Pediatric and Community Dentistry Department, Faculty of Dentistry, Minia University, El-Minya, Egypt.
Pediatric and Community Dentistry Department, Faculty of Dentistry, Minia University, El-Minya, Egypt.
J Endod. 2024 Jun;50(6):792-806. doi: 10.1016/j.joen.2024.01.017. Epub 2024 Jan 27.
The primary aim of this study was to compare the radiographic changes of immature incisors with periapical radiolucency after treatment with platelet-rich fibrin (PRF) and concentrated growth factor (CGF) platelet concentrate scaffolds as well as assessment of the clinical success rate over 12 months. The secondary aim was to monitor the radiographic changes in terms of reduction of periapical lesion diameter (PALD), root dentine thickness (RDT), root length (RL), and apical foramen width (AFW). The tertiary aim was to assess and pulp responses, after 12 months.
Fifty six children with seventy necrotic, single-rooted maxillary incisors with periapical radiolucency were treated with either CGF or PRF scaffolds (35 teeth per group). Two patients with 4 teeth (2 teeth in each group) failed to attain the follow-up recalls. Radiographic changes in terms of reduction of PALD, RDT, RL, and AFW were monitored using a 2-dimensional (2D) radiograph and cone-beam computed tomography (CBCT) scan. The clinical performance of teeth receiving both scaffolds was assessed after 6 and 12 months. Categorical and continuous data were analyzed using the chi-square test and the t test, respectively. The time and group effects on the means of different radiographic dimensions were tested using the general linear model. Bland-Altman plots were used to assess the level of agreement between the 2D radiographs and CBCT. The level of significance was defined at 0.05 and a 95% confidence interval.
The means of PALD and RL showed significant enhancement in the CGF group compared to the PRF group (P < .05). While the difference between the 2 scaffolds in terms of RDT and AFW was not significant (P > .05). The findings of the 2D radiograph and CBCT were consistent. Clinically, both scaffold success rates were similar (93.9%) over the follow-up intervals. The influence of study independent variables had no significant effect on the success of the regenerative endodontic procedures outcome (P > .05). There was no significant difference in the positive pulp responses to the thermal and electric pulp tests after one year of treatment (P > .05).
According to the short-term follow-up, PRF and CGF were successful in treating immature teeth with periapical radiolucency by regenerative endodontics. Both scaffold systems induced periapical healing and root lengthening with significant superiority of CGF.
本研究的主要目的是比较富血小板纤维蛋白(PRF)和浓缩生长因子(CGF)血小板浓缩物支架治疗伴根尖透光区的未成熟切牙的放射影像学变化,并在 12 个月内评估临床成功率。次要目的是监测放射影像学变化,包括根尖病变直径(PALD)、根牙本质厚度(RDT)、根长(RL)和根尖孔宽度(AFW)的减少。第三个目的是在 12 个月后评估和牙髓反应。
56 名儿童的 70 颗坏死、单根上颌切牙伴根尖透光区,分别用 CGF 或 PRF 支架治疗(每组 35 颗牙)。2 名患者的 4 颗牙(每组 2 颗)未进行随访。通过二维(2D)射线照相和锥形束计算机断层扫描(CBCT)扫描监测 PALD、RDT、RL 和 AFW 减少的放射影像学变化。在 6 个月和 12 个月后,评估两种支架治疗的牙齿的临床性能。使用卡方检验和 t 检验分别分析分类数据和连续数据。使用一般线性模型检验时间和组对不同放射影像学维度均值的影响。Bland-Altman 图用于评估 2D 射线照相和 CBCT 之间的一致性水平。显著性水平定义为 0.05 和 95%置信区间。
与 PRF 组相比,CGF 组的 PALD 和 RL 均值显著增加(P < 0.05)。而 RDT 和 AFW 两组之间的差异无统计学意义(P > 0.05)。2D 射线照相和 CBCT 的结果一致。临床随访期间,两种支架的成功率相似(93.9%)。研究独立变量的影响对再生牙髓治疗结果无显著影响(P > 0.05)。治疗 1 年后,热和电牙髓测试的阳性牙髓反应无显著差异(P > 0.05)。
根据短期随访结果,PRF 和 CGF 通过再生牙髓治疗成功治疗伴根尖透光区的未成熟切牙。两种支架系统均诱导根尖愈合和根长增加,CGF 具有显著优势。