Treatment Outcome of Regenerative Endodontic Procedures for Necrotic Immature and Mature Permanent Teeth: A Systematic Review and Meta-Analysis Based on Randomised Controlled Trials

作者全名："Li, Jiahua; Zheng, Leilei; Daraqel, Baraa; Liu, Jing; Hu, Yun"

作者地址："[Li, Jiahua; Zheng, Leilei; Daraqel, Baraa; Liu, Jing; Hu, Yun] Chongqing Med Univ, Dept Stomatol Hosp, Chongqing, Peoples R China; [Li, Jiahua; Zheng, Leilei; Daraqel, Baraa; Liu, Jing; Hu, Yun] Chongqing Key Lab Oral Dis & Biomed Sci, Chongqing, Peoples R China; [Li, Jiahua; Zheng, Leilei; Daraqel, Baraa; Liu, Jing; Hu, Yun] Chongqing Municipal Key Lab Oral Biomed Engn Highe, Chongqing, Peoples R China; [Hu, Yun] Chongqing Med Univ, Stomatol Hosp, 426 Songshibei Rd, Chongqing 401147, Peoples R China"

通信作者："Hu, Y (通讯作者)，Chongqing Med Univ, Stomatol Hosp, 426 Songshibei Rd, Chongqing 401147, Peoples R China."

来源：ORAL HEALTH & PREVENTIVE DENTISTRY

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:000996550400017

JCR分区：Q3

影响因子：1.4

年份：2023

卷号：21

期号：1

开始页：141

结束页：152

文献类型：Review

关键词：dental pulp necrosis; meta-analysis; regenerative endodontics

摘要："Purpose: To analyse whether the stage of apical development affects the effectiveness of regenerative endodontic treatment by comparing the outcomes for necrotic mature and immature permanent teeth treated with regenerative endodontic pro-cedures.Materials and Methods: Multiple databases (PubMed, Cochrane Library, Web of Science, EMBASE and OpenGrey databases) were searched through February 17th, 2022. Inclusion criteria were randomised controlled trials that included treatment of necrotic immature or mature permanent teeth using any regenerative endodontic procedures (REPs) that aimed to achieve pulp revascularisation or regeneration. The Cochrane Risk of Bias 2.0 tool was used to assess risk of bias. The included indica-tors were asymptomatic sign, success, pulp sensitivity, and discolouration. The extracted data were expressed by percentage for statistical analysis. The random effect model was used to explain the results. Comprehensive Meta-Analysis Version 2 was used to perform the statistical analyses.Results: Twenty-seven RCTs were eligible for inclusion in the meta-analysis. The success rates of necrotic immature and ma-ture permanent teeth were 95.6% (95% CI, 92.4%-97.5%; 12=34.9%) and 95.5% (95%CI, 87.9%-98.4%; I2=0%), respectively. The asymptomatic rates of necrotic immature and mature permanent teeth were 96.2% (95%CI, 93.5%-97.9%; 12=30.1%) and 97.0% (95%CI, 92.6%-98.8%; 12=0%), respectively. The treatment of immature and mature necrotic permanent teeth with REPs yields high success rates and low symptomatic rates. The incidence of positive sensitivity response for electric pulp test-ing in necrotic immature permanent teeth (25.2% [95% CI, 18.2%-33.8%; 12=0%]) was lower than that in necrotic mature per-manent teeth (45.4% [95% CI, 27.2%-64.8%; 12=75.2%]), and this difference was statistically significant. The restoration of pulp sensitivity seems to be more evident in necrotic mature permanent teeth than in necrotic immature permanent teeth. The crown discolouration rate of immature permanent teeth was 62.5% (95% CI, 49.7%-73.8%; 12=76.1%). Necrotic immature permanent teeth have a considerable crown discolouration rate.Conclusion: REPs for both immature and mature necrotic permanent teeth yield high success rates and promote root devel-opment. The vitality responses seem to be more evident in necrotic mature permanent teeth than in necrotic immature per-manent teeth."

基金机构：Chongqing Talent Program: Innovative leading talents [CQYC20210303384]; Chongqing Medical Scientific Research Project [2018ZDXM020]

基金资助正文："This work was supported by the Chongqing Talent Program: Innovative leading talents (Medical field, CQYC20210303384); Chongqing Medical Scientific Research Project (2018ZDXM020)."