Outcomes reporting in systematic reviews on revitalization: A scoping review for the development of a core outcome set

Abstract

Background Revitalization is a type of regenerative endodontic treatment (RET) that offers the exciting prospect of revitalizing damaged tissue, therefore improving outcomes for non‐vital immature teeth. To evaluate its potential, there needs to be consistency in outcome reporting of clinical studies investigating revitalization to allow for evidence synthesis and inform clinical decision making. Objectives The aim of this scoping review was to identify outcomes that are reported in systematic reviews on revitalization including how and when these outcomes are measured. Additionally, evidence of selective reporting bias in the reviews was assessed. Methods A comprehensive electronic search of healthcare databases and grey literature was conducted to identify systematic reviews published in the English language reporting outcomes of revitalization in permanent immature teeth. There was no restriction on the date of publication. Outcome data was extracted by four reviewers independently and mapped with a healthcare taxonomy into five core areas: survival, clinical/physiological changes, life impact, resource use and adverse events. Selective reporting bias and how it was measured was assessed independently by two reviewers. Results Twenty‐six systematic reviews were included in this scoping review. There was lack of standardization in reporting and significant heterogeneity across reviews in outcome endpoints. The outcomes reported could be aligned within the five core areas of the taxonomy including tooth survival which was reported in nine reviews. Patient‐reported outcomes were generally limited and no review reported on Oral Health Related Quality of Life. Many of the reviews reporting on randomized control trials were at low risk of selective reporting bias whilst other study designs were at higher risk. Discussion Consistency in outcome reporting is necessary to realize the benefits of old but particularly novel therapies. Data from this review confirmed heterogeneity in reporting outcomes of revitalization and the need for development of a core outcome set (COS). Conclusions Several important outcomes including survival, root development, tooth discolouration and periapical healing have been identified in this review which could inform the development of a COS in this area. Registration Core Outcome Measures in Effectiveness Trials (COMET) database (registration no. 1879).

Correlation between pulp sensibility and magnetic resonance signal intensity following regenerative endodontic procedures in mature necrotic teeth- a retrospective cohort study

“…However, longer-term and multi-centre clinical trials are still needed to reach a predictable measure of success regarding the regain of pulp sensibility following REPs in mature necrotic teeth. This would in turn allow the development of a precise core outcome [ 61 ] set to aid in clinical decision-making for applying REPs in the treatment of mature teeth.…”

A critical look at outcome measures: Comparison between four dental research journals by use of a hierarchical model

“…The lack of patient-related outcomes in endodontic research, such as functional aspects or Oral Health-Related Quality of Life was further established in a study by Duncan et al (2021). Recently, several scoping reviews on outcomes reporting on different endodontic treatments were published and patient-centred and societal aspects were rarely reported on Cushley, McLister, et al, 2022;Kirkevang et al, 2022;Shah et al, 2022). Similar tendencies have also been identified within the cariologic research field, where outcomes have focused on caries experience and the clinical performance of restoration materials rather than patient satisfaction (Levey et al, 2017).…”

An international consensus study to identify “what” outcomes should be included in a core outcome set for endodontic treatments (COSET) for utilization in clinical practice and research

“…To identify endodontic treatment outcomes reported in the literature, four scoping reviews were carried out for different endodontic treatment modalities. These were VPT (Cushley et al., 2022a), non‐surgical root canal treatment (Kirkevang et al., 2022), surgical endodontics (Shah et al., 2022), and revitalization (Cushley et al., 2022b). A list of outcomes was generated from each scoping review following acceptance of the relevant manuscript for publication and formatted for prioritization in the e‐Delphi consensus (Tables S1–S4 ) .…”