de Oliveira Cynthia Luiza Lopes, Ferreira Farley Mendes, Puppin-Rontani Julia, Puppin-Rontani Regina Maria, Pascon Fernanda Miori
Pediatric Dentistry Division, Faculdade de Odontologia de Piracicaba, Department of Health Science and Pediatric Dentistry, Universidade Estadual de Campinas, P.O. BOX 52, Piracicaba, SP, 13414-903, Brazil.
Private Practice, Piracicaba, SP, Brazil.
Odontology. 2025 Jun 15. doi: 10.1007/s10266-025-01128-y.
This study systematically reviews the literature on protocols used in regenerative endodontic procedures, focusing on the relationship between irrigants, intracanal medicaments, and the release of dentin-derived growth factors, which form one of the foundational pillars of regenerative endodontics. Systematic searches were conducted in PubMed, Web of Science, Scopus, Google Scholar, and gray literature for English studies (2015-2024). The included studies investigated growth factor release associated with irrigants or intracanal medicaments in human dentin. QUIN tool assessed methodological quality. Of the three-thousand-seven-hundred-and-seventy-four screened, seventeen studies were included in the review. Ethylenediaminetetraacetic acid (EDTA), either alone or combined with sodium hypochlorite (NaOCl) or chlorhexidine, and 10% citric acid were the most effective in releasing TGF-β1 and BMPs (BMP2 and BMP7). Although this systematic review demonstrates methodological heterogeneity among studies, there was a tendency for increased levels of TGF-β1 and BMP with the use of EDTA (10 or 17%) associated or not with NaOCl or chlorhexidine, while the release of VEGF and FGF2 was minimal or undetectable. Regarding the intracanal medicaments, the use of calcium hydroxide paste (Ca(OH)₂) paste demonstrated an increase in TGF-β1 release. However, this result should be interpreted with caution due to the limited number of available studies.
本研究系统回顾了再生牙髓治疗程序中使用的方案的相关文献，重点关注冲洗剂、根管内药物与牙本质衍生生长因子释放之间的关系，这些生长因子构成了再生牙髓治疗的基础支柱之一。在PubMed、科学网、Scopus、谷歌学术和灰色文献中对2015 - 2024年的英文研究进行了系统检索。纳入的研究调查了与人类牙本质中冲洗剂或根管内药物相关的生长因子释放情况。采用QUIN工具评估方法学质量。在筛选的3774项研究中，17项研究被纳入综述。单独使用乙二胺四乙酸（EDTA）或与次氯酸钠（NaOCl）或氯己定联合使用，以及10%的柠檬酸在释放转化生长因子-β1（TGF-β1）和骨形态发生蛋白（BMPs，BMP2和BMP7）方面最有效。尽管本系统综述表明各研究之间存在方法学异质性，但使用与NaOCl或氯己定相关或不相关的10%或17%的EDTA时，TGF-β1和BMP水平有升高的趋势，而血管内皮生长因子（VEGF）和碱性成纤维细胞生长因子2（FGF2）的释放量极少或无法检测到。关于根管内药物，使用氢氧化钙糊剂（Ca(OH)₂）可使TGF-β1释放增加。然而，由于现有研究数量有限，这一结果应谨慎解读。
