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European Archives of Paediatric Dentistry

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Open Access 01-06-2017 | Systematic Review

Interventions for the endodontic management of non-vital traumatised immature permanent anterior teeth in children and adolescents: a systematic review of the evidence and guidelines of the European Academy of Paediatric Dentistry

Authors: M. Duggal, H. J. Tong, M. Al-Ansary, W. Twati, P. F. Day, H. Nazzal

Published in: European Archives of Paediatric Dentistry | Issue 3/2017

Abstract

Aim

This systematic review was undertaken in order to develop guidelines for the European Academy of Paediatric Dentistry for the management of non-vital permanent anterior teeth with incomplete root development.

Methods

Three techniques were considered; apexification by single or multiple applications of calcium hydroxide, use of Mineral Trioxide Aggregate (MTA) for the creation of an apical plug followed by obturation of the root canal, and finally a Regenerative Endodontic Technique (RET). Scottish Intercollegiate Guideline Network (SIGN) Guidelines (2008) were used for the synthesis of evidence and grade of recommendation.

Results

Variable levels of evidence were found and generally evidence related to these areas was found to be weak and of low quality. It was not possible to produce evidence-based guidelines based on the strength of evidence that is currently available for the management of non-vital immature permanent incisors.

Conclusions

Based on the available evidence the European Academy of Paediatric Dentistry proposes Good Clinical Practice Points as a guideline for the management of such teeth. It is proposed that the long term use of calcium hydroxide in the root canals of immature teeth should be avoided and apexification with calcium hydroxide is no longer advocated. The evidence related to the use of a Regenerative Endodontic Technique is currently extremely weak and therefore this technique should only be used in very limited situations where the prognosis with other techniques is deemed to be extremely poor. The current review supports the use of MTA followed by root canal obturation as the treatment of choice.

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Title: Interventions for the endodontic management of non-vital traumatised immature permanent anterior teeth in children and adolescents: a systematic review of the evidence and guidelines of the European Academy of Paediatric Dentistry
Authors: M. Duggal
H. J. Tong
M. Al-Ansary
W. Twati
P. F. Day
H. Nazzal
Publication date: 01-06-2017
Publisher: Springer Berlin Heidelberg
Published in: European Archives of Paediatric Dentistry / Issue 3/2017
Print ISSN: 1818-6300
Electronic ISSN: 1996-9805
DOI: https://doi.org/10.1007/s40368-017-0289-5

At a glance: The STEP trials

Springer Medicine

Interventions for the endodontic management of non-vital traumatised immature permanent anterior teeth in children and adolescents: a systematic review of the evidence and guidelines of the European Academy of Paediatric Dentistry

Abstract

Aim

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Aim

Methods

Results

Conclusions

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