Maree Manal, Nabriski Omri, Yoshpe Margarita, Lin Shaul, Kaufman Arieh Y
Endodontics Department, School of Dentistry, Rambam Health Care Campus, Haifa, Israel.
Department of Endodontics, Hadassah Medical Center, Faculty of Dental Medicine, Hebrew University of Jerusalem, Jerusalem, Israel.
Dent Traumatol. 2025 Feb;41(1):47-58. doi: 10.1111/edt.12986. Epub 2024 Oct 23.
BACKGROUND/AIM: Regenerative endodontic treatment is a promising approach for healing periapical lesions and continuous root maturation. Although previous studies have reported its outcomes, the dynamics of morphological changes over time remain unclear. Therefore, this study aimed to evaluate changes in the periapical status and root dimensions over a 60-month follow-up period.
The follow-up duration, periapical status changes, calcific barrier formation, degree of apical closure and radiographic root area changes were compared with those of the last follow-up in this retrospective study. Radiographic root area changes were calculated as the difference between the total root and total canal areas.
Fifty-eight patients (81 teeth) underwent regenerative endodontic treatment during the study period, of whom 32 patients (36 teeth, 62%) were included. The survival and success rates of the treated teeth were 100% and 94.4%, respectively. All teeth developed a calcific bridge in the cervical third of the root canal, indicating the presence of vital tissue. Apical narrowing (partial or total) was observed in 75% of the cases. The root maturation stage affected the percentage increase in the radiographic root area. Teeth in Cvek stages II-III showed a higher radiographic root area increase than more mature teeth. All tooth radiographic root areas increased significantly in the initial 20 months of the treatment and moderately thereafter.
Regenerative endodontic treatment is a safe approach for traumatised immature teeth. The presence of a radiographic calcified bridge may be an early indication of treatment success. The main complete tooth morphological changes occur after approximately 20 months posttreatment. These findings may help clinicians better understand the time-dependent changes in the root morphology after treatment, improve the follow-up schedule and predict the progress of healing during follow-up visits.
背景/目的：再生性牙髓治疗是一种有望治愈根尖周病变并使牙根持续发育成熟的方法。尽管此前的研究已报道了其治疗结果，但随时间推移形态学变化的动态过程仍不明确。因此，本研究旨在评估60个月随访期内根尖周状况和牙根尺寸的变化。
在这项回顾性研究中，将随访时长、根尖周状况变化、钙化屏障形成、根尖闭合程度以及影像学上牙根面积变化与最后一次随访时的情况进行比较。影像学上牙根面积变化通过计算牙根总面积与根管总面积之差得出。
在研究期间，58例患者（81颗牙齿）接受了再生性牙髓治疗，其中32例患者（36颗牙齿，62%）被纳入研究。治疗后牙齿的存留率和成功率分别为100%和94.4%。所有牙齿在根管颈段三分之一处均形成了钙化桥，表明存在有活力的组织。75%的病例观察到根尖缩窄（部分或完全缩窄）。牙根发育成熟阶段影响影像学上牙根面积的增加百分比。处于Cvek II - III期的牙齿比更成熟的牙齿在影像学上牙根面积增加得更多。所有牙齿的影像学牙根面积在治疗的最初20个月内显著增加，之后增加幅度适中。
再生性牙髓治疗对于外伤导致的未成熟恒牙是一种安全的治疗方法。影像学上钙化桥的出现可能是治疗成功的早期指标。牙齿主要的形态学完整变化在治疗后约20个月发生。这些发现可能有助于临床医生更好地理解治疗后牙根形态随时间的变化，优化随访计划，并在随访时预测愈合进程。
