Dave Anjali K, Cheung Julia Y, Kim Sahng G
Division of Endodontics, Columbia University College of Dental Medicine, New York, NY 10032, USA.
Biomimetics (Basel). 2025 Aug 13;10(8):530. doi: 10.3390/biomimetics10080530.
Dehydrated human-derived amnion-chorion membranes (ACM), known for their bioactive composition of growth factors and cytokines, have demonstrated potential as a bioactive scaffold in regenerative medicine; however, their clinical application in regenerative endodontic procedures (REPs) remains unexplored. This retrospective study aimed to evaluate the clinical and radiographic outcomes of REPs using ACM compared to collagen matrices (CM) in immature necrotic permanent teeth. Forty-one immature necrotic teeth from 38 patients (mean age: 14.68 ± 7.43 years) were treated with REPs using either ACM ( = 21) or CM ( = 20) scaffolds over a mean follow-up period of 23.23 months. Outcomes assessed included survival, success, root development measured by radiographic root area (RRA), and pulp sensibility. Independent t-tests compared outcomes between groups, while Cox regression and generalized linear models identified predictors of treatment outcomes. Overall survival and success rates were 87.8% and 82.9%, respectively. ACM-treated teeth achieved 90.5% survival and 85.7% success rates, while CM-treated teeth demonstrated 85.0% survival and 80.0% success rates, with no statistically significant differences between groups ( > 0.05). Root development occurred in 85.4% of cases overall, with significant RRA increases of 13.89 ± 13.95% for ACM and 11.24 ± 11.21% for CM ( < 0.05 within each group). Pulp sensibility recovery was observed in 51.2% of treated teeth overall, with 42.9% for ACM-treated teeth and 55.0% for CM-treated teeth ( > 0.05). Notably, ACM-treated teeth demonstrated earlier sensibility recovery compared to those of CM-treated teeth. Age was identified as a significant negative predictor of root development outcomes ( < 0.05). This clinical study demonstrates that both ACM and CM are clinically effective scaffolds for REPs, achieving high survival rates and promoting root development in immature necrotic teeth. While overall success rates were comparable, ACM showed faster sensibility recovery, suggesting potential biological advantages for enhanced tissue regeneration and earlier functional recovery.
脱水人源羊膜绒毛膜（ACM）以其生长因子和细胞因子的生物活性成分而闻名，已显示出作为再生医学中生物活性支架的潜力；然而，其在再生牙髓治疗程序（REP）中的临床应用仍未得到探索。这项回顾性研究旨在评估与胶原基质（CM）相比，在未成熟坏死恒牙中使用ACM进行REP的临床和影像学结果。对38例患者（平均年龄：14.68±7.43岁）的41颗未成熟坏死牙齿进行了REP治疗，使用ACM（n = 21）或CM（n = 20）支架，平均随访期为23.23个月。评估的结果包括存活率、成功率、通过影像学根面积（RRA）测量的牙根发育情况以及牙髓敏感性。独立t检验比较了两组之间的结果，而Cox回归和广义线性模型确定了治疗结果的预测因素。总体存活率和成功率分别为87.8%和82.9%。接受ACM治疗的牙齿存活率为90.5%，成功率为85.7%，而接受CM治疗的牙齿存活率为85.0%，成功率为80.0%，两组之间无统计学显著差异（P>0.05）。总体而言，85.4%的病例出现了牙根发育，ACM组RRA显著增加13.89±13.95%，CM组为11.24±11.21%（每组内P<0.05）。总体而言，51.2%的治疗牙齿观察到牙髓敏感性恢复，ACM治疗的牙齿为42.9%，CM治疗的牙齿为55.0%（P>0.05）。值得注意的是，与CM治疗的牙齿相比，ACM治疗的牙齿显示出更早的敏感性恢复。年龄被确定为牙根发育结果的显著负预测因素（P<0.05）。这项临床研究表明，ACM和CM都是REP临床上有效的支架，在未成熟坏死牙齿中实现了高存活率并促进了牙根发育。虽然总体成功率相当，但ACM显示出更快的敏感性恢复，表明在增强组织再生和更早功能恢复方面具有潜在的生物学优势。
