Radiographic and clinical outcomes of the treatment of immature permanent teeth by revascularization or apexification: a pilot retrospective cohort study.
Radiographic and clinical outcomes of the treatment of immature permanent teeth by revascularization or apexification: a pilot retrospective cohort study.
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DOI：
10.1016/j.joen.2014.02.016
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发表时间：
2014-08
影响因子：
4.2
通讯作者：
Gibbs JL
中科院分区：
文献类型：
--
作者：
Alobaid AS;Cortes LM;Lo J;Nguyen TT;Albert J;Abu-Melha AS;Lin LM;Gibbs JL
这项回顾性队列研究比较了根尖诱导成形术（氢氧化钙或三氧化物矿物聚集体（MTA）的根尖屏障）与血运重建术对未成熟非活髓恒牙进行牙髓治疗的临床和影像学结局。进行了全面的病历审查，以获得一组先前完成的召回病例。收集了31颗治疗牙齿（19颗血运重建和12颗根尖诱导成形术）的临床和影像学数据，平均随访时间为17个月，召回率为63%。分析牙齿存活率、成功率和不良事件。对放射学牙根长度、宽度和面积的变化进行量化。在整个研究期间，大多数治疗牙齿存活，30/31（97%）牙齿存活（18/19（95%）血运重建，12/12根尖诱导成形）。大多数病例在临床上也取得了成功，27/31例（87%）符合成功标准（15/19例（78%）血运重建和12/12例根尖诱导成形;无显著差异）。在血运重建组中观察到更高的不良事件发生率（8/19（42%）vs根尖诱导成形术组1/12（11%））（风险比= 5.1，p=0.04，95%CI（0.719，35.48））。尽管与根尖诱导成形术病例相比，更多的血运重建病例显示了放射学根面积和宽度的增加，但效果无统计学显著性。在本研究中，血运重建术在临床或影像学结局方面均不上级其他根尖诱导成形术。需要进行大受试者队列和长随访期的研究，以评价血运重建和根尖诱导成形术的结局，同时考虑与临床成功相关的重要协变量。
This retrospective cohort study compared clinical and radiographic outcomes of endodontic treatment performed in immature non-vital permanent teeth, by apexification (calcium hydroxide or apical barrier with Mineral Trioxide Aggregate (MTA)), versus revascularization. A comprehensive chart review was performed to obtain a cohort of sequential previously completed cases with recalls. Clinical and radiographic data were collected for 31 treated teeth (19 revascularization and 12 apexification) with an average follow up time of 17 months and a recall rate of 63%. Tooth survival, success rate, and adverse events were analyzed. Changes in radiographic root length, width and area were quantified. The majority of treated teeth survived throughout the study period with 30/31 (97%) teeth surviving (18/19 (95%) revascularization, 12/12 apexification). Most cases were also clinically successful with 27/31 (87%) meeting criteria for success, (15/19 (78%) revascularization and 12/12 apexification; non-significant difference). A greater incidence of adverse events was observed in the revascularization group (8/19 (42%) versus 1/12 (11%) in apexification (Risk Ratio= 5.1, p=0.04, 95%CI (0.719, 35.48)). Although more revascularization cases than apexification cases demonstrated an increase in radiographic root area and width, the effect was not statistically significant. In this study, revascularization was not superior to other apexification techniques in either clinical or radiographic outcomes. Studies with large subject cohorts, and long follow up periods are needed to evaluate outcomes of revascularization and apexification, while accounting for important co-variants relevant to clinical success.
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