Parchami Kiarash, Dastorani Mehdi, Barati Mohammad
Infectious Diseases Research Center, AJA University of Medical Sciences, Tehran, Iran.
Trauma and Surgery Research Center, Aja University of Medical Sciences, Tehran, Iran.
Saudi Dent J. 2024 Sep;36(9):1170-1178. doi: 10.1016/j.sdentj.2024.07.006. Epub 2024 Jul 14.
The success of regenerative endodontic procedures (REPs) is significantly influenced by the choice of endodontic irrigant solution. However, the impact of these solutions on the viability of stem cells from the apical papilla (SCAP), a critical component of the REP, remains a subject of ongoing debate.
This study aimed to investigate the effects of various endodontic irrigant solutions on the viability of stem cells from the apical papilla in an in vitro setting.
A systematic literature search was conducted using databases such as PubMed/Medline, Scopus, the Cochrane Library, Web of Science, Embase, gray literature, and reference lists up to August 2023. The search was limited to in vitro studies investigating the impact of endodontic irrigant solutions on SCAP viability. The risk of bias in these studies was evaluated using the Joanna Briggs Institute's checklist.
Of the 131 articles retrieved, 14 were selected for review. The effects of eighteen different root canal irrigants, such as ethylenediaminetetraacetic acid, sodium hypochlorite, chlorhexidine, and citric acid, on the viability of SCAPs were evaluated. The risk-of-bias analysis showed a high risk in sample randomization and size justification but a low risk in other areas.
The effects of endodontic irrigant solutions on the viability of SCAPs are concentration dependent. Concentrations higher than 1.5% sodium hypochlorite, 2 % chlorhexidine, 10 % citric acid, and 2.5 % EDTA significantly reduced cell viability. However, additional research is necessary to determine the effect of these irrigants on tissue regeneration.
再生性牙髓治疗程序（REPs）的成功受到牙髓冲洗液选择的显著影响。然而，这些冲洗液对根尖乳头干细胞（SCAP）活力的影响，而SCAP是REP的关键组成部分，仍然是一个持续争论的话题。
本研究旨在调查各种牙髓冲洗液在体外环境中对根尖乳头干细胞活力的影响。
使用PubMed/Medline、Scopus、Cochrane图书馆、科学网、Embase、灰色文献等数据库以及截至2023年8月的参考文献列表进行系统的文献检索。检索限于调查牙髓冲洗液对SCAP活力影响的体外研究。使用乔安娜·布里格斯研究所的清单评估这些研究中的偏倚风险。
在检索到的131篇文章中，选择了14篇进行综述。评估了18种不同根管冲洗剂，如乙二胺四乙酸、次氯酸钠、氯己定和柠檬酸，对SCAP活力的影响。偏倚风险分析显示，样本随机化和样本量合理性方面存在高风险，但其他方面风险较低。
牙髓冲洗液对SCAP活力的影响取决于浓度。高于1.5%的次氯酸钠、2%的氯己定、10%的柠檬酸和2.5%的乙二胺四乙酸浓度会显著降低细胞活力。然而，需要进一步研究以确定这些冲洗剂对组织再生的影响。
