Elheeny Ahmad Abdel Hamid, El Bahnasy Sherif Shafik, ElMakawi Yassmin Mohamed, Turky Mohammed, Ahmed Eman Farouk, Wahba Norhan Khaled Omar
Assistant Professor of Paediatric and Community Dentistry, Faculty of Dentistry, Minia University, Minia, Egypt.
Assistant Professor of Paediatric and Community Dentistry, Faculty of Dentistry, Sphinx University, Sphinx, Egypt.
BDJ Open. 2025 Apr 11;11(1):36. doi: 10.1038/s41405-025-00324-w.
The primary aim was to monitor the healing of the periapical radiolucencies of adolescents' mature permanent teeth with apical periodontitis after root canal retreatment with two REPs techniques at 24 months of follow-up. The secondary aim was to assess clinical outcomes and positive responses of retreated teeth to pulp sensibility tests.
Forty adolescents with 48 teeth were enroled and randomly allocated into two equal groups after being matched according to their periapical index (PAI) scores. Root canal retreatment was performed with blood clot (BC) formation in one group and platelet-rich fibrin (PRF) in the other group. The healing process was tracked using standardized two-dimensional radiographic images to record the changes in the PAI scores after 3, 6, 12, and 24 months. Additionally, the clinical signs and symptoms and the positive responses to pulp sensibility tests were monitored. The difference between the PAI medians was analysed using the Mann-Whitney U test. The main impact of time on the PAI values and the interaction between time and the REPs technique were assessed using the general linear model (GLM). The alpha level of significance was 5%.
After two years of follow-up, there was no significant difference between the two groups clinically and in the PAI medians. The overall success rates in the BC and PRF groups were 95% and 100%, respectively (P > 0.05). Positive pulp responses were detected in 71% of the BC group and 73% in the PRF group (P > 0.05). The EPT mean values in the BC and PRF groups were 40.86 ± 6.60 and 37.9 ± 15.22, respectively (P > 0.05). Time had a significant impact on the PAI scores over the follow-up periods (P > 0.0001), while the interaction effect of time with the REPs technique had no significant effect on the PAI scores (P = 0.126).
REPs were effective in the retreatment of mature maxillary permanent incisors with apical periodontitis with a comparable reduction in the periapical radiolucencies and clinical outcomes associated with approximately similar positive responses to thermal and electric pulp tests.
主要目的是在24个月的随访期内，监测采用两种根管再治疗（REPs）技术对患有根尖周炎的青少年成熟恒牙进行根管再治疗后根尖周透射区的愈合情况。次要目的是评估再治疗牙齿的临床结果以及对牙髓敏感性测试的阳性反应。
40名患有48颗牙齿的青少年入组，根据根尖周指数（PAI）评分匹配后随机分为两组。一组采用形成血凝块（BC）的方法进行根管再治疗，另一组采用富血小板纤维蛋白（PRF）。使用标准化的二维放射图像跟踪愈合过程，记录3、6、12和24个月后PAI评分的变化。此外，监测临床体征和症状以及对牙髓敏感性测试的阳性反应。使用Mann-Whitney U检验分析PAI中位数之间的差异。使用一般线性模型（GLM）评估时间对PAI值的主要影响以及时间与REPs技术之间的相互作用。显著性水平α为5%。
经过两年的随访，两组在临床和PAI中位数方面均无显著差异。BC组和PRF组的总体成功率分别为95%和100%（P>0.05）。BC组71%的牙齿和PRF组73%的牙齿检测到阳性牙髓反应（P>0.05）。BC组和PRF组的牙髓电活力测试（EPT）平均值分别为40.86±6.60和37.9±15.22（P>0.05）。在随访期间，时间对PAI评分有显著影响（P>0.0001），而时间与REPs技术的相互作用对PAI评分无显著影响（P=0.126）。
REPs技术在患有根尖周炎的成熟上颌恒切牙根管再治疗中有效，根尖周透射区的减少程度相当，临床结果相似，对冷热和牙髓电活力测试的阳性反应也大致相似。
