Outcome and Survival of Endodontically Treated Cracked Posterior Permanent Teeth: A Systematic Review and Meta-analysis.

Abstract:

INTRODUCTION:The aim of the present systematic review and meta-analysis was to evaluate the success and survival rate of endodontically treated cracked posterior teeth and to assess the preoperative factors that affect teeth survival. METHODS:The study protocol was registered on the PROSPERO international prospective database of systematic reviews (CRD42019119091). Electronic search was performed for studies up to November 30, 2018 in the following databases: PubMed, Scopus, and Cochrane. All searches were done following the PRISMA guidelines. Clinical studies evaluating the success and/or the survival rate of cracked teeth that were endodontically treated with at least 1-year follow-up were selected. The Newcastle-Ottawa scale was used to evaluate risk assessment. Publication bias was evaluated with funnel plots, and the Egger's test was performed to test asymmetry. RESULTS:From the 410 studies identified through the initial search, 7 studies qualified for the final analysis, all of which were longitudinal cohort studies. The results of the meta-analysis indicated a survival rate of 88% (confidence interval, 0.81-0.94) and a success rate of 82% (confidence interval, 0.78-0.86) after 1 year of follow-up. The presence of a periodontal pocket associated to a crack (relative risk, 1.11) resulted in a higher risk of tooth loss. Patient sex, tooth type, position, the number of cracks present, and preoperative pulp status did not affect treatment survival rate (P > .05). Most of the included studies did not have an accurate record of many variables that could affect the tooth survival. Plus, studies did not present extended follow-up periods or an adequate dropout rate to properly assess treatment outcome and survival. CONCLUSIONS:According to the results of the present systematic review and meta-analysis, root canal treatment in cracked posterior teeth can be considered a suitable treatment option. The presence of an associated periodontal pocket results in a lower survival rate.

journal_name

J Endod

journal_title

Journal of endodontics

authors

Olivieri JG,Elmsmari F,Miró Q,Ruiz XF,Krell KV,García-Font M,Durán-Sindreu F

doi

10.1016/j.joen.2020.01.006

subject

Has Abstract

pub_date

2020-04-01 00:00:00

pages

455-463

issue

4

eissn

0099-2399

issn

1878-3554

pii

S0099-2399(20)30010-8

journal_volume

46

pub_type

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