Department of Pediatric 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 Key Laboratory of Digital Stomatology & Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health & NMPA Key Laboratory for Dental Materials, Beijing, China.
Clin Oral Investig. 2023 Dec 20;28(1):6. doi: 10.1007/s00784-023-05403-6.
To describe the potential possibility of complete root formation after regenerative endodontic procedures (REPs) in immature permanent teeth with different initial pre-operative conditions.
Children who underwent REPs in the Department of Pediatric Dentistry, Peking University School and Hospital of Stomatology, Beijing, China, from January 2013 to December 2022 were enrolled. Whether the tooth achieved complete root formation was determined using post-operative periapical radiography. The potential possibility of complete root formation after REPs in immature permanent teeth with different initial conditions is discussed.
A total of 428 teeth from 401 patients were included, of which 258 (60.2%) achieved complete root formation. In cases that achieved complete root formation, the most serious type of trauma was avulsion, the teeth with the worst initial root development were less than one-third of the development (stages 6-7), and the longest duration of the presence of apical lesions in the tooth before the first visit was more than 180 days. There is a significant difference in the root formation of teeth with different initial developmental stages and diagnoses.
The active period of continued root formation was 5-21 months post-operatively. The higher the initial stage of root development and the shorter the duration of the presence of apical lesions in the tooth before the first visit, the greater the possibility of root formation. However, complete root formation may still be expected after REPs in severely injured immature permanent teeth and teeth with poor initial pre-operative root development conditions (less than stage 7) at the first visit. This is also true for teeth with long-term and large-scale apical lesions.
描述在不同初始术前条件的未成熟恒牙中,再生牙髓治疗(REP)后完全根形成的潜在可能性。
纳入 2013 年 1 月至 2022 年 12 月期间在北京口腔医院儿童口腔科行 REP 的患儿。采用术后根尖片确定牙齿是否实现完全根形成。讨论不同初始条件下未成熟恒牙 REP 后完全根形成的潜在可能性。
共纳入 401 名患者的 428 颗牙,其中 258 颗(60.2%)实现完全根形成。在实现完全根形成的病例中,最严重的创伤类型是脱位,初始根发育最差的牙齿不到三分之一(6-7 期),首次就诊前根尖病变存在的最长时间超过 180 天。不同初始发育阶段和诊断的牙齿在根形成方面存在显著差异。
术后持续根形成的活跃期为 5-21 个月。初始根发育阶段越高,首次就诊前根尖病变存在的时间越短,根形成的可能性越大。然而,在初次就诊时就存在严重损伤的未成熟恒牙和初始术前根发育条件较差(小于 7 期)的牙齿,以及根尖病变长期且范围较大的牙齿,仍可期待 REP 后完全根形成。