TY - JOUR
T1 - An Evidence-based Review of the Efficacy of Treatment Approaches for Immature Permanent Teeth with Pulp Necrosis
AU - Kahler, Bill
AU - Rossi-Fedele, Giampiero
AU - Chugal, Nadia
AU - Lin, Louis M.
PY - 2017/7
Y1 - 2017/7
N2 - Introduction Two fundamental assumptions for teeth treated with regenerative endodontic procedures (REPs) are (1) that the clinical outcome is comparable with the traditional techniques of calcium hydroxide apexification and mineral trioxide aggregate apical barrier techniques and (2) that REPs will result in further root maturation. Methods A systematic review of the electronic databases (Scopus, PubMed, and Web of Science) involved a search for studies that used quantitative assessments of root maturation. The search terms were “dental pulp,” “regenerative endodontic therapy,” “revascularization,” and “revitalization.” The identified studies were further screened for cohort studies that compared clinical outcomes between teeth treated with REPs and apexification/apical barrier approaches. The primary question under review was framed according to the population, exposure, and outcome format. Results Of the 368 studies identified by the search, 6 cohort studies used quantitative assessments of any further root maturation after REPs, and a subset of 4 of these cohort studies assessed and compared clinical outcomes between the different treatment approaches. Conclusions Immature teeth with pulp necrosis treated with REPs generally show further root maturation although the results are variable. Clinical outcomes were similar for both groups. Patient-based criteria such as tooth discoloration, indications for changing the treatment option, and number of treatment appointments are all important for discussion before electing the appropriate treatment plan for the management of immature teeth with pulp necrosis.
AB - Introduction Two fundamental assumptions for teeth treated with regenerative endodontic procedures (REPs) are (1) that the clinical outcome is comparable with the traditional techniques of calcium hydroxide apexification and mineral trioxide aggregate apical barrier techniques and (2) that REPs will result in further root maturation. Methods A systematic review of the electronic databases (Scopus, PubMed, and Web of Science) involved a search for studies that used quantitative assessments of root maturation. The search terms were “dental pulp,” “regenerative endodontic therapy,” “revascularization,” and “revitalization.” The identified studies were further screened for cohort studies that compared clinical outcomes between teeth treated with REPs and apexification/apical barrier approaches. The primary question under review was framed according to the population, exposure, and outcome format. Results Of the 368 studies identified by the search, 6 cohort studies used quantitative assessments of any further root maturation after REPs, and a subset of 4 of these cohort studies assessed and compared clinical outcomes between the different treatment approaches. Conclusions Immature teeth with pulp necrosis treated with REPs generally show further root maturation although the results are variable. Clinical outcomes were similar for both groups. Patient-based criteria such as tooth discoloration, indications for changing the treatment option, and number of treatment appointments are all important for discussion before electing the appropriate treatment plan for the management of immature teeth with pulp necrosis.
KW - Calcium hydroxide apexification
KW - clinical outcomes
KW - clinician- and patient-based criterion
KW - mineral trioxide aggregate apical barrier
KW - quantitative assessment
KW - regenerative endodontic procedures
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U2 - 10.1016/j.joen.2017.03.003
DO - 10.1016/j.joen.2017.03.003
M3 - Review article
C2 - 28511779
AN - SCOPUS:85018933694
VL - 43
SP - 1052
EP - 1057
JO - Journal of Endodontics
JF - Journal of Endodontics
SN - 0099-2399
IS - 7
ER -