Dataset Information

Treatment outcome of regenerative endodontic procedures in mature permanent teeth compared to nonsurgical endodontic treatment: A systematic review and meta-analysis.

ABSTRACT:

Background

Regenerative endodontic procedures (REP) have the advantage of restoring root canal's native defense ability by re-establishing vital pulp-like tissue. This review aims to determine the overall clinical and/or radiographic success rate (O) of REP (I) in mature permanent teeth (P) and to compare it (C) with nonsurgical endodontic treatment (NSET).

Materials and methods

Sources: PubMed, Web of Science, Embase, EBSCO, Cochrane Central Register of Controlled trials, ClinicalTrials.gov, Clinical Trials Registry-India and OpenGrey. Inclusion: Randomized clinical trials and single-arm prospective studies evaluating the treatment outcomes of REP in mature permanent teeth. Exclusion: Incomplete trials/studies, in vitro studies, animal studies, case reports/series, conference proceedings. Cochrane ROB2.0 and ROBINS-I tools were used to assess the risk of bias. Risk difference (R.D.) between NSET and REP was determined by meta-analysis of the randomized clinical trials. The overall success rate of REP was calculated using data from both randomized clinical trials and single-arm prospective studies. Sensitivity analysis and subgroup analysis were performed.

Results

Ten studies (n = 552) were included. R.D between REP and NSET was 0.032 (95% C.I: 0.023-0.087; P = 0.258). Overall success rate of REP was 96.0% (95% confidence interval: 94%-98%). No significant difference was found in sensitivity analysis (P = 0.551), or any of the subgroup analysis (P > 0.05).

Discussion

A limited number of randomized clinical trials were available, and only two of them had a low risk of bias. Consistent results were obtained in both types of included studies.

Conclusion

Based on a limited number of comparative studies, REP has a similar success rate to NSET in mature permanent teeth.

Other

Funding: Nil. Registration: PROSPERO (CRD42020204882).

SUBMITTER: Nangia D

PROVIDER: S-EPMC9089762 | biostudies-literature | 2021 Nov-Dec

REPOSITORIES: biostudies-literature

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Publications

Treatment outcome of regenerative endodontic procedures in mature permanent teeth compared to nonsurgical endodontic treatment: A systematic review and meta-analysis.

Nangia Divya D Saini Aakriti A Sharma Sidhartha S Kumar Vijay V Chawla Amrita A Perumal Vanamail V Logani Ajay A

Journal of conservative dentistry : JCD 20211101 6

<h4>Background</h4>Regenerative endodontic procedures (REP) have the advantage of restoring root canal's native defense ability by re-establishing vital pulp-like tissue. This review aims to determine the overall clinical and/or radiographic success rate (O) of REP (I) in mature permanent teeth (P) and to compare it (C) with nonsurgical endodontic treatment (NSET).<h4>Materials and methods</h4>Sources: PubMed, Web of Science, Embase, EBSCO, Cochrane Central Register of Controlled trials, Clinica ...[more]

PMID: 35558674

Similar Datasets

Project description:AimsThe current study aimed to determine how the disinfection strategy for regenerative endodontic procedures (REPs) influences overall bacterial load and REP outcomes. Different bacterial species in the teeth were also examined in this study.MethodsA previously reported non-randomized controlled clinical research on REP ± leukocyte and platelet-rich fibrin gathered microbial samples from 14 of 29 patients during REP (LPRF). Four microbiological samples were obtained in two treatment sessions. S1 and S2 were taken before and after the first irrigation with 1.5% NaOCl and saline. Samples S3 and S4 were obtained before and after rinsing with 17% EDTA in the second treatment session. Microbial samples were identified using a quantitative polymerase chain reaction with species-specific primers.ResultsThe total bacterial load recovered from patients showed a significant (p < 0.05) decrease after the first treatment and was maintained throughout the second treatment. Fusobacterium nucleatum, Treponema denticola, and Enterococcus faecalis were the most prevalent species in root canals, detected in all analyzed cases (100%), followed by Prevotella intermedia and Tannerella forsythia, both in six of 14 (42.9%) cases. The presence of these abundant species was significantly reduced after sample S1 was obtained. Parvimonas micra was present in four of 14 (28.6%) cases and Actinomyces naeslundii in two of 14 (14.3%) cases. Filifactor alocis, Porphyromonas endodontalis, and Porphyromonas gingivalis were each detected in only one of 14 (7.1%) cases. No statistical correlation could be made between bacterial species and clinical or radiographic outcomes due to the small sample size. In the LPRF group, two cases required retreatment due to early post-treatment flare-up, and two other cases presented radiographically presented a persistent apical periodontitis 3 years after treatment. In the control group, all analyzed cases were clinically asymptomatic after treatment, and radiographically, the final periapical index score at the last recall revealed healthy periapices.ConclusionThe REP disinfection protocol of the present study seems to be satisfactorily effective in reducing the total bacterial load, omitting clinical symptoms and inducing periapical bone healing in immature permanent teeth with pulp necrosis. However, LPRF seems to prevent these outcomes from being achieved and should consequently therefore not be recommended in REPs.

Project description:BackgroundWith increasing studies being published on regenerative endodontic procedures (REPs) as a treatment modality for mature necrotic teeth, the assessment of outcomes following regenerative endodontic procedures has become more challenging and the demand for a better understanding of the regenerated tissues following this treatment is rising. The study aimed to correlate cold, electric pulp testing (EPT), and magnetic resonance imaging (MRI) signal intensity (SI) in mature necrotic teeth treated with regenerative endodontic procedures.MethodologyThis retrospective cohort study included eighteen adult patients who experienced tooth necrosis in mature maxillary anterior teeth recruited from the outpatient clinic, Conservative Dentistry Department, Faculty of Dentistry, Alexandria University, Alexandria, Egypt from July 2017 until December 2018 with 12 months of follow-up. regenerative endodontic procedures via blood clot were performed. The canals were instrumented by ProTaper Next (PTN) files until final sizes X3 or X5. Biodentine was used as cervical plug material. Pre and post-operative clinical follow-up was done where the patients' responses to cold and electric pulp testing were given a scoring system and were compared to the normal contralateral tooth. Pre and post-operative magnetic resonance imaging signal intensity of both the involved tooth and its contralateral at the middle and the apical thirds of the root canals were assessed after 3, 6, and 12 months. Data was analyzed using the ANOVA, Friedman and Bonferroni tests. Significance was set at a p-value < 0.05.ResultsAll 18 teeth scored a baseline score of "2" for cold and electric pulp testing. There was a significant difference between scores of the cold test at baseline and 12-month follow-up (p < 0.001). There was a significant difference between scores of the electric pulp testing of baseline and 12-month follow-up (p < 0.001). There was a moderately significant indirect (inverse) correlation between magnetic resonance imaging signal intensity and cold test in both the middle and apical thirds at 12 months. No significant correlations were detected between magnetic resonance imaging signal intensity and electric pulp testingat any of the time intervals (p > 0.05).ConclusionMagnetic resonance imaging is a successful non-invasive method to assess outcomes of regenerative endodontic procedures and correlating it with another reliable method of assessing pulpal responses, cold test, could validate these outcomes.Clinical trial registrationThe study was registered with ClinicalTrials.gov (ID: NCT03804450).

Project description:BackgroundThis study aimed to establish and validate machine learning (ML) models to predict the prognosis of regenerative endodontic procedures (REPs) clinically, assisting clinicians in decision-making and avoiding treatment failure.MethodsA total of 198 patients with 268 teeth were included for radiographic examination and measurement. Five Machine Learning (ML) models, including Random forest (RF), gradient boosting machine (GBM), extreme gradient boosting (XGB), Logistic regression (logR) and support vector machine (SVM) are implemented for the prediction on two datasets of follow-up periods of 1-year and 2-year, respectively. Using a stratified five folds of cross-validation method, each dataset is randomly divided into a training set and test set in a ratio of 8 : 2. Correlation analysis and importance ranking were performed for feature extraction. Seven performance metrics including area under curve (AUC), accuracy, F1-score, sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were calculated to compare the predictive performance.ResultsThe RF (Accuracy = 0.91, AUC = 0.94; Accuracy = 0.84, AUC = 0.86) and GBM (Accuracy = 0.91, AUC = 0.93; Accuracy = 0.84, AUC = 0.85) had the best and similar performance simultaneously in the prediction of 1-year follow-up period and 2-year follow-up period, respectively. The variables applied to predict the primary outcome in REPs were ranked accordingly to their values of feature importance, including age, sex, etiology, the number of root canals, trauma type, swelling or sinus tract, periapical lesion size, root development stage, pre-operative root resorption, medicaments, scaffold, second REPs, previous root canal filling.ConclusionsRF and GBM models outperformed XGB, logR, SVM models on the overall performance on our datasets, exhibiting the potential capability to predict the prognosis of REPs. The ranking of feature importance contributes to establishing the scoring system for prognosis prediction in REPs, assisting clinicians in decision-making.

Dataset Information

Treatment outcome of regenerative endodontic procedures in mature permanent teeth compared to nonsurgical endodontic treatment: A systematic review and meta-analysis.

Background

Materials and methods

Results

Discussion

Conclusion

Other

Publications

Treatment outcome of regenerative endodontic procedures in mature permanent teeth compared to nonsurgical endodontic treatment: A systematic review and meta-analysis.

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