Although almost all of the identified studies presented moderate risk of bias, MTA apexification seems to produce overall better clinical and radiographic success rates among the endodontic treatment available in immature necrotic permanent teeth.
This systematic review and meta-analysis assessed clinical, radiographic and functional retention outcomes in immature necrotic permanent teeth treated either with pulp revascularization or apexification after a minimum of three months to determine which one provides the best results. The literature was screened via PubMed/MEDLINE and Embase databases up to June 2017 to select observational studies that compared pulp revascularization and apexification treatments assessing clinical, radiographic and functional retention outcomes. Two reviewers independently performed screening and evaluation of articles. A total of 231 articles were retrieved from databases, wherein only four articles were selected for full-text analyses. After exclusion criteria, three studies remained in quantitative and qualitative analyses. Pooled-effect estimates were obtained comparing clinical and radiographic outcomes (‘overall outcome’) and functional retention rates between apexification and pulp revascularization treatment. The meta-analysis comparing apexification vs. revascularization for ‘overall outcome’ (Z=0.113, p=0.910, RR=1.009, 95%CI:0.869–1.171) and functional retention rates (Z=1.438, p=0.150, RR=1.069, 95%CI:0.976–1.172) showed no statistically significant differences between the treatments. All studies were classified as high quality. The current literature regarding the clinical, radiographic and functional retention outcomes in immature necrotic permanent teeth treated either with pulp revascularization or apexification is limited. Based on our meta-analysis, the results do not favor one treatment modality over the other.
Ankyloglossia entails short lingual frenum, impairing satisfactory tongue movement and leading to problems related to deglutition, feeding and diction. This clinical report uses laser technology, rather than traditional surgical procedure with scalpel, to perform a lingual frenulotomy on a 9-year old child diagnosed with ankyloglossia, aiming to investigate more conservative and less traumatic dental procedures. Due to the many advantages of the laser device, such as bloodless surgical field, absence of sutures, minimal swelling and post-surgical pain, the high intensity diode laser is a viable alternative technique in soft tissue surgeries.
Aim
This retrospective study investigated the prevalence of defective restorations in a public dental service and factors associated with re‐intervention in primary teeth.
Design
The sample consisted of all clinical records (census) of children presenting restorations in primary teeth, who had undergone dental treatment in a public set during 1‐year period. For analysis, only restorations presenting defects related to esthetic, functional, or biological reasons at first clinical examination were included. The outcome ‘Success’ was set when the restoration received no treatment (monitored), refurbishing, sealing of margins, or was repaired. Otherwise, ‘Failure’ was set whenever the restoration was either replaced or if another treatment affecting the restoration was necessary (endodontic treatment or tooth extraction). Poisson regression model was used to assess the prevalence of patient‐ and tooth‐related factors that may influence the re‐intervention decision (repair or replacement).
Results
From a total of 302 restorations placed in 114 children, 37.7% presented some type of defect. Restorations with recurrent caries were more frequently present in caries‐active patients (P = 0.03) and were frequently replaced (95% CI, 1.05‐3.22, RR = 1.84, P = 0.03).
Conclusion
Presence of recurrent caries influences the re‐intervention decision, leading to restoration replacement in most cases.
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