An Evidence-based Review of the Efficacy of Treatment Approaches for Immature Permanent Teeth with Pulp Necrosis

Bill Kahler; Giampiero Rossi-Fedele; Nadia Chugal; Louis M. Lin

doi:10.1016/j.joen.2017.03.003

An Evidence-based Review of the Efficacy of Treatment Approaches for Immature Permanent Teeth with Pulp Necrosis

Bill Kahler, Giampiero Rossi-Fedele, Nadia Chugal, Louis M. Lin

Endodontics

Research output: Contribution to journal › Article

Abstract

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.

Original language	English (US)
Journal	Journal of Endodontics
DOIs	http://dx.doi.org/10.1016/j.joen.2017.03.003
State	Accepted/In press - 2017

Fingerprint

Dental Pulp Necrosis

Endodontics

Tooth

Cohort Studies

Apexification

Tooth Discoloration

Calcium Hydroxide

Dental Pulp

Minerals

Appointments and Schedules

Keywords

Calcium hydroxide apexification
Clinical outcomes
Clinician- and patient-based criterion
Mineral trioxide aggregate apical barrier
Quantitative assessment
Regenerative endodontic procedures

ASJC Scopus subject areas

Dentistry(all)

Cite this

Kahler, B., Rossi-Fedele, G., Chugal, N., & Lin, L. M. (2017). An Evidence-based Review of the Efficacy of Treatment Approaches for Immature Permanent Teeth with Pulp Necrosis. Journal of Endodontics. DOI: 10.1016/j.joen.2017.03.003

An Evidence-based Review of the Efficacy of Treatment Approaches for Immature Permanent Teeth with Pulp Necrosis. / Kahler, Bill; Rossi-Fedele, Giampiero; Chugal, Nadia; Lin, Louis M.

In: Journal of Endodontics, 2017.

Research output: Contribution to journal › Article

Kahler, B, Rossi-Fedele, G, Chugal, N & Lin, LM 2017, 'An Evidence-based Review of the Efficacy of Treatment Approaches for Immature Permanent Teeth with Pulp Necrosis' Journal of Endodontics. DOI: 10.1016/j.joen.2017.03.003

Kahler B, Rossi-Fedele G, Chugal N, Lin LM. An Evidence-based Review of the Efficacy of Treatment Approaches for Immature Permanent Teeth with Pulp Necrosis. Journal of Endodontics. 2017. Available from, DOI: 10.1016/j.joen.2017.03.003

Kahler, Bill; Rossi-Fedele, Giampiero; Chugal, Nadia; Lin, Louis M. / An Evidence-based Review of the Efficacy of Treatment Approaches for Immature Permanent Teeth with Pulp Necrosis.

In: Journal of Endodontics, 2017.

Research output: Contribution to journal › Article

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10.1016/j.joen.2017.03.003