›› 2020, Vol. 40 ›› Issue (9): 807-813.

• 临床研究 • 上一篇    下一篇

再生性牙髓治疗的临床和组织学结果的描述性系统评价

陈霞,汪成林,叶玲   

  1. 四川大学华西口腔医学院
  • 收稿日期:2020-05-29 修回日期:2020-06-29 出版日期:2020-09-28 发布日期:2020-10-07
  • 通讯作者: 叶玲 E-mail:yeling@scu.edu.cn
  • 基金资助:
    四川省科技计划项目;四川大学华西口腔医院临床研究项目

Clinical and Histological Assessment of Regenerative Endodontic Procedures:A Descriptive Systematic Review

  • Received:2020-05-29 Revised:2020-06-29 Online:2020-09-28 Published:2020-10-07
  • Supported by:
    Sichuan Province Science and Technology Support Program;Clinical Research Program of West China Hospital of Stomatology, Sichuan University

摘要: 目的 分析年轻恒牙经再生性牙髓治疗后的临床结果与组织学结果,对年轻恒牙的再生性治疗的愈合结果进行描述性评价。方法 在MEDLINE和Web of Science数据库搜索至2019年12月31日前对人年轻恒牙行再生性牙髓治疗且有组织学结果的相关文献,并对其进行分析。结果 最终纳入16篇文献,所有文献均为病例报道,共包括25颗患牙。临床评价中,2颗牙治疗失败,2颗牙达一级目标,16颗牙达二级目标,5颗牙达三级目标。组织学评价中,达二级目标和三级目标的21颗牙中,有19颗牙行硬组织检查,仅2颗牙的组织学检查见典型的牙本质样结构,17颗牙硬组织均为骨样、牙骨质样或第三期牙本质样结构;有20颗牙行软组织的组织学检查,3颗牙见典型的成牙本质细胞样细胞,有10颗牙行免疫组织化学检查,其中5颗牙表现出神经再生。结论 年轻恒牙经再生性牙髓治疗后,可取得临床检查上的成功,但牙根的继续发育的实质为牙本质样、骨样和牙骨质样组织在根管壁的沉积;牙髓活力的恢复则伴有神经再生。

关键词: 再生性牙髓治疗, 年轻恒牙, 临床症状, 组织学, 描述性系统评价

Abstract: Objective To analyze the clinical and histological results of regenerative endodontic procedures of immature permanent teeth and to evaluate the healing outcomes of regenerative treatment for immature permanent teeth. Methods MEDLINE and Web of Science databases were used to search and analyze the literatures with histological results of regenerative endodontic procedures of human immature permanent teeth before December 31, 2019. Results Sixteen literatures were included, all of which were case reports, including 25 teeth. Of the 25 included teeth, 2 failed, 2 reached the primary-goal, 16 reached the secondary goal, and 5 reached the tertiary goal in clinical evaluation. Histological evaluation to 21 teeth reaching secondary goal and tertiary goal, among 19 teeth receiving hard tissue histological examination, only 2 teeth of found typical of dentine structure, and 17 teeth found bone-like, cementum-like or tertiary dentin-like tissue. Among 20 teeth receiving soft tissue histological examination, only 3 teeth found typical odontoblast-like cells. In immunohistochemistry examination of 10 teeth, 5 teeth found nerve regeneration. Conclusions Immature permanent teeth could achieve the success of clinical examination after regenerative endodontic procedures, but the continued development of the root was the deposition of dentin-like, bone-like and cement-like tissues in the root canal wall, the regain of pulp vitality was due to nerve regeneration.

Key words: Regenerative endodontic procedures, ?immature?permanent?teeth, clinical symptoms, histology, descriptive systematic review