Publicación:
Use of scaffolds and regenerative materials for the treatment of immature necrotic permanent teeth with periapical lesion: Umbrella review

dc.contributor.authorMuñoz Alvear, Hernán Dario
dc.contributor.authorLópez Moncayo, Luis Fernando
dc.coverage.temporal55es
dc.date.accessioned2022-10-11T23:14:13Z
dc.date.available2022-10-11T23:14:13Z
dc.date.issued2022-10
dc.descriptionResumen Antecedentes: El tratamiento actual de los dientes permanentes necróticos inmaduros con lesión periapical es la endodoncia regenerativa, la cual se basa en la ingeniería de tejidos bajo la tríada de células madre, andamios y moléculas bioactivas. Objetivos: esta revisión general tuvo como objetivo evaluar el éxito de los materiales de andamiaje y regenerativos utilizados para el tratamiento de estos dientes, en términos de cierre apical, aumento de la longitud del diente, ensanchamiento de las paredes del conducto radicular, vitalidad del tejido y reparación de lesiones periapicales. Métodos: Se llevó a cabo una extensa investigación bibliográfica en las bases de datos Medline, ISI Web of Science y Scopus para revisiones sistemáticas relevantes que coincidieran con la estrategia de búsqueda de palabras clave. Según los criterios de inclusión y exclusión, los revisores calificaron de forma independiente la calidad de cada estudio para determinar su nivel de evidencia. La evaluación de la calidad metodológica de cada artículo se obtuvo mediante la herramienta A Measurement Tool to Assess Systematic Reviews (AMSTAR)-2, y el riesgo de sesgo se evaluó con la herramienta Risk of Bias in Systematic Reviews (ROBIS). Resultados: Después de eliminar los duplicados, se encontraron 155 artículos; de los cuales 133 fueron excluidos por no ser relevantes y otros 15 por criterios de exclusión. Uno más fue descartado luego de la evaluación de la calidad metodológica, para un total de seis artículos restantes. El andamio más utilizado fue el coágulo de sangre, otros utilizados fueron el ácido poliláctico-co-glicólico y la matriz de fibrina rica en plaquetas. El material de regeneración más utilizado fue el agregado de trióxido mineral (MTA), seguido de Biodentine. En todos los estudios seleccionados se informó un aumento en la longitud de los dientes y un ensanchamiento de las paredes del conducto radicular en diferentes proporciones, así como reparación de lesiones periapicales. El análisis ROBIS mostró que solo un artículo tenía un sesgo bajo, dos se clasificaron como sesgo poco claro, mientras que los tres restantes tenían un alto riesgo de sesgo. Discusión: Se realizó una búsqueda bibliográfica exhaustiva aplicando filtros de idioma, revistas indexadas de alta calidad, año de publicación, lo que asegura que se incluyeron artículos de la mejor calidad. El coágulo de sangre fue el andamio más utilizado, ya que es el más fácil de colocar dentro del canal y no requiere extraer sangre del paciente. El uso de MTA y Biodentine como materiales de sellado se ha asociado con el engrosamiento de las paredes del canal, el cierre apical y la reducción de los signos y síntomas de la periodontitis apical. Sin embargo, la mayoría de las revisiones incluidas evaluadas fueron informes de casos y solo en algunas de ellas se incluyeron ensayos clínicos. También hay una falta de análisis del riesgo de sesgo en la mayoría de las revisiones. Conclusión: El coágulo de sangre es el armazón más común utilizado para inducir la regeneración durante el tratamiento de dientes necróticos inmaduros. El aumento de la longitud de los dientes y el ensanchamiento de las paredes del conducto radicular son los criterios más comunes utilizados en los estudios como indicadores de éxito. MTA y Biodentine no mostraron diferencias en los resultados analizados. La evaluación de la calidad y la evaluación del riesgo de sesgo mostraron que es necesario diseñar mejores estudios con una metodología rigurosa para recomendar un protocolo confiable y predecible para el tratamiento de dientes permanentes necróticos inmaduros con lesiones periapicales.es
dc.description.abstractAbstract Background: Current treatment of immature necrotic permanent teeth with a peri- apical lesion is regenerative endodontics, which is based on tissue engineering under the triade of stem cells, scaffolds and bioactive molecules. Objectives: This Umbrella Review was aimed to evaluate the success of scaffold and regenerative materials used for the treatment of these teeth, in terms of apical closure, tooth length increase, widening of root canal walls, tissue vitality and peri- apical lesion repair. Methods: An extensive literature research was carried out in the Medline, ISI Web of Science, and Scopus databases for relevant systematic reviews matching the keyword search strategy. Based on inclusion and exclusion criteria, reviewers independently rated the quality of each study to determine their level of evidence. Methodological quality assessment of each article was obtained using A Measurement Tool to Assess Systematic Reviews (AMSTAR)-2 tool, and risk of bias was assessed with the Risk of Bias in Systematic Reviews (ROBIS) tool. Results: After removing duplicates, 155 articles were found; from which 133 were excluded for being non-relevant and 15 other due to exclusion criteria. One more was discarded after methodological quality evaluation, for a total of six articles re- maining. The most common scaffold used was the blood clot, others used were poly lactic-co-glycolic acid and platelet-rich fibrin matrix. The most common regenera- tion material used was Mineral Trioxide Aggregate (MTA), followed by Biodentine. An increase in tooth length and widening of root canal walls were reported in all selected studies with different proportions, as well as periapical lesion repair. ROBIS analysis showed that only one article had low bias, two were classified as unclear bias, while the remaining three had high risk of bias. Discussion: An exhaustive literature search was carried out applying language filters, high-quality indexed journals, year of publication, which ensures the best quality arti- cles were included. Blood clot was the most used scaffold as is the most easy to place inside the canal and does not require to extract blood from the patient. The use of MTA and Biodentine as sealing materials has been associated with thickening of canal walls, apical closure and reduced signs and symptoms of apical periodontitis. However, most of the included reviews assessed were case reports and only in a few of them were clini- cal trials included. There is also a lack of risk of bias analysis in most reviews. Conclusion: The blood clot is the most common scaffold used for inducing regen- eration during the treatment of immature necrotic teeth. Tooth length increase and widening of root canal walls are the most common criteria used in the studies as suc- cess indicators. MTA and Biodentine did not show differences in the results analysed. Quality assessment and bias risk evaluation showed that it is necessary to design bet- ter studies with rigorous methodology to recommend a trustable and predictable pro- tocol for the treatment of immature necrotic permanent teeth with periapical lesions.es
dc.description.cvlachttps://scienti.minciencias.gov.co/cvlac/EnRecursoHumano/query.does
dc.description.emailhernan.munoz@campusucc.edu.coes
dc.description.gruplachttps://scienti.minciencias.gov.co/gruplac/jsp/visualiza/visualizagr.jsp?nro=00000000002911es
dc.description.orcidhttps://orcid.org/my-orcid?orcid=0000-0002-4327-4242es
dc.description.tableofcontentsIntroducción. -- Materiales y Métodos. -- Registro. -- Formulación PICO. -- Estrategia de Búsqueda. -- Estudios de Selección. -- Extracción de datos. -- Evaluación de Calidad usando AMSTAR 2. -- Evaluación de Riesgo de de Sesgo de Estudios Individuales. -- Resultados. -- Artículos Obtenidos en la búsqueda de literatura. -- Características Generales de los estudios seleccionados. -- Hallazgos de Materiales y Métodos. -- Resultados Observados. -- Evaluación de Calidad. -- Evaluación de riesgo de sesgo. -- Discusión. -- Necesidad de Umbrella Review. -- Hallazgos y posibles explicaciones. -- Andamios. -- Materiales de selle. -- Métodos de evaluación clinica y radiografica. -- resultados observados. -- Evaluación de calidad. -- Evaluación de riesgo de sesgo. -- Fortalezas Limitaciones. -- Recomendaciones. -- Conclusion. --es
dc.format.extent22es
dc.identifier.bibliographicCitationCaviedes-Bucheli, J., Muñoz-Alvear, H. D., Lopez-Moncayo, L. F., Narvaez-Hidalgo, A., Zambrano-Guerrero, L., Gaviño-Orduña, J. F., Portigliatti, R., Gomez-Sosa, J. F., & Munoz, H. R. (2022). Use of scaffolds and regenerative materials for the treatment of immature necrotic permanent teeth with periapical lesion: Umbrella review. International endodontic journal, 55(10), 967–988.https://repository.ucc.edu.co/handle/20.500.12494/46689es
dc.identifier.issn1365-2591es
dc.identifier.urihttps://doi.org/10.1111/iej.13799es
dc.identifier.urihttps://hdl.handle.net/20.500.12494/46689
dc.publisherHAL DUNCANes
dc.publisherUniversidad Cooperativa de Colombia, Posgrado, Especialización en Endodoncia, Pastoes
dc.publisher.placePastoes
dc.publisher.programEspecialización en endodonciaes
dc.relation.ispartofjournalINTERNATIONAL ENDODONTIC JOURNALes
dc.relation.isversionofhttps://onlinelibrary.wiley.com/doi/10.1111/iej.13799es
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dc.rights.accessrightsinfo:eu-repo/semantics/openAccesses
dc.rights.licenseAtribución – No comercial – Compartir iguales
dc.subjectdientes necróticos inmaduroses
dc.subjectlesión periapicales
dc.subjectmateriales regenerativoses
dc.subjectandamioses
dc.subject.otherimmature necrotic teethes
dc.subject.otherperiapical lesiones
dc.subject.otherregenerative materialses
dc.subject.otherscaffoldses
dc.titleUse of scaffolds and regenerative materials for the treatment of immature necrotic permanent teeth with periapical lesion: Umbrella reviewes
dc.typeArtículos Científicoses
dspace.entity.typePublication

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2022-caviedesbuchelijavermunozalvearhernandariolopezmoncayoluis fernando-Use_of_scaffolds_and_regenerative_materials_for_the_treatment_of_immature_necrotic_permanent_teeth_with_periapical_lesion_Umbrella_review-FormatoPublicacionWeb.pdf
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2022-caviedesbuchelijavermunozalvearhernandariolopezmoncayoluis fernando-Use_of_scaffolds_and_regenerative_materials_for_the_treatment_of_immature_necrotic_permanent_teeth_with_periapical_lesion_Umbrella_review-licenciadeuso.pdf
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