SynthesisBMC oral health2023
Incidence and influential factors in pulp necrosis and periapical pathosis following indirect restorations: a systematic review and meta-analysis.
Synthesis in BMC oral health, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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Who cites it
10 citing papers in PubMed, 11 citations in OpenAlex.
- Biological interaction, esthetics, handling, and loss rate of temporary luting cements - a clinical single-blind randomized controlled trial.Clinical oral investigations · 2024Trial
- From Caries to Periodontal Breakdown: A Biological and Clinical Continuum Linking Cariology, Operative Dentistry, Endodontics, and Periodontology.Dentistry journal · 2026Review
- Assessing the suitability of ChatGPT in responding to public inquiries about dental crown restorations.BMC oral health · 2025Article
- Strategies for Restoration of Compromised First Permanent Molars in Children: Challenges and Optimal Timing.Oral health & preventive dentistry · 2025Review
- Dental trauma in children: monitoring, management, and challenges-a narrative review.Translational pediatrics · 2025Review
- Instrument retrieval using ultrasonics and minimally invasive guided endodontics using ARenetoJournal of medical case reports · 2025Article
- Comparative Outcomes of Apical Induction Versus Pulp Revascularization in Young Permanent Anterior Teeth with Traumatic Pulp Necrosis.Therapeutics and clinical risk management · 2025Article
- Occurrence rate and estimated economic burden of pulp and periapical disease treatment among Korean older adults: a national population-based retrospective study.Epidemiology and health · 2025Article
- Article
- Augmented reality-guided endodontics: Minimally invasive access through the prosthesis using AReneto® system - A case series.Journal of oral biology and craniofacial researchArticle
Corrections and comments
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Authors and funding
5 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundRestoring vital teeth with indirect restorations may threaten dental pulp integrity. However, the incidence of and influential factors on pulp necrosis and periapical pathosis in such teeth are still unknown. Therefore, this systematic review and meta-analysis aimed to investigate the incidence of and influential factors on pulp necrosis and periapical pathosis of vital teeth following indirect restorations.
methodsThe search was conducted in five databases, using MEDLINE via PubMed, Web of Science, EMBASE, CINAHL, and Cochrane Library. Eligible clinical trials and cohort studies were included. The risk of bias was assessed using Joanna Briggs Institute's critical appraisal tool and Newcastle-Ottawa Scale. The overall incidences of pulp necrosis and periapical pathosis following indirect restorations were calculated using a random effects model. Subgroup meta-analyses were also performed to determine the potential influencing factors for pulp necrosis and periapical pathosis. The certainty of the evidence was assessed using the GRADE tool.
resultsA total of 5,814 studies were identified, of which 37 were included in the meta-analysis. The overall incidences of pulp necrosis and periapical pathosis following indirect restorations were determined to be 5.02% and 3.63%, respectively. All studies were assessed as having a moderate-low risk of bias. The incidence of pulp necrosis following indirect restorations increased when the pulp status was objectively assessed (thermal/electrical testing). The presence of pre-operative caries or restorations, treatment of anterior teeth, temporization for more than two weeks, and cementation with eugenol-free temporary cement, all increased this incidence. Final impression with polyether and permanent cementation with glass ionomer cement both increased the incidence of pulp necrosis. Longer follow-up periods (> 10 years) and treatment provided by undergraduate students or general practitioners were also factors that increased this incidence. On the other hand, the incidence of periapical pathosis increased when teeth were restored with fixed partial dentures, the bone level was < 35%, and the follow-up was > 10 years. The certainty of the evidence overall was assessed as low.
conclusionsAlthough the incidences of pulp necrosis and periapical pathosis following indirect restorations remain low, many factors affect these incidences that should thus be considered when planning indirect restorations on vital teeth. DATABASE REGISTRATION: PROSPERO (CRD42020218378).
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