A Retrospective Evaluation of Radiographic Outcomes in Immature Teeth With Necrotic Root Canal Systems Treated With Regenerative Endodontic Procedures
A Retrospective Evaluation of Radiographic Outcomes in Immature Teeth With Necrotic Root Canal Systems Treated With Regenerative Endodontic Procedures
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DOI：
10.1016/j.joen.2009.06.021
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发表时间：
2009-10-01
影响因子：
4.2
通讯作者：
Hargreaves, Kenneth
中科院分区：
文献类型：
--
作者：
Bose, Raison;Nummikoski, Pirkka;Hargreaves, Kenneth
前言：最近发表了几例涉及未成熟恒牙的牙髓再生病例报告。这些病例系列使用了不同的治疗方法来实现牙髓再生，包括三联抗生素糊剂、Ca（OH）（2）和甲醛甲酚。然而，没有研究分析了总体结果。研究方法：在这项回顾性研究中，我们收集了54例已发表和未发表的牙髓再生病例和40例对照病例（20例根尖诱导成形术和20例非手术根管治疗）的X线照片，并使用几何成像程序NIH ImageJ with TurboReg插件，以最大限度地减少术前和召回图像之间的角度差异，并计算根长和牙本质壁厚度的持续发展。结果：与2个对照组的比较为该方法提供了验证试验。54例再生病例中有48例（89%）的X线片具有足够相似的方向，可以进行分析。结果显示，与MTA根尖诱导术或NSRCT对照组相比，使用三联抗生素糊剂（P < .001）和Ca（OH）（2）（P < .001）进行再生根管治疗可显著增加根长。三联抗生素糊剂组的根壁厚度显著大于Ca（OH）（2）或甲醛甲酚组（P <0.05）。Ca（OH）（2）的位置也影响结果。当Ca（OH）（2）被限制在根管系统的冠侧时，它比当它被放置在冠侧之外时产生更好的效果。结论：Ca（OH）2和三联抗生素糊剂在未成熟坏死牙齿中用作根管内药物时，有助于促进牙髓-牙本质复合体的进一步发育。（J Endod 2009;35：1343-1349）
Introduction: Several case reports on endodontic regeneration involving immature permanent teeth have recently been published. These case series have used varying treatments to achieve endodontic regeneration including triple antibiotic paste, Ca(OH)(2), and formocresol. However, no study has analyzed the overall results. Methods: In this retrospective study, we collected radiographs from 54 published and unpublished endodontic regenerative cases and 40 control cases (20 apexification and 20 nonsurgical root canal treatments) and used a geometrical imaging program, NIH ImageJ with TurboReg plug-in, to minimize potential differences in angulations between the preoperative and recall images and to calculate continued development of root length and dentin wall thickness. Results: The comparison to the 2 control groups provided a validation test for this method. Forty-eight of the 54 regenerative cases (89%) had radiographs of sufficiently similar orientation to permit analysis. The results showed regenerative endodontic treatment with triple antibiotic paste (P < .001) and Ca(OH)(2) (P < .001) produced significantly greater increases in root length than either the MTA apexification or NSRCT control groups. The triple antibiotic paste produced significantly greater differences in root wall thickness than either the Ca(OH)(2) or formocresol groups (P < .05 for both). The position of Ca(OH)(2) also influenced the outcome. When Ca(OH)(2) was radiographically restricted to the coronal half of the root canal system, it produced better results than when it was placed beyond the coronal half. Conclusions: Ca(OH)(2) and triple antibiotic paste when used as an intracanal medicament in immature necrotic teeth can help promote further development of the pulp-dentin complex. (J Endod 2009;35:1343-1349)