Is there a best endodontic treatment for immature necrotic permanent teeth? A systematic review and meta-analysis

Abstract

Aim: To systematically review the literature available to elucidate if there is a best endodontic treatment for immature necrotic permanent teeth. Methods: The literature was screened via PubMed/MEDLINE, the Cochrane Central Register of Controlled Trials (CENTRAL) and ClinicalTrials databases until August 2015 to select randomized clinical trials that compared at least two different treatments regarding immature necrotic permanent teeth comprising clinical and radiographic success as outcome. A total of 648 studies were retrieved from the databases, in which only 14 were selected to full-text analysis by appliance of inclusion criteria. After exclusion criteria, the remaining 7 studies had their data extracted and assessed for bias risk. Two reviewers independently performed the screening and evaluation of the articles. Pooled-effect estimates were obtained comparing clinical and radiographic success rates among MTA vs other treatments and Blood Clot vs other regenerative procedures. Results: MTA showed statistically significant better results when compared to other endodontic treatments (p < 0.05) regarding clinical and radiographic outcomes. On 3 the other hand, it was not found a significant difference when Blood Clot was compared to any other regenerative procedure. Conclusions: Necrotic immature teeth endodontic-treated with MTA plugs still present more reliable results when compared to any endodontic treatment, despite that there is in promising tendency to regenerative approaches.