Comparative Effectiveness of Regenerative Endodontic Treatment Versus Apexification for Necrotic Immature Permanent Teeth With or Without Apical Periodontitis: An Umbrella Review.

IF 2.3 3区医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE

Dental Traumatology Pub Date : 2024-12-18 DOI:10.1111/edt.13028

Nitesh Tewari, Pavithra Devi, Svetha Sampath, Vijay Prakash Mathur, Georgios Tsilingaridis, Alina Wikström, Morankar Rahul, Kalpana Bansal

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Abstract

Background/aim: The evidence related to the superiority of the recommended treatment protocols for necrotic immature permanent teeth is unclear. We aimed to compare the clinical, radiographic, and overall success rates of apexification and regenerative endodontic treatment (RET), assess the methodological quality, and assess the strength of evidence for outcomes.

Methods: A search was performed in PubMed, Scopus, LILACS, EMBASE, Web of Science, and the Cochrane Library. The titles, abstracts and full texts of systematic reviews (SRs) comparing RET and apexification were screened. The quality and strength of evidence were analyzed via AMSTAR-2, ROBIS, and modified Kohler's criteria.

Results: Twelve SRs were included, with nine having meta-analytic outcomes. The quality of only one study was high, and the risk of bias was low in two studies. Comparable success and survival rates for RET and apexification, with no superiority of any treatment, were reported. RET was superior in stimulating root thickness and lengthening. Weak evidence was noted for a higher clinical and radiographic success rate of the apical plug technique and for root lengthening and an increase in root thickness in RET.

Conclusion: RET and apexification exhibited comparable success rates of > 85% across all domains. Most comparisons did not reveal significant differences in clinical, radiographic, or overall success. However, the quality of evidence was weak (class IV) for both outcomes, and the majority of systematic reviews exhibited low or critically low quality and high risk of bias.

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再生根管治疗与根尖化治疗有或无根尖牙周炎的坏死未成熟恒牙的疗效比较：综述。

背景/目的：推荐的未成熟恒牙坏死治疗方案的优越性尚不清楚。我们的目的是比较根尖矫正和再生根管治疗（RET）的临床、影像学和总体成功率，评估方法学质量，并评估结果的证据强度。方法：检索PubMed、Scopus、LILACS、EMBASE、Web of Science和Cochrane Library。筛选比较RET和apexification的系统综述（SRs）的标题、摘要和全文。通过AMSTAR-2、ROBIS和修改后的Kohler标准分析证据的质量和强度。结果：纳入了12例SRs，其中9例具有元分析结果。只有一项研究的质量高，两项研究的偏倚风险低。RET和根尖矫正术的成功率和生存率相当，没有任何治疗的优势。RET在促进根粗和根长方面具有优势。薄弱的证据表明，在RET中，根尖塞技术的临床和影像学成功率较高，根延长和根厚度增加的成功率也较高。结论：RET和根尖化在所有领域的成功率相当，约为85%。大多数比较没有显示临床、放射学或总体成功的显著差异。然而，这两个结果的证据质量较弱（IV级），大多数系统评价表现为低质量或极低质量和高偏倚风险。

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来源期刊

Dental Traumatology 医学-牙科与口腔外科

CiteScore

6.40

自引率

32.00%

发文量

审稿时长

6-12 weeks

期刊介绍： Dental Traumatology is an international journal that aims to convey scientific and clinical progress in all areas related to adult and pediatric dental traumatology. This includes the following topics: - Epidemiology, Social Aspects, Education, Diagnostics - Esthetics / Prosthetics/ Restorative - Evidence Based Traumatology & Study Design - Oral & Maxillofacial Surgery/Transplant/Implant - Pediatrics and Orthodontics - Prevention and Sports Dentistry - Endodontics and Periodontal Aspects The journal"s aim is to promote communication among clinicians, educators, researchers, and others interested in the field of dental traumatology.