European Society of Endodontology position statement: endodontic management of traumatized permanent teeth

Krastl, Gabriel; Weiger, Roland; Filippi, Andreas; Waes, Hubertus van; Ebeleseder, K. A.; Ree, Marga; Connert, Thomas; Widbiller, Matthias; Tjäderhane, Leo; Dummer, P. M. H.; Galler, Kerstin M.

doi:10.1111/iej.13543

Cited by 30 publications

(22 citation statements)

References 65 publications

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“…In fact, endodontic treatment might have been initiated in order to enable root canal anchorage for complication-free extrusion. According to current guidelines, (partial) pulpotomy is considered the treatment of choice for fractured teeth with pulp exposure [ 48 , 49 ]. This approach is only feasible when there is sufficient dental hard tissue to bond a bracket and no need for an intracanal anchorage.…”

Section: Discussionmentioning

confidence: 99%

Orthodontic Forced Eruption of Permanent Anterior Teeth with Subgingival Fractures: A Systematic Review

Reichardt

Krug

Bornstein

et al. 2021

IJERPH

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(1) Background: To assess orthodontic forced eruption (OFE) as a pre-restorative procedure for non-restorable permanent teeth with subgingival dental hard tissue defects after dental trauma. (2) Methods: A systematic electronic search of three databases, namely, MEDLINE, Cochrane Library, and EMBASE, revealed a total of 2757 eligible publications. Randomized controlled clinical trials (RCT), retro- and prospective clinical studies, or case series (with a minimum of three patients) were reviewed. (3) Results: Thirteen full-text papers were included: one RCT, one prospective clinical trial, two retrospective cohort studies, and nine case series. Within case series, statistical significance between age and cause of fracture (p < 0.03) was determined. The mean extrusion rate of OFE was 1.5 mm a week within a four to six weeks treatment period followed by retention. Three OFE protocols for maxillary single teeth are available: 1. OFE without migration of gingiva and alveolar bone, 2. OFE with gingival migration and slight alveolar bone migration, and 3. OFE with migration of both gingiva and alveolar bone. (4) Conclusions: The current state of the evidence suggests that OFE is a feasible pre-treatment option for non-restorable permanent teeth. OFE can promote the migration of tooth surrounding hard and soft tissues in the esthetic zone. Root resorption does not seem to be a relevant side effect of OFE.

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Section: Discussionmentioning

confidence: 99%

Orthodontic Forced Eruption of Permanent Anterior Teeth with Subgingival Fractures: A Systematic Review

Reichardt

Krug

Bornstein

et al. 2021

IJERPH

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“…Most children perceive sensibility pulp testing as unpleasant stimuli, therefore, false-positive and false-negative responses are commonly encountered. Such situations may lead to incorrect treatment strategies [ 28 , 40 ]. Teeth erroneously diagnosed as nonvital may undergo unnecessary endodontic treatments, whereas those erroneously diagnosed as vital may be left untreated, causing further complications to the supporting tissues [ 27 ], and even affecting the successor tooth bud [ 41 ] if primary teeth are involved.…”

Section: Sensibility Pulp Testsmentioning

confidence: 99%

“…Sensibility tests are considered unreliable during the root formation period, due to the underdevelopment of Raschkow’s plexus [ 12 ]. EPT is associated with an increased threshold value in teeth with open apices, which frequently results in increased rates of false-negative results [ 40 ]. HPT have shown limited value because of inconsistent responses, whereas CPT with CO 2 ice proved to offer consistently more reliable results [ 42 ].…”

Section: Sensibility Pulp Testsmentioning

confidence: 99%

“…The likely causes behind this transient loss of pulp sensibility include pressure or tension on the nerve fibers, blood vessel rupture, and ischaemic injury [ 76 ]. In pediatric trauma cases, patient compliance might be also challenging, because of the young age of the patient and the distress felt after a traumatic event, consequently leading to false results of the sensibility tests [ 40 ]. Furthermore, the International Association of Dental Traumatology guidelines recommend against the use of sensibility tests in primary teeth, due to their lack of reliability [ 17 ].…”

Section: Pulp Testing Of Traumatized Teethmentioning

confidence: 99%

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A Diagnostic Insight of Dental Pulp Testing Methods in Pediatric Dentistry

et al. 2022

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The accurate diagnosis of pulpal pathology in pediatric dentistry is essential for the success of vital pulp therapy. Pulp testing is often a challenging task due to understanding and cooperation issues of pediatric patients, as well as the particularities of pulpal physiology encountered in primary and immature permanent teeth. Sensibility tests, although still widely used by dental practitioners, are no longer recommended by pediatric specialists mainly due to their subjective nature. Vitality pulp tests have gained popularity in the last decade in light of some encouraging results of clinical studies. However, their use is not a routine practice yet. This paper is a literature review aimed to guide dental practitioners towards selecting the appropriate pulp testing method for their pediatric cases. It provides an overview on a multitude of pulp testing methods and an update in recommendations for primary and immature permanent teeth.

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“…Guidance published by the European Society of Endodontology (ESE), The International Association of Dental Traumatology (IADT) and the American Academy of Paediatric Dentistry (AAPD) currently indicate that complicated (i.e. exposure of pulp) crown fractures of mature and immature permanent teeth should be treated by a vital pulp therapy, which includes pulp capping or pulpotomy (AAPD, 2014 ; Bourguignon et al, 2020 ; ESE, 2021 ). However, some studies have suggested a higher rate of pulpal necrosis for those teeth treated by pulp capping compared to pulpotomy (Fuks et al, 1982 ; Hecova et al, 2010 ; Wang et al, 2017 ).…”

Section: Introductionmentioning

confidence: 99%

Pulpotomy for treatment of complicated crown fractures in permanent teeth: A systematic review

Donnelly

Foschi

McCabe³

et al. 2022

Int Endodontic J

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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.

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European Society of Endodontology position statement: endodontic management of traumatized permanent teeth

Cited by 30 publications

References 65 publications

Orthodontic Forced Eruption of Permanent Anterior Teeth with Subgingival Fractures: A Systematic Review

Orthodontic Forced Eruption of Permanent Anterior Teeth with Subgingival Fractures: A Systematic Review

A Diagnostic Insight of Dental Pulp Testing Methods in Pediatric Dentistry

Pulpotomy for treatment of complicated crown fractures in permanent teeth: A systematic review

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