Donnelly, Aisling;
Foschi, Federico;
McCabe, Paul;
Duncan, Henry F;
(2022)
Pulpotomy for treatment of complicated crown fractures in permanent teeth: A systematic review.
International Endodontic Journal
, 55
(4)
pp. 290-311.
10.1111/iej.13690.
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Abstract
BACKGROUND: Consensus on the treatment of choice for complicated crown fractures of teeth is limited. Recent guidance recommends vital-pulp-therapy; however, the preferred type is not specified. Higher success rates for pulpotomy compared to pulp-capping have been documented, which suggests pulpotomy may be a preferable option for complicated crown-fractures. OBJECTIVES: The purpose of this systematic review was to determine the success rate of pulpotomy (partial and complete) on teeth that suffered complicated crown fractures. PARTICIPANTS: patients who have suffered a complicated crown fracture to an anterior permanent tooth. INTERVENTION: pulpotomy (partial or complete). Comparator: pulp-capping or root canal treatment. OUTCOME: combined clinical and radiographic success at or after 12 months. METHODS: A systematic literature using key search terms was conducted using PubMed, Web of Science and Cochrane-Central-Register-of-Controlled-Trials (CENTRAL) as well as a grey literature search from inception to May 2021 and without language restricted to English. Strict inclusion criteria were applied. A standardized tool with defined criteria to assess the risk of bias in each study was used. For non-randomized comparative trials, the Robins-I tool was used while the Newcastle-Ottawa scale was used for non-comparative non-randomized studies. RESULTS: Seven retrospective clinical studies were included. The studies reported high success rates for pulpotomy with overall success ranges for partial or complete pulpotomy ranging from 75% to 96%. One study compared the success rates of pulpotomy to an alternative treatment option pulp capping (90.9% vs. 67%, respectively). Due to the lack of homogeneity in the included studies, a meta-analysis was not possible. DISCUSSION: This review highlights the limited evidence based for the current guidance on treatment of complicated crown fractures. The findings of the review indicate high success rates for pulpotomy; however, there is a moderate risk of bias and small sample sizes in the included studies with the result that the overall results should be interpreted with caution. CONCLUSION: Within the limitations of this review, the benefits and high success rates reported for partial pulpotomy suggest this procedure, rather than pulp-capping, should be considered as the treatment of choice for both immature and mature teeth that have suffered complicated crown-fractures.
| Type: | Article |
|---|---|
| Title: | Pulpotomy for treatment of complicated crown fractures in permanent teeth: A systematic review |
| Location: | England |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1111/iej.13690 |
| Publisher version: | http://dx.doi.org/10.1111/iej.13690 |
| Language: | English |
| Additional information: | © 2022 The Authors. International Endodontic Journal published by John Wiley & Sons Ltd on behalf of British Endodontic Society This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made. |
| Keywords: | complicated crown fractures, dental trauma, follow-up, pulp exposure, pulpotomy, vital pulp therapy, Crowns, Dental Pulp Capping, Dentition, Permanent, Humans, Pulpotomy, Retrospective Studies, Treatment Outcome |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Eastman Dental Institute UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Eastman Dental Institute > Restorative Dental Sciences |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10188466 |
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