di Lauro Alessandro Espedito, Valletta Alessandra, Aliberti Angelo, Cangiano Mario, Dolce Pasquale, Sammartino Gilberto, Gasparro Roberta
Department of Neurosciences, Reproductive Sciences and Odontostomatological Sciences, University of Naples Federico II, 80131 Naples, Italy.
Department of Public Health, University of Naples Federico II, 80131 Naples, Italy.
Materials (Basel). 2023 Nov 16;16(22):7187. doi: 10.3390/ma16227187.
Regenerative techniques are increasingly applied in endodontic surgery, but different materials may have varying impacts on soft and hard tissue healing. This systematic review aims to evaluate the effectiveness of autologous platelet concentrates (APCs) in clinical and radiographic healing after endodontic surgery. The data for this systematic review were processed following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines for improving the reporting of systematic reviews and meta-analyses. A literature search was conducted until October 2023 on PubMed, Scopus, and Cochrane Databases. Randomized controlled trials and controlled clinical trials addressing the use of APCs in patients who presented persistent periapical lesions and needed periapical surgery were included. Dual publications, narrative reviews, systematic reviews, case series, questionnaires, animal studies, case reports, letters to the editor, in vitro studies, and abstracts were excluded. In total, the search resulted in 14 papers. Clinical and radiographical findings were reported, showing that when APCs were used, patients exhibited less pain and swelling and a greater reduction of apical radiolucency after 12 months follow-up on average. However, the moderate/high risk of bias of included studies and their high heterogeneity, do not allow one to draw definitive conclusions on the effectiveness of APC after endodontic surgery.
再生技术在牙髓外科手术中的应用越来越广泛，但不同材料对软硬组织愈合的影响可能有所不同。本系统评价旨在评估自体血小板浓缩物（APCs）在牙髓外科手术后临床和影像学愈合方面的有效性。本系统评价的数据处理遵循PRISMA（系统评价和Meta分析优先报告项目）指南，以改进系统评价和Meta分析的报告。截至2023年10月，在PubMed、Scopus和Cochrane数据库上进行了文献检索。纳入了针对存在持续性根尖周病变且需要根尖周手术的患者使用APCs的随机对照试验和对照临床试验。排除重复发表、叙述性综述、系统评价、病例系列、问卷调查、动物研究、病例报告、给编辑的信、体外研究和摘要。检索总共得到14篇论文。报告了临床和影像学结果，表明使用APCs时，患者平均随访12个月后疼痛和肿胀减轻，根尖透影区缩小更明显。然而，纳入研究的偏倚风险为中度/高度，且异质性高，因此无法就牙髓外科手术后APCs的有效性得出明确结论。
