Management of Pulp Canal Obliteration—Systematic Review of Case Reports

<i>Background and Objectives</i>: This systematic review aimed to assess the literature focusing on the clinical management of traumatized teeth with Pulp Canal Obliteration (PCO) and propose an updated clinical decision-making algorithm. The present review follows the PRISMA guidelines...

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Autores principales:	Alexandra Vinagre, Catarina Castanheira, Ana Messias, Paulo J. Palma, João C. Ramos
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	pulp canal obliteration tooth injuries watchful waiting tooth bleaching root canal treatment Medicine (General) R5-920
Acceso en línea:	https://doaj.org/article/3324492abfde49b18c17126a60b05d0b
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spelling	oai:doaj.org-article:3324492abfde49b18c17126a60b05d0b2021-11-25T18:18:51ZManagement of Pulp Canal Obliteration—Systematic Review of Case Reports10.3390/medicina571112371648-91441010-660Xhttps://doaj.org/article/3324492abfde49b18c17126a60b05d0b2021-11-01T00:00:00Zhttps://www.mdpi.com/1648-9144/57/11/1237https://doaj.org/toc/1010-660Xhttps://doaj.org/toc/1648-9144<i>Background and Objectives</i>: This systematic review aimed to assess the literature focusing on the clinical management of traumatized teeth with Pulp Canal Obliteration (PCO) and propose an updated clinical decision-making algorithm. The present review follows the PRISMA guidelines and was registered on PROSPERO database (CRD42020200656). <i>Materials and Methods</i>: An electronic search strategy was performed in Pubmed, EBSCOhost and LILACS from inception to March 2021. Only anterior permanent teeth with PCO due to dental trauma were included. Regarding clinical approaches, only teeth managed with a “watchful waiting” approach, tooth bleaching or root canal treatment (RCT) were included. Quality assessment was performed using the JBI Critical Appraisal Tool for Case Reports. <i>Results</i>: Twenty case reports were selected, resulting in a total of 27 patients. The number of traumatized teeth diagnosed with PCO was 33. The “watchful waiting” approach was the most implemented clinical strategy. Discolored non-symptomatic PCO teeth were mostly managed with external bleaching. The prevalence of pulp necrosis (PN) was 36.4%. For teeth diagnosed with PN, non-surgical RCT was performed in 10 teeth and surgical RCT in one tooth. Guided endodontic technique was performed in six of those teeth. <i>Conclusions</i>: For discolored non-symptomatic PCO teeth, external bleaching is advocated and the RCT approach should not be implemented as a preventive intervention strategy. Symptomatic PCO teeth should follow regular endodontic treatment pathways. Clinical approach of teeth with PCO should follow a decision-making algorithm incorporating clinical and radiographic signs and patient-reported symptoms.Alexandra VinagreCatarina CastanheiraAna MessiasPaulo J. PalmaJoão C. RamosMDPI AGarticlepulp canal obliterationtooth injurieswatchful waitingtooth bleachingroot canal treatmentMedicine (General)R5-920ENMedicina, Vol 57, Iss 1237, p 1237 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	pulp canal obliteration tooth injuries watchful waiting tooth bleaching root canal treatment Medicine (General) R5-920
spellingShingle	pulp canal obliteration tooth injuries watchful waiting tooth bleaching root canal treatment Medicine (General) R5-920 Alexandra Vinagre Catarina Castanheira Ana Messias Paulo J. Palma João C. Ramos Management of Pulp Canal Obliteration—Systematic Review of Case Reports
description	<i>Background and Objectives</i>: This systematic review aimed to assess the literature focusing on the clinical management of traumatized teeth with Pulp Canal Obliteration (PCO) and propose an updated clinical decision-making algorithm. The present review follows the PRISMA guidelines and was registered on PROSPERO database (CRD42020200656). <i>Materials and Methods</i>: An electronic search strategy was performed in Pubmed, EBSCOhost and LILACS from inception to March 2021. Only anterior permanent teeth with PCO due to dental trauma were included. Regarding clinical approaches, only teeth managed with a “watchful waiting” approach, tooth bleaching or root canal treatment (RCT) were included. Quality assessment was performed using the JBI Critical Appraisal Tool for Case Reports. <i>Results</i>: Twenty case reports were selected, resulting in a total of 27 patients. The number of traumatized teeth diagnosed with PCO was 33. The “watchful waiting” approach was the most implemented clinical strategy. Discolored non-symptomatic PCO teeth were mostly managed with external bleaching. The prevalence of pulp necrosis (PN) was 36.4%. For teeth diagnosed with PN, non-surgical RCT was performed in 10 teeth and surgical RCT in one tooth. Guided endodontic technique was performed in six of those teeth. <i>Conclusions</i>: For discolored non-symptomatic PCO teeth, external bleaching is advocated and the RCT approach should not be implemented as a preventive intervention strategy. Symptomatic PCO teeth should follow regular endodontic treatment pathways. Clinical approach of teeth with PCO should follow a decision-making algorithm incorporating clinical and radiographic signs and patient-reported symptoms.
format	article
author	Alexandra Vinagre Catarina Castanheira Ana Messias Paulo J. Palma João C. Ramos
author_facet	Alexandra Vinagre Catarina Castanheira Ana Messias Paulo J. Palma João C. Ramos
author_sort	Alexandra Vinagre
title	Management of Pulp Canal Obliteration—Systematic Review of Case Reports
title_short	Management of Pulp Canal Obliteration—Systematic Review of Case Reports
title_full	Management of Pulp Canal Obliteration—Systematic Review of Case Reports
title_fullStr	Management of Pulp Canal Obliteration—Systematic Review of Case Reports
title_full_unstemmed	Management of Pulp Canal Obliteration—Systematic Review of Case Reports
title_sort	management of pulp canal obliteration—systematic review of case reports
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/3324492abfde49b18c17126a60b05d0b
work_keys_str_mv	AT alexandravinagre managementofpulpcanalobliterationsystematicreviewofcasereports AT catarinacastanheira managementofpulpcanalobliterationsystematicreviewofcasereports AT anamessias managementofpulpcanalobliterationsystematicreviewofcasereports AT paulojpalma managementofpulpcanalobliterationsystematicreviewofcasereports AT joaocramos managementofpulpcanalobliterationsystematicreviewofcasereports
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Management of Pulp Canal Obliteration—Systematic Review of Case Reports

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