Abstract：
BACKGROUND: To manage apical periodontitis in root filled maxillary and mandibular molars, root resection techniques may be employed to avoid the loss of the tooth.
OBJECTIVE: The objectives of the study were to systematically analyse the effectiveness of root resection techniques (root resection/crown resection/root amputation) for the management of apical periodontitis with non-surgical root canal retreatment or apical surgery by the evaluation of clinical and patient-related outcomes (PROMS), in human experimental studies and longitudinal studies.
METHODS: An electronic literature search in PubMed, MEDLINE via OVID interface, EMBASE and Cochrane Central, supplemented by a manual hand search of the grey literature, was performed up to 25th September 2021. Randomized controlled trials, comparative clinical trials and observational studies reporting on the outcome (tooth survival and patient-reported outcome measures with a minimum follow-up of 1 year) of root resection techniques for treating apical periodontitis were identified. The risk of bias was evaluated using the Newcastle-Ottawa scale.
RESULTS: From a total of 2098 reports, 36 were considered for further screening. Three retrospective studies, published between 2018 and 2020, were included in this systematic review. A high heterogeneity in terms of protocols, study design and the reported outcomes were observed. The risk of bias was scored as low to moderate. These three studies consisted of data from 305 resected teeth, from 254 patients, with a follow-up period of 1-16.8 years. Overall, 151 teeth were extracted during the follow-up period. In these studies, root resection treatment was carried out on 42 teeth exclusively for endodontic reasons. One of these studies reported 12 out of 23 teeth lost at follow-up. None of the studies reported on PROMS.
CONCLUSIONS: Although root resection techniques may be used for treating teeth with apical periodontitis, the data are limited. Furthermore, the studies are very heterogeneous and associated with high risk of bias.
CONCLUSIONS: Given the current level of available evidence, it is not possible to recommend, or dismiss, root resection techniques for managing apical periodontitis.
BACKGROUND: PROSPERO database (CRD42021260306).
OBJECTIVE: The objectives of the study were to systematically analyse the effectiveness of root resection techniques (root resection/crown resection/root amputation) for the management of apical periodontitis with non-surgical root canal retreatment or apical surgery by the evaluation of clinical and patient-related outcomes (PROMS), in human experimental studies and longitudinal studies.
METHODS: An electronic literature search in PubMed, MEDLINE via OVID interface, EMBASE and Cochrane Central, supplemented by a manual hand search of the grey literature, was performed up to 25th September 2021. Randomized controlled trials, comparative clinical trials and observational studies reporting on the outcome (tooth survival and patient-reported outcome measures with a minimum follow-up of 1 year) of root resection techniques for treating apical periodontitis were identified. The risk of bias was evaluated using the Newcastle-Ottawa scale.
RESULTS: From a total of 2098 reports, 36 were considered for further screening. Three retrospective studies, published between 2018 and 2020, were included in this systematic review. A high heterogeneity in terms of protocols, study design and the reported outcomes were observed. The risk of bias was scored as low to moderate. These three studies consisted of data from 305 resected teeth, from 254 patients, with a follow-up period of 1-16.8 years. Overall, 151 teeth were extracted during the follow-up period. In these studies, root resection treatment was carried out on 42 teeth exclusively for endodontic reasons. One of these studies reported 12 out of 23 teeth lost at follow-up. None of the studies reported on PROMS.
CONCLUSIONS: Although root resection techniques may be used for treating teeth with apical periodontitis, the data are limited. Furthermore, the studies are very heterogeneous and associated with high risk of bias.
CONCLUSIONS: Given the current level of available evidence, it is not possible to recommend, or dismiss, root resection techniques for managing apical periodontitis.
BACKGROUND: PROSPERO database (CRD42021260306).
摘要：
背景：为了治疗充满根的上颌和下颌磨牙的根尖周炎，可以采用牙根切除技术来避免牙齿的丢失。
目的：本研究的目的是通过对临床和患者相关结果（PROMS）的评估，系统地分析根切技术（根切/牙冠切除/根截肢）对非手术根管再治疗或根尖手术治疗根尖周炎的有效性。在人体实验研究和纵向研究中。
方法：在PubMed，MEDLINE通过OVID接口，EMBASE和CochraneCentral,辅以手工搜索灰色文献，截至2021年9月25日。随机对照试验,我们确定了比较性临床试验和观察性研究,这些研究报告了根尖牙周炎根切技术治疗的结局(牙齿存活率和患者报告的结局指标,最少随访1年).使用纽卡斯尔-渥太华量表评估偏倚风险。
结果：在总共2098份报告中，36人考虑进一步筛查。三项回顾性研究,发表于2018年至2020年之间，纳入本系统综述。协议方面的高度异质性，观察研究设计和报告的结果.偏倚风险评分为低至中度。这三项研究由305颗切除牙齿的数据组成，来自254名患者，随访1-16.8年。总的来说,在随访期间拔除151颗牙齿。在这些研究中,仅出于牙髓原因，对42颗牙齿进行了根切治疗。其中一项研究报告说，在随访时，23颗牙齿中有12颗脱落。没有关于PROMS的研究报道。
结论：尽管根切技术可用于治疗根尖周炎的牙齿，数据有限。此外，这些研究是非常异质性的,并且与高偏倚风险相关.
结论：鉴于现有证据的当前水平，不可能推荐,或解雇，根尖牙周炎的根切术。
背景：PROSPERO数据库（CRD42021260306）。
目的：本研究的目的是通过对临床和患者相关结果（PROMS）的评估，系统地分析根切技术（根切/牙冠切除/根截肢）对非手术根管再治疗或根尖手术治疗根尖周炎的有效性。在人体实验研究和纵向研究中。
方法：在PubMed，MEDLINE通过OVID接口，EMBASE和CochraneCentral,辅以手工搜索灰色文献，截至2021年9月25日。随机对照试验,我们确定了比较性临床试验和观察性研究,这些研究报告了根尖牙周炎根切技术治疗的结局(牙齿存活率和患者报告的结局指标,最少随访1年).使用纽卡斯尔-渥太华量表评估偏倚风险。
结果：在总共2098份报告中，36人考虑进一步筛查。三项回顾性研究,发表于2018年至2020年之间，纳入本系统综述。协议方面的高度异质性，观察研究设计和报告的结果.偏倚风险评分为低至中度。这三项研究由305颗切除牙齿的数据组成，来自254名患者，随访1-16.8年。总的来说,在随访期间拔除151颗牙齿。在这些研究中,仅出于牙髓原因，对42颗牙齿进行了根切治疗。其中一项研究报告说，在随访时，23颗牙齿中有12颗脱落。没有关于PROMS的研究报道。
结论：尽管根切技术可用于治疗根尖周炎的牙齿，数据有限。此外，这些研究是非常异质性的,并且与高偏倚风险相关.
结论：鉴于现有证据的当前水平，不可能推荐,或解雇，根尖牙周炎的根切术。
背景：PROSPERO数据库（CRD42021260306）。
