METHODS: We systematically search the PubMed, the Cochrane Central Register of Controlled Trials (CENTRAL), Embase, and Google Scholar databases. Randomized controlled trials examining the use of BC and other scaffold materials in the regenerative endodontic procedures were included. A random effects model was used for the meta-analysis. The GRADE method was used to determine the quality of the evidence.
RESULTS: We screened 168 RCTs related to young permanent tooth pulp necrosis through electronic and manual retrieval. A total of 28 RCTs were related to regenerative endodontic procedures. Ultimately, 12 articles met the inclusion criteria and were included in the relevant meta-analysis. Only 2 studies were assessed to have a low risk of bias. High quality evidence indicated that there was no statistically significant difference in the success rate between the two groups (RR=0.99, 95% CI=0.96 to 1.03; 434 participants, 12 studies); low-quality evidence indicated that there was no statistically significant difference in the increase in root length or root canal wall thickness between the two groups. Medium quality evidence indicated that there was no statistically significant difference in pulp vitality testing between the two groups.
CONCLUSIONS: For clinical regenerative endodontic procedures, the most commonly used scaffolds include BC, PRP, and PRF. All the different scaffolds had fairly high clinical success rates, and the difference was not significant. For regenerative endodontic procedures involving young permanent teeth with pulp necrosis, clinical practitioners could choose a reasonable scaffold considering the conditions of the equipment and patients.
方法:我们系统地搜索PubMed,Cochrane中央控制试验登记册(CENTRAL),Embase,和谷歌学者数据库。包括研究BC和其他支架材料在再生牙髓手术中使用的随机对照试验。Meta分析采用随机效应模型。采用GRADE法测定证据质量。
结果:我们通过电子和手动检索筛选了168个与年轻恒牙牙髓坏死相关的RCT。共有28个RCT与再生牙髓手术有关。最终,12篇文章符合纳入标准,纳入相关荟萃分析。只有两项研究被评估为具有低偏倚风险。高质量的证据表明,两组之间的成功率没有统计学上的显着差异(RR=0.99,95%CI=0.96至1.03;434名参与者,12项研究);低质量证据表明,两组之间的根长或根管壁厚度的增加没有统计学上的显着差异。中等质量证据表明,两组之间的纸浆活力测试没有统计学上的显着差异。
结论:对于临床再生牙髓手术,最常用的支架包括BC,PRP,和PRF。所有不同的支架都有相当高的临床成功率,差异不显著。对于涉及牙髓坏死的年轻恒牙的再生牙髓手术,临床医生可以根据设备和患者的情况选择合理的支架。