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一项为期 12 个月的随机对照试验,旨在评估在青少年患者中,对有根尖暗影的复发成熟切牙进行再治疗以恢复活力的疗效。

A 12-month randomized controlled trial to assess the efficacy of revitalization of retreated mature incisors with periapical radiolucency in adolescents.

机构信息

Paediatric and Community Dentistry, Faculty of Dentistry, Minia University, Ard Shalaby, El Minia, Minya, 61519, Egypt.

Paediatric Dentistry, Faculty of Dentistry, Minia University, Minya, Egypt.

出版信息

Sci Rep. 2024 Jul 16;14(1):16366. doi: 10.1038/s41598-024-66305-5.

Abstract

The use of regenrative endodontics is restoring the health status of the root canals of retreated mature teeth is a novel approach. Therefore, the current trial aimed to compare the effectiveness of regenerative endodontic procedures (REPs) to non-surgical root canal retreatment (NS-RCR) in reducing periapical radiolucency over one year for the retreatment of mature incisors with periapical periodontitis. The secondary purpose was to assess clinical success and regain pulp sensibility. A parallel randomized controlled trial, 66 mature incisors with periapical radiolucencies were randomly divided into two equal groups and retreated with either REPs or NS-RCR. At baseline and after 6 and 12 months, teeth were assessed clinically and radiographically using a periapical index (PAI). The Mann-Whitney test was used to analyze nonparametric PAI scores. The Electric pulp test readings were analyzed using the repeated measure analysis of variance (ANOVA). Over the follow-up intervals, there was no significant intergroup difference in the PAI medians, the majority of the teeth displayed a reduction in periapical radiolucency. At the end of the follow-up period, the clinical successes for the REP and NS-RCR groups were 93.9% and 97%, respectively (p = 0.555). Positive pulp sensibility was recorded in 54.54% of cases in the REPs after 12 months. Both approaches showed a comparable diminishing of periapical radiolucencies and equivalent clinical results. A conventional, non-surgical endodontic retreatment may not always be necessary.

摘要

再生牙髓治疗用于恢复退缩成熟牙的根管健康状态是一种新方法。因此,本试验旨在比较再生牙髓治疗(REP)与非手术根管再治疗(NS-RCR)在 1 年内减少成熟切牙根尖周炎的根尖周透光率的效果。次要目的是评估临床成功率和牙髓活力恢复情况。这是一项平行随机对照试验,66 颗有根尖透光区的成熟切牙被随机分为两组,分别用 REP 或 NS-RCR 进行再治疗。在基线和 6 个月和 12 个月后,使用根尖指数(PAI)进行临床和影像学评估。非参数 PAI 评分采用曼-惠特尼检验进行分析。电动牙髓测试读数采用重复测量方差分析(ANOVA)进行分析。在随访期间,两组的 PAI 中位数没有显著差异,大多数牙齿的根尖透光率都有所降低。在随访期末,REP 和 NS-RCR 组的临床成功率分别为 93.9%和 97%(p=0.555)。REP 组在 12 个月后有 54.54%的病例记录到牙髓活力阳性。两种方法都显示出相似的根尖周透光率减少和等效的临床结果。传统的非手术根管再治疗不一定总是必要的。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/13b4/11649900/0fdaa338cc56/41598_2024_66305_Fig1_HTML.jpg

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