Department of Paediatric Dentistry, Charles Clifford Dental Hospital, Sheffield Teaching Hospitals NHS Foundation Trust, 76 Wellesley Road, Sheffield, S10 2SZ, UK.
Academic Unit of Oral Health, Dentistry and Society, School of Clinical Dentistry, University of Sheffield, Sheffield, UK.
Eur Arch Paediatr Dent. 2024 Dec;25(6):821-835. doi: 10.1007/s40368-024-00941-3. Epub 2024 Sep 10.
To assess the technical quality and clinical outcomes of non-surgical endodontic treatment of immature permanent incisor teeth with three different bioceramic plug materials and highlight variables which may influence treatment and quality outcomes.
This cross-sectional analysis forms part of a retrospective service evaluation of the technical quality and clinical outcome of orthograde root canal treatment carried out in the Paediatric Dentistry Department of Charles Clifford Dental Hospital (United Kingdom). Twenty-five cases were identified chronologically, using the electronic patient record system, for three bioceramic plug materials: Mineral Trioxide Aggregate (MTA), Biodentine, and TotalFill Putty. All radiographs were analysed using standard conditions. Intra- and inter-examiner agreement was calculated using Kappa and weighted Kappa tests. Data were collected using a data collection tool, entered into Microsoft Excel, and analysed using descriptive statistics, exploratory analysis with Chi-squared tests, and multivariable analyses (logistic regression).
At 12-month review, the success rate for each apexification material was MTA (84%), Biodentine (88%), and TotalFill Putty (92%). MTA had the highest frequency of post-operative coronal discolouration, with Biodentine most associated with apical extrusion. A number of variables and trends that affect the clinical outcome were identified, including the presence of pre-operative resorption, the number of operators involved in treatment, the number of appointments to complete treatment, as well as how non-use of local anaesthetic during apical plug placement had no adverse effect on technical quality or clinical outcome.
MTA, Biodentine, and TotalFill Putty are highly effective apexification materials which produce excellent clinical outcomes. As such, logistical and situational factors, such as continuity of care from operators with increased levels of experience, skill and ability, rather than material choice, may be more prognostic regarding the technical quality and clinical outcome of immature endodontic treatment. Further high-quality evidence is required.
评估三种不同生物陶瓷塞材料在未成熟恒牙牙髓治疗中的技术质量和临床效果，并强调可能影响治疗和质量结果的变量。
这是查尔斯克利福德牙科医院（英国）牙髓病科进行的顺行根管治疗技术质量和临床结果的回顾性服务评估的一部分，本横断面分析从电子病历系统中按时间顺序确定了 25 例病例，用于三种生物陶瓷塞材料：矿物三氧化物聚合体（MTA）、Biodentine 和 TotalFill 腻子。所有射线照片均在标准条件下进行分析。使用 Kappa 和加权 Kappa 检验计算内部和外部检查者之间的一致性。使用数据收集工具收集数据，将其输入 Microsoft Excel，并使用描述性统计、卡方检验和多变量分析（逻辑回归）进行分析。
在 12 个月的复查中，每种根尖封闭材料的成功率为 MTA（84%）、Biodentine（88%）和 TotalFill 腻子（92%）。MTA 术后冠部变色的频率最高，Biodentine 最易发生根尖外溢。确定了一些影响临床结果的变量和趋势，包括术前吸收的存在、参与治疗的操作人员数量、完成治疗所需的预约次数，以及根尖塞放置过程中不使用局部麻醉是否对技术质量或临床结果没有不良影响。
MTA、Biodentine 和 TotalFill 腻子是高效的根尖封闭材料，可产生出色的临床效果。因此，逻辑和情况因素，例如操作人员的连续性，这些操作人员的经验、技能和能力水平较高，而不是材料选择，可能更能预测未成熟牙髓治疗的技术质量和临床效果。需要进一步的高质量证据。
