Browsing by Author "Fernandes, Nuno Gonçalo de Almeida"
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- Apexification VS revascularization in immature necrotic teeth : systematic reviewPublication . Fernandes, Nuno Gonçalo de Almeida; Bernardo, Maria Alexandra; Franco, Carlos InácioAim: Dental infections are common in younger ages, leading to pulp necrosis and subsquently tooth loss. In immature permanent teeth, apexification or revascularization techniques can be chosen as a therapeutic option. This study aims to perform a systematic review and meta-analysis to compare clinical outcomes between traditional apexifcation procedures and revascularization techniques. Methods: Search was made in PubMed database involving quantitative assessments of clinical outcomes such as clinical resolution, root maturation, and root wall thickness made through January 2007 until May 2018. The weighted pooled success for success rate of revascularization and apexification was estimated and compared in 3 follow-up groups: 6-12 months, 12-36 months and >36 months. The weighted pooled success of the material success rate of used in apexification was estimated and compared in 2 follow-up groups: 6-24 months and ≥36 months. DerSimonian-Laird method was used to calculate the random effect of weighted pooled success rate of each treatment and the 95% confidence interval. All statistics were performed by OpenMeta[analyst] Yosemite (10.10). Results: The treatment technique success rate obtained for each follow-up period considered, 6-12, >12-36 and >36 months, were 99.2%, 83.38% and 75.6% respectively, for revascularization, and 94.9%, 96.5% and 95.2% respectively, for apexification. For the same follow-up period groups, success rate for root wall thickness was 64.9%, 48.3% and 43.3%, respectively and for root maturation 77.6%, 51.9% and 43.3%, respectively. The evaluation of the success rate concerning the material used in apexification, for the follow-up period considered, 6-24 and ≥24 months, was 88.3% and 95.7% respectively for CH and 95.5% and 92.3% for MTA respectively. Meta-analyse revealed difference, with statistical significance, between the success rate of revascularization and apexification procedures for each considered follow-up period. Conclusions: Meta analyse results suggest that apexification has higher success rate for clinical resolution when compared with revascularization. Root maturation and root wall thickness success rate results revealed that root development can be expected as soons as 12 months. Comparison between the two materials, revealed that they are clinically equivalent concerning clinical resolution.