血凝块、S-PRF和A-PRF作为支架在再生性牙髓治疗后治疗慢性根尖周炎的非活髓成熟单根牙中的愈合潜力：随机临床试验

Healing potentiality of blood clot, S-PRF and A-PRF as scaffold in treatment of non-vital mature single rooted teeth with chronic peri-apical periodontitis following regenerative endodontic therapy: randomized clinical trial.

作者信息

Darwish Omnia Badawy, Aziz Said Mohamed Abdel, Sadek Hany Samy

机构信息

Endodontics Department, Faculty of Dentistry, Cairo University, 11 El-Saraya Street, Manial, Cairo, Egypt.

Endodontics Department, Faculty of Dentistry, Menofia University, Shibin Al kawm, Menofia, Egypt.

出版信息

BMC Oral Health. 2025 Jan 9;25(1):50. doi: 10.1186/s12903-024-05378-0.

DOI:10.1186/s12903-024-05378-0

PMID:39789544

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11715601/

Abstract

OBJECTIVES

This randomized prospective controlled trial investigated the effectiveness of different strategies of regenerative endodontic therapy on necrotic mature anterior teeth with chronic periapical periodontitis with 18 months follow up.

METHODS

A total analyzed 51 adult participant with mature single rooted teeth having necrotic pulp with chronic periapical periodontitis (PAI ≥ 3) were selected. Patients had been randomly categorized into three distinct groups (n = 17 each group). All groups received the same treatment on the first visit. After 2 weeks, regenerative treatment was performed using either blood clot technique, Standard-PRF and Advanced-PRF approach. A standardized radiograph was taken, and the patients instructed for 6, 12 and 18 months follow up periods. Fisher's exact test was applied to compare the frequency of PAI scores at different follow-up intervals between the three groups.

RESULTS

The results showed radiographic success at 18 months (58.8% in blood group, 94.1% in S-PRF group and 76.5% in A-PRF group). There was no statistically significant difference between the three groups according to incidence of healing at 6, 12 and 18 months. Clinical success was 82.4% in blood group and 88.2% in both S-PRF and A-PRF groups. There was no significant difference between the three groups (p = 1). The overall success (clinical and radigraphic) was 76.5%. Incidence of the gaining sensitivity after 12 and 18 months was 29.4% with A-PRF group and 41.2% within the S-PRF group, 17.6% with BC group.

CONCLUSION

PRF based regenerative technique may outperform the blood clot technique in treatment of non-vital mature teeth with chronic periapical periodontitis. There is a need for future randomized clinical studies to consolidate procedures in this field with more prolonged evaluation periods.

CLINICAL TRIAL REGISTRATION

The study was retrospectively registered with ClinicalTrials.gov (ID: NCT04606719 ) in 28/10/2020.

摘要

目的

本随机前瞻性对照试验研究了不同再生性牙髓治疗策略对患有慢性根尖周炎的坏死成熟前牙的有效性，并进行了18个月的随访。

方法

共选取51名患有坏死牙髓伴慢性根尖周炎（PAI≥3）的成年单根成熟牙患者。患者被随机分为三个不同组（每组n = 17）。所有组在首次就诊时接受相同治疗。2周后，采用血凝块技术、标准PRF和高级PRF方法进行再生治疗。拍摄标准化X线片，并指导患者进行6个月、12个月和18个月的随访。应用Fisher精确检验比较三组在不同随访间隔时PAI评分的频率。

结果

结果显示18个月时影像学成功率（血凝块组为58.8%，标准PRF组为94.1%，高级PRF组为76.5%）。根据6个月、12个月和18个月时的愈合发生率，三组之间无统计学显著差异。血凝块组临床成功率为82.4%，标准PRF组和高级PRF组均为88.2%。三组之间无显著差异（p = 1）。总体成功率（临床和影像学）为76.5%。12个月和18个月后恢复感觉的发生率，高级PRF组为29.4%，标准PRF组为41.2%，血凝块组为17.6%。