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. 2021 Aug 6;14(16):4418.
doi: 10.3390/ma14164418.

Prognosis of Regenerative Endodontic Procedures in Mature Teeth: A Systematic Review and Meta-Analysis of Clinical and Radiographic Parameters

Pantaleo Scelza  1 , Fabiano Gonçalves  2 , Isleine Caldas  1 , Fernanda Nunes  1 , Emanuelle Stellet Lourenço  2 , Sandro Tavares  2 , Marcela Magno  3 , Andrea Pintor  3 , Pietro Montemezzi  4 , Emanuele Di Edoardo  5 , Carlos Fernando de Almeida Barros Mourão  6 , Gutemberg Alves  6 , Miriam Zaccaro Scelza  7
Affiliations

Prognosis of Regenerative Endodontic Procedures in Mature Teeth: A Systematic Review and Meta-Analysis of Clinical and Radiographic Parameters

Pantaleo Scelza et al. Materials (Basel). .

Abstract

This work aimed to investigate the use of Regenerative Endodontic Procedures (REP) on the treatment of pulp necrosis in mature teeth through systematic review and meta-analysis of evidence on clinical and radiographic parameters before and after REP. A search was performed in different databases on 9 September 2020, including seven clinical studies and randomized controlled trials (RCT). The methodological quality was assessed using Revised Cochrane risk-of-bias (RoB 2) and Before-and-After tools. Meta-analyses were performed to evaluate the success incidences regarding the reduction of periapical lesion and recovery of sensitivity. The certainty of the evidence was assessed using GRADE. Meta-analysis showed a high overall success of 0.95 (0.92, 0.98) I2 = 6%, with high periapical lesion reduction at 12 months (0.93 (0.86, 0.96) I2 = 37%) and by the end of follow-up (0.91 (0.83, 0.96) I2 = 13%). Lower incidences of positive sensitivity response were identified for the electrical (0.58 (0.46, 0.70) I2 = 51%) and cold tests (0.70 (0.54, 0.84) I2 = 68%). The calculated levels of REP success were similar to those reported for immature teeth. With a very low certainty of evidence, the meta-analysis showed a high incidence of REP's success for mature teeth with necrotic pulp evidenced by periapical lesion reduction and moderate positive responses to sensitivity tests.

Keywords: dentition; meta-analysis; permanent; regenerative endodontics; systematic review.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
PRISMA flow diagram.
Figure 2
Figure 2
Incidence of success of mature teeth with necrotic pulp treated with REP.
Figure 3
Figure 3
Outcomes of meta-analysis at: (a) incidence of periapical lesion reduction of mature teeth with necrotic pulp treated with REP; (b) incidence of periapical lesion reduction of mature teeth with necrotic pulp treated with REP with 12-month follow-up; (c) incidence of positive electrical test response of mature teeth with necrotic pulp treated with REP with 12-month follow-up; (d) incidence of positive cold test response of mature teeth with necrotic pulp treated with REP with 12-month follow-up.
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