| ObjectiveThe purpose of this study was to evaluate the clinical efficacy of concentrated growth factor(CGF)in pulp revascularization of young permanent teeth with chronic periapical periodontitis,and to compare the efficacy differences between the two cases of dental trauma and central cusp fracture,so as to provide reference and basis for the clinical application and indication selection of CGF pulp revascularization.MethodsThe study reviewed the data of patients diagnosed with chronic periapical periodontitis and subsequently treated with CGF pulp revascularization in the Pediatric Dentistry Department of Shandong University Stomatological Hospital from September 2019 to January 2022,and finally selected 26 patients with 27 teeth in total as research subjects under strict standards.According to the etiology,they were divided into dental trauma group(14 cases)and central cusp fracture group(13 cases).Collect the basic information(gender,age,root development stage,tooth position,etc.),preoperative clinical symptoms,radiographic data,Intraoperative manipulation,postoperative follow-up and other records of the patients.And then compare the clinical effective rate,healing of periapical lesions,root development and pulp vitality recovery of the two groups.Mimics software was used to measure the CBCT imaging data of the affected teeth,and the changes of periapical lesion volume,periapical bone density,root length and diameter of apical foramen before and after the treatment were recorded in detail.All data were imported into SPSS 26.0 software for qualitative and quantitative statistical analysis.Results1.After 24.26±5.07 months of follow-up,the overall clinical survival rate of the 27 teeth was 100%(27/27)and the effective rate was 85.19%(23/27).The effective rate was 78.57%(11/14)in the dental trauma group and 92.31%(12/13)in the central cusp fracture group.The effective rate of the central cusp fracture group was higher.2.In the trauma group,the mean decrease ratio of periapical lesion volume was 76.02%±43.70%and the mean increase ratio of periapical bone density was 48.00%±67.84%;In the central cusp fracture group,the mean decrease ratio of periapical lesion volume was 84.06%±45.15%,and the mean increase ratio of periapical bone density was 89.03%±63.62%.The difference in the two groups before and after treatment was statistically significant(p<0.05).However,changes in these two indicators were not statistically significant between the two groups(p>0.05).3.In the trauma group,the root length increased by 8.34%±7.54%while the mesial-distal diameter of apical foramen decreased by 22.94%±17.07%and the buccolingual diameter of apical foramen decreased by 16.43%±10.44%.In the central cusp fracture group,the root length increased by 16.13%±4.96%while the mesial-distal diameter of apical foramen decreased by 32.29%± 14.10%and the buccolingual diameter of apical foramen decreased by 27.30%±12.74%.The difference in the two groups before and after treatment was statistically significant(p<0.05),the changes of root length and buccolingual diameter of apical foramen between the two groups were statistically significant(p<0.05)while the change of mesial-distal diameter of apical foramen between the two groups was not statistically significant(p>0.05).4.There were 36%(5/14)of the teeth in trauma group and 46%(6/13)of the teeth in central cusp fracture group showed positive results in pulp vitality test,and there was no significant difference between the two groups(p>0.05).Conclusion1.CGF pulp revascularization has a good therapeutic effect on chronic periapical periodontitis of young permanent teeth,which can eliminate clinical symptoms,reduce or eliminate periapical lesion,promote the continuous development of the root and restore the pulp vitality of some affected teeth.2.The clinical efficiency of the central cusp fracture group was higher than that of the trauma group,and the effect in the root development of the central cusp fracture group was also more significant compared with the trauma group. |
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