A 12-month randomized controlled trial to assess the efficacy of revitalization of retreated mature incisors with periapical radiolucency in adolescents.
Journal
Scientific reports
ISSN: 2045-2322
Titre abrégé: Sci Rep
Pays: England
ID NLM: 101563288
Informations de publication
Date de publication:
16 Jul 2024
16 Jul 2024
Historique:
received:
08
11
2023
accepted:
01
07
2024
medline:
17
7
2024
pubmed:
17
7
2024
entrez:
16
7
2024
Statut:
epublish
Résumé
The use of regenrative endodontics is restoring the health status of the root canals of retreated mature teeth is a novel approach. Therefore, the current trial aimed to compare the effectiveness of regenerative endodontic procedures (REPs) to non-surgical root canal retreatment (NS-RCR) in reducing periapical radiolucency over one year for the retreatment of mature incisors with periapical periodontitis. The secondary purpose was to assess clinical success and regain pulp sensibility. A parallel randomized controlled trial, 66 mature incisors with periapical radiolucencies were randomly divided into two equal groups and retreated with either REPs or NS-RCR. At baseline and after 6 and 12 months, teeth were assessed clinically and radiographically using a periapical index (PAI). The Mann-Whitney test was used to analyze nonparametric PAI scores. The Electric pulp test readings were analyzed using the repeated measure analysis of variance (ANOVA). Over the follow-up intervals, there was no significant intergroup difference in the PAI medians, the majority of the teeth displayed a reduction in periapical radiolucency. At the end of the follow-up period, the clinical successes for the REP and NS-RCR groups were 93.9% and 97%, respectively (p = 0.555). Positive pulp sensibility was recorded in 54.54% of cases in the REPs after 12 months. Both approaches showed a comparable diminishing of periapical radiolucencies and equivalent clinical results. A conventional, non-surgical endodontic retreatment may not always be necessary.
Identifiants
pubmed: 39013938
doi: 10.1038/s41598-024-66305-5
pii: 10.1038/s41598-024-66305-5
doi:
Types de publication
Journal Article
Randomized Controlled Trial
Langues
eng
Sous-ensembles de citation
IM
Pagination
16366Informations de copyright
© 2024. The Author(s).
Références
Del Fabbro, M. et al. Endodontic procedures for retreatment of periapical lesions. Cochrane Database Syst. Rev. 10, CD005511. https://doi.org/10.1002/14651858.CD005511.pub3 (2016).
doi: 10.1002/14651858.CD005511.pub3
pubmed: 27759881
Riis, A., Taschieri, S., Del Fabbro, M. & Kvist, T. Tooth survival after surgical or nonsurgical endodontic retreatment: Long-term follow-up of a randomized clinical trial. J. Endod. 44, 1480–1486. https://doi.org/10.1016/j.joen.2018.06.019 (2018).
doi: 10.1016/j.joen.2018.06.019
pubmed: 30154003
Al-Nazhan, S. et al. Microorganism penetration in dentinal tubules of instrumented and retreated root canal walls. In vitro SEM study. Restor. Dent. Endod. 39, 258–264. https://doi.org/10.5395/rde.2014.39.4.258 (2014).
doi: 10.5395/rde.2014.39.4.258
pubmed: 25383343
pmcid: 4223094
He, L. et al. Regenerative endodontics for adult patients. J. Endod. 43, S57–S64. https://doi.org/10.1016/j.joen.2017.06.012 (2017).
doi: 10.1016/j.joen.2017.06.012
pubmed: 28844305
Nageh, M., Ahmed, G. M. & El-Baz, A. A. Assessment of regaining pulp sensibility in mature necrotic teeth using a modified revascularization technique with platelet-rich fibrin: A clinical study. J. Endod. 44, 1526–1533. https://doi.org/10.1016/j.joen.2018.06.014 (2018).
doi: 10.1016/j.joen.2018.06.014
pubmed: 30174103
Youssef, A., Ali, M., ElBolok, A. & Hassan, R. Regenerative endodontic procedures for the treatment of necrotic mature teeth: A preliminary randomized clinical trial. Int. Endod. J. 55, 334–346. https://doi.org/10.1111/iej.13681 (2022).
doi: 10.1111/iej.13681
pubmed: 35030270
Ostby, B. N. The role of the blood clot in endodontic therapy. An experimental histologic study. Acta Odontol. Scand. 19, 324–353 (1961).
doi: 10.3109/00016356109043395
pubmed: 14482575
Sedgley, C. M. & Botero, T. M. Dental stem cells and their sources. Dent. Clin. N. Am. 56, 549–561. https://doi.org/10.1016/j.cden.2012.05.004 (2012).
doi: 10.1016/j.cden.2012.05.004
pubmed: 22835537
Sedgley, C. M. & Messer, H. H. Are endodontically treated teeth more brittle?. J. Endod. 18, 332–335. https://doi.org/10.1016/S0099-2399(06)80483-8 (1992).
doi: 10.1016/S0099-2399(06)80483-8
pubmed: 1402595
Palma, P. J. et al. Histologic evaluation of regenerative endodontic procedures with the use of chitosan scaffolds in immature dog teeth with apical periodontitis. J. Endod. 43, 1279–1287. https://doi.org/10.1016/j.joen.2017.03.005 (2017).
doi: 10.1016/j.joen.2017.03.005
pubmed: 28577961
Palma, P. J. et al. Does apical papilla survive and develop in apical periodontitis presence after regenerative endodontic procedures?. Appl. Sci. 9, 3942 (2019).
doi: 10.3390/app9193942
Kranz, S. et al. Antibacterial effect of endodontic disinfections on Enterococcus faecalis in dental root canals-an in-vitro model study. Materials (Basel) https://doi.org/10.3390/ma14092427 (2021).
doi: 10.3390/ma14092427
pubmed: 34683566
Siren, E. K., Haapasalo, M. P., Waltimo, T. M. & Orstavik, D. In vitro antibacterial effect of calcium hydroxide combined with chlorhexidine or iodine potassium iodide on Enterococcus faecalis. Eur. J. Oral Sci. 112, 326–331. https://doi.org/10.1111/j.1600-0722.2004.00144.x (2004).
doi: 10.1111/j.1600-0722.2004.00144.x
pubmed: 15279651
Tagelsir, A., Yassen, G. H., Gomez, G. F. & Gregory, R. L. Effect of antimicrobials used in regenerative endodontic procedures on 3-week-old Enterococcus faecalis biofilm. J. Endod. 42, 258–262. https://doi.org/10.1016/j.joen.2015.09.023 (2016).
doi: 10.1016/j.joen.2015.09.023
pubmed: 26577870
Meschi, N., Palma, P. J. & Cabanillas-Balsera, D. Effectiveness of revitalization in treating apical periodontitis: A systematic review and meta-analysis. Int. Endod. J. https://doi.org/10.1111/iej.13778 (2022).
doi: 10.1111/iej.13778
pubmed: 35699668
pmcid: 9314068
Torabinejad, M., Nosrat, A., Verma, P. & Udochukwu, O. Regenerative endodontic treatment or mineral trioxide aggregate apical plug in teeth with necrotic pulps and open apices: A systematic review and meta-analysis. J. Endod. 43, 1806–1820. https://doi.org/10.1016/j.joen.2017.06.029 (2017).
doi: 10.1016/j.joen.2017.06.029
pubmed: 28822564
Arslan, H. et al. Regenerative endodontic procedures in necrotic mature teeth with periapical radiolucencies: A preliminary randomized clinical study. J. Endod. 45, 863–872. https://doi.org/10.1016/j.joen.2019.04.005 (2019).
doi: 10.1016/j.joen.2019.04.005
pubmed: 31155298
Brizuela, C. et al. Cell-based regenerative endodontics for treatment of periapical lesions: A randomized, controlled phase I/II clinical trial. J. Dent. Res. 99, 523–529. https://doi.org/10.1177/0022034520913242 (2020).
doi: 10.1177/0022034520913242
pubmed: 32202965
El-Kateb, N. M., El-Backly, R. N., Amin, W. M. & Abdalla, A. M. Quantitative assessment of intracanal regenerated tissues after regenerative endodontic procedures in mature teeth using magnetic resonance imaging: A randomized controlled clinical trial. J. Endod. 46, 563–574. https://doi.org/10.1016/j.joen.2020.01.026 (2020).
doi: 10.1016/j.joen.2020.01.026
pubmed: 32173020
Paryani, K. & Kim, S. G. Regenerative endodontic treatment of permanent teeth after completion of root development: A report of 2 cases. J. Endod. 39, 929–934. https://doi.org/10.1016/j.joen.2013.04.029 (2013).
doi: 10.1016/j.joen.2013.04.029
pubmed: 23791266
Saoud, T. M., Sigurdsson, A., Rosenberg, P. A., Lin, L. M. & Ricucci, D. Treatment of a large cystlike inflammatory periapical lesion associated with mature necrotic teeth using regenerative endodontic therapy. J. Endod. 40, 2081–2086. https://doi.org/10.1016/j.joen.2014.07.027 (2014).
doi: 10.1016/j.joen.2014.07.027
pubmed: 25292168
Lakens, D. Calculating and reporting effect sizes to facilitate cumulative science: A practical primer for t-tests and ANOVAs. Front. Psychol. 4, 863. https://doi.org/10.3389/fpsyg.2013.00863 (2013).
doi: 10.3389/fpsyg.2013.00863
pubmed: 24324449
pmcid: 3840331
Doig, G. S. & Simpson, F. Randomization and allocation concealment: A practical guide for researchers. J. Crit. Care 20, 187–191. https://doi.org/10.1016/j.jcrc.2005.04.005 (2005).
doi: 10.1016/j.jcrc.2005.04.005
pubmed: 16139163
Comparin, D. et al. Postoperative pain after endodontic retreatment using rotary or reciprocating instruments: A randomized clinical trial. J. Endod. 43, 1084–1088. https://doi.org/10.1016/j.joen.2017.02.010 (2017).
doi: 10.1016/j.joen.2017.02.010
pubmed: 28477995
Fernandez-Formoso, N., Rilo, B., Mora, M. J., Martinez-Silva, I. & Santana, U. A paralleling technique modification to determine the bone crest level around dental implants. Dentomaxillofac. Radiol. 40, 385–389. https://doi.org/10.1259/dmfr/45365752 (2011).
doi: 10.1259/dmfr/45365752
pubmed: 21831979
pmcid: 3520342
Orstavik, D., Kerekes, K. & Eriksen, H. M. The periapical index: A scoring system for radiographic assessment of apical periodontitis. Endod. Dent. Traumatol. 2, 20–34. https://doi.org/10.1111/j.1600-9657.1986.tb00119.x (1986).
doi: 10.1111/j.1600-9657.1986.tb00119.x
pubmed: 3457698
Zandi, H. et al. Outcome of endodontic retreatment using 2 root canal irrigants and influence of infection on healing as determined by a molecular method: A randomized clinical trial. J. Endod. 45, 1089-1098.e1085. https://doi.org/10.1016/j.joen.2019.05.021 (2019).
doi: 10.1016/j.joen.2019.05.021
pubmed: 31300248
Fouad, A. F., Diogenes, A. R., Torabinejad, M. & Hargreaves, K. M. Microbiome changes during regenerative endodontic treatment using different methods of disinfection. J. Endod. 48, 1273–1284. https://doi.org/10.1016/j.joen.2022.07.004 (2022).
doi: 10.1016/j.joen.2022.07.004
pubmed: 36030971
Pinheiro, E. T., Karygianni, L., Attin, T. & Thurnheer, T. Antibacterial effect of sodium hypochlorite and EDTA in combination with high-purity Nisin on an endodontic-like biofilm model. Antibiotics (Basel) https://doi.org/10.3390/antibiotics10091141 (2021).
doi: 10.3390/antibiotics10091141
pubmed: 34572723
pmcid: 8231883
Galler, K. M. et al. Dentin conditioning codetermines cell fate in regenerative endodontics. J. Endod. 37, 1536–1541. https://doi.org/10.1016/j.joen.2011.08.027 (2011).
doi: 10.1016/j.joen.2011.08.027
pubmed: 22000458
Aksel, H., Albanyan, H., Bosaid, F. & Azim, A. A. Dentin conditioning protocol for regenerative endodontic procedures. J. Endod. 46, 1099–1104. https://doi.org/10.1016/j.joen.2020.05.010 (2020).
doi: 10.1016/j.joen.2020.05.010
pubmed: 32479803
Galler, K. M. et al. EDTA conditioning of dentine promotes adhesion, migration and differentiation of dental pulp stem cells. Int. Endod. J. 49, 581–590. https://doi.org/10.1111/iej.12492 (2016).
doi: 10.1111/iej.12492
pubmed: 26114662
Barbosa-Ribeiro, M. et al. Effectiveness of calcium hydroxide-based intracanal medication on infectious/inflammatory contents in teeth with post-treatment apical periodontitis. Clin. Oral Investig. 23, 2759–2766. https://doi.org/10.1007/s00784-018-2719-0 (2019).
doi: 10.1007/s00784-018-2719-0
pubmed: 30367257
Hargreaves, K. M., Diogenes, A. & Teixeira, F. B. Treatment options: Biological basis of regenerative endodontic procedures. J. Endod. 39, S30-43. https://doi.org/10.1016/j.joen.2012.11.025 (2013).
doi: 10.1016/j.joen.2012.11.025
pubmed: 23439043
pmcid: 3589799
Abou Samra, R. A., El Backly, R. M., Aly, H. M., Nouh, S. R. & Moussa, S. M. Revascularization in mature permanent teeth with necrotic pulp and apical periodontitis: case series. Alex. Dent. J. 43, 7–12 (2018).
doi: 10.21608/adjalexu.2018.57617
Saoud, T. M. et al. Treatment of mature permanent teeth with necrotic pulps and apical periodontitis using regenerative endodontic procedures: A case series. J. Endod. 42, 57–65. https://doi.org/10.1016/j.joen.2015.09.015 (2016).
doi: 10.1016/j.joen.2015.09.015
pubmed: 26525552
Fang, Y. et al. Influence of apical diameter on the outcome of regenerative endodontic treatment in teeth with pulp necrosis: A review. J. Endod. 44, 414–431. https://doi.org/10.1016/j.joen.2017.10.007 (2018).
doi: 10.1016/j.joen.2017.10.007
pubmed: 29273495
Keskin, C., Demiryurek, E. O. & Ozyurek, T. Color stabilities of calcium silicate-based materials in contact with different irrigation solutions. J. Endod. 41, 409–411. https://doi.org/10.1016/j.joen.2014.11.013 (2015).
doi: 10.1016/j.joen.2014.11.013
pubmed: 25576203
Shokouhinejad, N., Khoshkhounejad, M., Alikhasi, M., Bagheri, P. & Camilleri, J. Prevention of coronal discoloration induced by regenerative endodontic treatment in an ex vivo model. Clin. Oral Investig. 22, 1725–1731. https://doi.org/10.1007/s00784-017-2266-0 (2018).
doi: 10.1007/s00784-017-2266-0
pubmed: 29090391
Ramos, J. C. et al. 1-year in vitro evaluation of tooth discoloration induced by 2 calcium silicate-based cements. J. Endod. 42, 1403–1407. https://doi.org/10.1016/j.joen.2016.06.012 (2016).
doi: 10.1016/j.joen.2016.06.012
pubmed: 27497511
Palma, P. J. et al. Tooth discoloration after regenerative endodontic procedures with calcium silicate-based cements—An ex vivo study. Appl. Sci. 10, 5793 (2020).
doi: 10.3390/app10175793
Palma, P. J. et al. Six-month color stability assessment of two calcium silicate-based cements used in regenerative endodontic procedures. J. Funct. Biomater. https://doi.org/10.3390/jfb10010014 (2019).
doi: 10.3390/jfb10010014
pubmed: 31575005
pmcid: 6963755
Palma, P. J. et al. Effect of restorative timing on shear bond strength of composite resin/calcium silicate-based cements adhesive interfaces. Clin. Oral Investig. 25, 3131–3139. https://doi.org/10.1007/s00784-020-03640-7 (2021).
doi: 10.1007/s00784-020-03640-7
pubmed: 33047203
Tarcin, B., Gumru, B., Iriboz, E., Turkaydin, D. E. & Ovecoglu, H. S. Radiologic assessment of periapical health: Comparison of 3 different index systems. J. Endod. 41, 1834–1838. https://doi.org/10.1016/j.joen.2015.08.010 (2015).
doi: 10.1016/j.joen.2015.08.010
pubmed: 26386947
Haxhia, E., Ibrahim, M. & Bhagavatula, P. Root-end surgery or nonsurgical retreatment: Are there differences in long-term outcome?. J. Endod. 47, 1272–1277. https://doi.org/10.1016/j.joen.2021.04.024 (2021).
doi: 10.1016/j.joen.2021.04.024
pubmed: 33961913
Chercoles-Ruiz, A., Sanchez-Torres, A. & Gay-Escoda, C. Endodontics, endodontic retreatment, and apical surgery versus tooth extraction and implant placement: A systematic review. J. Endod. 43, 679–686. https://doi.org/10.1016/j.joen.2017.01.004 (2017).
doi: 10.1016/j.joen.2017.01.004
pubmed: 28343928
Law, A. S. Considerations for regeneration procedures. J. Endod. 39, S44-56. https://doi.org/10.1016/j.joen.2012.11.019 (2013).
doi: 10.1016/j.joen.2012.11.019
pubmed: 23439044
Elheeny, A. A. H. & Tony, G. E. Two-dimensional radiographs and cone-beam computed tomography assessment of concentrated growth factor and platelet-rich fibrin scaffolds in regenerative endodontic treatment of immature incisors with periapical radiolucency: A randomized clinical trial. J. Endod. https://doi.org/10.1016/j.joen.2024.01.017 (2024).
doi: 10.1016/j.joen.2024.01.017
pubmed: 38281658