Radiographic Evaluation of Regenerative Endodontic Procedures and Apexification Treatments with the Assessment of External Root Resorption

IF 3.5 2区 医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE
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Abstract

Introduction

This multicentered cohort study evaluated the radiographic outcomes of regenerative endodontic procedures (REPs) and apexification treatments (APEX) of immature teeth with endodontic disease.

Materials and Methods

This cohort study included a retrospective record review and prospective data collection of pediatric patients with teeth treated with REPs or APEX between 2005 and 2014. Data including the presence of a periapical lesion, external root resorption, obliteration, apical hard tissue, apical closure, intracanal calcifications, and radiographic root area (RRA) change based on measurements were collected/measured from radiographic images. Univariate and multivariate analyses were conducted.

Results

The cohort included 190 subjects (204 teeth (92 REPs; 112 APEX)). The frequency of pretreatment periapical pathology was similar between cases in which the clinical treatment failed versus successful treatment cases. However, the frequency of pretreatment external root resorption was higher in failed cases than in successful cases (P = .007). The mean RRA change was greater than twenty percent in 21% of the REPs cases. In traumatized teeth, REPs resulted in less hard tissue formation than other endodontic disease etiologies measured by RRA (P = .001). Fifty-three percent of cases with ERR (16/30) showed signs of healing/arrest and were mostly treated with REPs (11/16).

Conclusions

The presence of ERR negatively affected the treatment outcome. There was significant variability in RRA change in REPs. Signs of healing/arrest of the resorptive lesion were radiographically visible in many cases treated with REPs.
通过评估外根吸收对牙髓再生程序和根尖化治疗进行放射学评估。
简介:这项多中心队列研究评估了对患有牙髓病的未成熟牙齿进行再生根管治疗(REPs)和顶点化治疗(APEX)的影像学结果:这项队列研究包括对 2005-2014 年间接受 REP 或 APEX 治疗的儿童患者进行回顾性记录审查和前瞻性数据收集。数据包括根尖周病变的存在、外根吸收(ERR)、阻塞、根尖硬组织、根尖闭合、根管内钙化以及根据放射影像测量的放射根面积(RRA)变化。进行了单变量和多变量分析:研究对象包括 190 名受试者(204 颗牙齿(92 颗 REP;112 颗 APEX))。临床治疗失败的病例与治疗成功的病例在治疗前出现根尖周病变的频率相似。但是,治疗失败病例治疗前出现ERR的频率高于治疗成功病例(P=0.007)。在 21% 的 REP 病例中,平均 RRA 变化超过 20%。在受创伤的牙齿中,REP 治疗导致的硬组织形成少于 RRA 测量的其他牙髓病病因(p=0.001)。53%的ERR病例(16/30)显示出愈合/停滞的迹象,大部分病例接受了REP治疗(11/16):结论:ERR的存在对治疗效果有负面影响。结论:ERR的存在对治疗结果产生了负面影响,REPs的RRA变化差异很大。在许多使用 REP 治疗的病例中,吸收性病变的愈合/恢复迹象在影像学上是可见的。
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来源期刊
Journal of endodontics
Journal of endodontics 医学-牙科与口腔外科
CiteScore
8.80
自引率
9.50%
发文量
224
审稿时长
42 days
期刊介绍: The Journal of Endodontics, the official journal of the American Association of Endodontists, publishes scientific articles, case reports and comparison studies evaluating materials and methods of pulp conservation and endodontic treatment. Endodontists and general dentists can learn about new concepts in root canal treatment and the latest advances in techniques and instrumentation in the one journal that helps them keep pace with rapid changes in this field.
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