Language: RCTs published in English.
Types of studies: (1) case reports, (2) retrospective cohort trials, (3) prospective cohort trials, (4) animal trials, (5) in-vitro trials, (6) non-randomised trials.
primary teeth. Types of interventions: no details about the clinical procedures. Follow-up period: <6 months.
The titles and abstracts of the RCTs identified by the search strategies were independently screened by two reviewers. After the initial screening, the full text of the relevant trials were reassessed against the inclusion and exclusion criteria. Discrepancies and disagreements were resolved by consensus after including a third reviewer.
Following the initial electronic and manual searches, a total of 3766 articles were initially identified. This was reduced to 2739 articles after duplicates were removed. However, after the initial screening phase, 35 articles were considered potentially relevant and qualified for full-text scrutiny. Out of the 35 articles, only 27 were considered eligible for inclusion. The differences in the success rate and the asymptomatic rate between the mature and immature permanent teeth with necrotic pulp were not statistically significant. However, the differences between the two groups were statistically significant in the rate of positive response to electrical pulp testing.
Based on the results of this systematic review and meta-analysis, the authors concluded that REPs are an effective therapy and can achieve high success rates for both mature and immature necrotic permanent teeth. It was also concluded that the REPs were more successful in regaining vitality responses for mature compared with immature permanent teeth with necrotic pulps.
电子检索了五个科学数据库：PubMed、EMBASE、OpenGrey、Web of Science 和 Cochrane Library。检索截止日期为 2022 年 2 月 17 日，没有对出版物日期的任何限制，但仅限于英文。还对相关研究进行了筛查，以寻找相关出版物。本系统评价和荟萃分析的目的是评估再生牙髓治疗术（REP）在有坏死牙髓的成熟和未成熟恒牙中的疗效，并评估成功率是否受根发育阶段的影响。
研究类型：所有纳入的研究均为随机对照试验（RCT）。
接受再生牙髓治疗术的有坏死的恒牙（成熟或未成熟）。干预类型：再生牙髓治疗术。语言：发表在英文的 RCTs。
研究类型：（1）病例报告，（2）回顾性队列试验，（3）前瞻性队列试验，（4）动物试验，（5）体外试验，（6）非随机试验。
乳牙。干预类型：未详细说明临床操作。随访时间：<6 个月。
通过搜索策略确定的 RCT 的标题和摘要由两名评审员独立筛选。经过初步筛选后，对相关试验的全文重新评估了纳入和排除标准。分歧和意见通过包括第三位评审员来解决。
经过初步的电子和手动搜索，共初步确定了 3766 篇文章。去除重复项后，这一数字减少到 2739 篇。然而，在初步筛选阶段后，有 35 篇文章被认为具有潜在相关性，并符合全文审查标准。在 35 篇文章中，只有 27 篇被认为符合纳入标准。在有坏死牙髓的成熟和未成熟恒牙之间，成功率和无症状率的差异没有统计学意义。然而，两组之间在电牙髓测试阳性反应率方面的差异具有统计学意义。
根据本系统评价和荟萃分析的结果，作者得出结论，REP 是一种有效的治疗方法，可实现成熟和未成熟坏死恒牙的高成功率。还得出结论，REP 在恢复成熟恒牙活力反应方面比未成熟恒牙更成功。
