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

Research output: Contribution to journalArticle

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 languageEnglish (US)
JournalJournal of Endodontics
DOIs
StateAccepted/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

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 journalArticle

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 journalArticle

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