Mujawar Asiya, Pandit Varsha, Shaikh Sumaiyya, Shaikh Bilal, Alessa Noura A, Kader Mohammed Abdul, Alqarni Mohammed, Karobari Mohmed Isaqali
Department of Conservative Dentistry and Endodontics, Sinhgad Dental College and Research Centre, India.
Department of Conservative Dentistry and Endodontics, Bharati Vidyapeeth Deemed to be University Dental College and Hospital, India.
J Int Med Res. 2025 Sep;53(9):3000605251379243. doi: 10.1177/03000605251379243. Epub 2025 Sep 26.
ObjectiveThis systematic review and meta-analysis aimed to evaluate the efficacy of regenerative endodontic procedures compared with conventional root canal treatment procedures in mature permanent teeth with periapical lesions.MethodsThis systematic review and meta-analysis were conducted following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Randomized controlled trials that were included in the study compared regenerative endodontic procedures with traditional root canal treatment procedures in mature permanent teeth with irreversible pulpitis. The Risk of Bias 2 tool was used for quality assessment, and the certainty of the evidence was evaluated using the GRADE approach. Meta-analysis was performed using the RevMan Web software, using odds ratios for dichotomous outcomes and mean differences for continuous outcomes, with a random-effects model applied. Heterogeneity was assessed using the I statistic, and publication bias was evaluated using funnel plots and Egger's test.ResultsThe analysis included five studies encompassing diverse regenerative strategies. Overall, regenerative endodontic procedures demonstrated comparable or superior clinical and radiographic healing outcomes relative to conventional treatments. Notably, certain regenerative approaches showed greater potential for restoring pulp vitality and reducing early postoperative pain. However, the quality of evidence was moderate, constrained by small sample sizes, methodological heterogeneity, and blinding challenges.ConclusionCurrent evidence suggests that regenerative endodontic procedures are promising alternatives to conventional root canal treatment procedures for mature teeth with periapical lesions. Despite these encouraging findings, further high-quality, multicenter trials with standardized protocols and extended follow-up periods are necessary to confirm the results and establish the long-term benefits and cost-effectiveness of regenerative endodontics.
目的
本系统评价和荟萃分析旨在评估在患有根尖周病变的成熟恒牙中，再生性牙髓治疗程序与传统根管治疗程序相比的疗效。
方法
本系统评价和荟萃分析按照系统评价和荟萃分析的首选报告项目指南进行。纳入研究的随机对照试验比较了在患有不可逆性牙髓炎的成熟恒牙中再生性牙髓治疗程序与传统根管治疗程序。使用偏倚风险2工具进行质量评估，并使用GRADE方法评估证据的确定性。使用RevMan Web软件进行荟萃分析，对于二分结果使用比值比，对于连续结果使用均值差异，并应用随机效应模型。使用I统计量评估异质性，并使用漏斗图和埃格检验评估发表偏倚。
结果
该分析纳入了五项涵盖不同再生策略的研究。总体而言，相对于传统治疗，再生性牙髓治疗程序显示出相当或更好的临床和影像学愈合结果。值得注意的是，某些再生方法在恢复牙髓活力和减轻术后早期疼痛方面显示出更大的潜力。然而，证据质量为中等，受到样本量小、方法学异质性和盲法挑战的限制。
结论
目前的证据表明，对于患有根尖周病变的成熟牙齿，再生性牙髓治疗程序是传统根管治疗程序的有前景的替代方法。尽管有这些令人鼓舞的发现，但仍需要进一步开展高质量、多中心试验，采用标准化方案并延长随访期，以证实结果并确定再生性牙髓治疗的长期益处和成本效益。
