Question · asked by 1 review

Indirect restorations (crowns, fixed partial dentures, inlays/onlays/veneers) vs None (single-group incidence): Pulp necrosis

Population
Vital teeth restored with indirect restorations
Intervention
Indirect restorations (crowns, fixed partial dentures, inlays/onlays/veneers)
Comparison
None (single-group incidence)
Outcome
Pulp necrosis

Pulp necrosis incidence among treated by prosthodontists was 1.87% (subgroup analysis; not GRADE-rated).

What each review found

Include earlier review versions
No studies found 0 · 0%GRADE not reported 22 · 95.7%Very low 0 · 0%Low 1 · 4.3%Moderate 0 · 0%High 0 · 0%
FindingEffectStudiesGRADE certainty
Indirect restorations (crowns, fixed partial dentures, inlays/onlays/veneers) vs None (single-group incidence)
Pulp necrosis · Vital teeth restored with indirect restorations · Follow-up ≤5 to >10 years, University clinics and dental practices, multiple countries, Treated by prosthodontists
Pulp necrosis incidence among treated by prosthodontists was 1.87% (subgroup analysis; not GRADE-rated).
Incidence and influential factors in pulp necrosis and periapical pathosis following indirect restorations:… (2023) All outcomes
Proportion 1.87 [0.84, 3.31]3834 participantsGRADE not reported
Indirect restorations (crowns, fixed partial dentures, inlays/onlays/veneers) vs None (single-group incidence)
Pulp necrosis · Vital teeth restored with indirect restorations · Follow-up ≤5 to >10 years, University clinics and dental practices, multiple countries, PFM fabrication material
Pulp necrosis incidence among pfm fabrication material was 5.71% (subgroup analysis; not GRADE-rated).
Incidence and influential factors in pulp necrosis and periapical pathosis following indirect restorations:… (2023) All outcomes
Proportion 5.71 [0.12, 18.75]1980 participantsGRADE not reported
Indirect restorations (crowns, fixed partial dentures, inlays/onlays/veneers) vs None (single-group incidence)
Pulp necrosis · Vital teeth restored with indirect restorations · >5-10 years, University clinics and dental practices, multiple countries, Follow-up >5-10 years
Pulp necrosis incidence among follow-up >5-10 years was 5.53% (subgroup analysis; not GRADE-rated).
Incidence and influential factors in pulp necrosis and periapical pathosis following indirect restorations:… (2023) All outcomes
Proportion 5.53 [3.74, 7.64]2443 participantsGRADE not reported
Indirect restorations (crowns, fixed partial dentures, inlays/onlays/veneers) vs None (single-group incidence)
Pulp necrosis · Vital teeth restored with indirect restorations · Follow-up ≤5 to >10 years, University clinics and dental practices, multiple countries, Temporization >2 weeks
Pulp necrosis incidence among temporization >2 weeks was 4.25% (subgroup analysis; not GRADE-rated).
Incidence and influential factors in pulp necrosis and periapical pathosis following indirect restorations:… (2023) All outcomes
Proportion 4.25 [1.28, 8.85]2280 participantsGRADE not reported
Indirect restorations (crowns, fixed partial dentures, inlays/onlays/veneers) vs None (single-group incidence)
Pulp necrosis · Vital teeth restored with indirect restorations · >10 years, University clinics and dental practices, multiple countries, Follow-up >10 years
Pulp necrosis incidence among follow-up >10 years was 6.74% (subgroup analysis; not GRADE-rated).
Incidence and influential factors in pulp necrosis and periapical pathosis following indirect restorations:… (2023) All outcomes
Proportion 6.74 [2.82, 12.18]3640 participantsGRADE not reported
Indirect restorations (crowns, fixed partial dentures, inlays/onlays/veneers) vs None (single-group incidence)
Pulp necrosis · Vital teeth restored with indirect restorations · Follow-up ≤5 to >10 years, University clinics and dental practices, multiple countries, Temporization ≤2 weeks
Pulp necrosis incidence among temporization ≤2 weeks was 1.47% (subgroup analysis; not GRADE-rated).
Incidence and influential factors in pulp necrosis and periapical pathosis following indirect restorations:… (2023) All outcomes
Proportion 1.47 [0.81, 2.31]1907 participantsGRADE not reported
Indirect restorations (crowns, fixed partial dentures, inlays/onlays/veneers) vs None (single-group incidence)
Pulp necrosis · Vital teeth restored with indirect restorations · Follow-up ≤5 to >10 years, University clinics and dental practices, multiple countries, Radiographic pulp-status assessment
Pulp necrosis incidence among radiographic pulp-status assessment was 4.95% (subgroup analysis; not GRADE-rated).
Incidence and influential factors in pulp necrosis and periapical pathosis following indirect restorations:… (2023) All outcomes
Proportion 4.95 [2.43, 8.29]1853 participantsGRADE not reported
Indirect restorations (crowns, fixed partial dentures, inlays/onlays/veneers) vs None (single-group incidence)
Pulp necrosis · Vital teeth restored with indirect restorations · Follow-up ≤5 to >10 years, University clinics and dental practices, multiple countries, Polyvinyl siloxane impression material
Pulp necrosis incidence among polyvinyl siloxane impression material was 3.17% (subgroup analysis; not GRADE-rated).
Incidence and influential factors in pulp necrosis and periapical pathosis following indirect restorations:… (2023) All outcomes
Proportion 3.17 [1.55, 5.34]636 participantsGRADE not reported
Indirect restorations (crowns, fixed partial dentures, inlays/onlays/veneers) vs None (single-group incidence)
Pulp necrosis · Vital teeth restored with indirect restorations · Follow-up ≤5 to >10 years, University clinics and dental practices, multiple countries, Resin permanent cement
Pulp necrosis incidence among resin permanent cement was 3.37% (subgroup analysis; not GRADE-rated).
Incidence and influential factors in pulp necrosis and periapical pathosis following indirect restorations:… (2023) All outcomes
Proportion 3.37 [1.90, 5.23]738 participantsGRADE not reported
Indirect restorations (crowns, fixed partial dentures, inlays/onlays/veneers) vs None (single-group incidence)
Pulp necrosis · Vital teeth restored with indirect restorations · Follow-up ≤5 to >10 years, University clinics and dental practices, multiple countries, Eugenol-based temporary cement
Pulp necrosis incidence among eugenol-based temporary cement was 3.34% (subgroup analysis; not GRADE-rated).
Incidence and influential factors in pulp necrosis and periapical pathosis following indirect restorations:… (2023) All outcomes
Proportion 3.34 [1.66, 5.58]7043 participantsGRADE not reported
Indirect restorations (crowns, fixed partial dentures, inlays/onlays/veneers) vs None (single-group incidence)
Pulp necrosis · Vital teeth restored with indirect restorations · ≤5 years, University clinics and dental practices, multiple countries, Follow-up ≤5 years
Pulp necrosis incidence among follow-up ≤5 years was 3.53% (subgroup analysis; not GRADE-rated).
Incidence and influential factors in pulp necrosis and periapical pathosis following indirect restorations:… (2023) All outcomes
Proportion 3.53 [2.10, 5.31]5532 participantsGRADE not reported
Indirect restorations (crowns, fixed partial dentures, inlays/onlays/veneers) vs None (single-group incidence)
Pulp necrosis · Vital teeth restored with indirect restorations · Follow-up ≤5 to >10 years, University clinics and dental practices, multiple countries
About 5% of vital teeth develop pulp necrosis after indirect restorations (low certainty).
Incidence and influential factors in pulp necrosis and periapical pathosis following indirect restorations:… (2023) All outcomes
Proportion 5.02 [3.70, 6.52]37 studies · 11615 participantsLow
Indirect restorations (crowns, fixed partial dentures, inlays/onlays/veneers) vs None (single-group incidence)
Pulp necrosis · Vital teeth restored with indirect restorations · Follow-up ≤5 to >10 years, University clinics and dental practices, multiple countries, Treated by general practitioners
Pulp necrosis incidence among treated by general practitioners was 4.44% (subgroup analysis; not GRADE-rated).
Incidence and influential factors in pulp necrosis and periapical pathosis following indirect restorations:… (2023) All outcomes
Proportion 4.44 [2.16, 7.49]2113 participantsGRADE not reported
Indirect restorations (crowns, fixed partial dentures, inlays/onlays/veneers) vs None (single-group incidence)
Pulp necrosis · Vital teeth restored with indirect restorations · Follow-up ≤5 to >10 years, University clinics and dental practices, multiple countries, Single-unit restorations
Pulp necrosis incidence among single-unit restorations was 5.46% (subgroup analysis; not GRADE-rated).
Incidence and influential factors in pulp necrosis and periapical pathosis following indirect restorations:… (2023) All outcomes
Proportion 5.46 [3.63, 7.64]20 studies · 5491 participantsGRADE not reported
Indirect restorations (crowns, fixed partial dentures, inlays/onlays/veneers) vs None (single-group incidence)
Pulp necrosis · Vital teeth restored with indirect restorations · Follow-up ≤5 to >10 years, University clinics and dental practices, multiple countries, Zinc phosphate permanent cement
Pulp necrosis incidence among zinc phosphate permanent cement was 4.92% (subgroup analysis; not GRADE-rated).
Incidence and influential factors in pulp necrosis and periapical pathosis following indirect restorations:… (2023) All outcomes
Proportion 4.92 [3.85, 6.20]1387 participantsGRADE not reported
Indirect restorations (crowns, fixed partial dentures, inlays/onlays/veneers) vs None (single-group incidence)
Pulp necrosis · Vital teeth restored with indirect restorations · Follow-up ≤5 to >10 years, University clinics and dental practices, multiple countries, Polyether impression material
Pulp necrosis incidence among polyether impression material was 4.02% (subgroup analysis; not GRADE-rated).
Incidence and influential factors in pulp necrosis and periapical pathosis following indirect restorations:… (2023) All outcomes
Proportion 4.02 [2.47, 5.92]2985 participantsGRADE not reported
Indirect restorations (crowns, fixed partial dentures, inlays/onlays/veneers) vs None (single-group incidence)
Pulp necrosis · Vital teeth restored with indirect restorations · Follow-up ≤5 to >10 years, University clinics and dental practices, multiple countries, Ceramic fabrication material
Pulp necrosis incidence among ceramic fabrication material was 5.59% (subgroup analysis; not GRADE-rated).
Incidence and influential factors in pulp necrosis and periapical pathosis following indirect restorations:… (2023) All outcomes
Proportion 5.59 [2.89, 9.12]460 participantsGRADE not reported
Indirect restorations (crowns, fixed partial dentures, inlays/onlays/veneers) vs None (single-group incidence)
Pulp necrosis · Vital teeth restored with indirect restorations · Follow-up ≤5 to >10 years, University clinics and dental practices, multiple countries, Subjective pulp-status assessment
Pulp necrosis incidence among subjective pulp-status assessment was 3.91% (subgroup analysis; not GRADE-rated).
Incidence and influential factors in pulp necrosis and periapical pathosis following indirect restorations:… (2023) All outcomes
Proportion 3.91 [1.86, 6.66]3181 participantsGRADE not reported
Indirect restorations (crowns, fixed partial dentures, inlays/onlays/veneers) vs None (single-group incidence)
Pulp necrosis · Vital teeth restored with indirect restorations · Follow-up ≤5 to >10 years, University clinics and dental practices, multiple countries, Eugenol-free temporary cement
Pulp necrosis incidence among eugenol-free temporary cement was 5.77% (subgroup analysis; not GRADE-rated).
Incidence and influential factors in pulp necrosis and periapical pathosis following indirect restorations:… (2023) All outcomes
Proportion 5.77 [3.72, 8.24]639 participantsGRADE not reported
Indirect restorations (crowns, fixed partial dentures, inlays/onlays/veneers) vs None (single-group incidence)
Pulp necrosis · Vital teeth restored with indirect restorations · Follow-up ≤5 to >10 years, University clinics and dental practices, multiple countries, Treated by undergraduate students
Pulp necrosis incidence among treated by undergraduate students was 5.68% (subgroup analysis; not GRADE-rated).
Incidence and influential factors in pulp necrosis and periapical pathosis following indirect restorations:… (2023) All outcomes
Proportion 5.68 [3.17, 8.86]1604 participantsGRADE not reported
Indirect restorations (crowns, fixed partial dentures, inlays/onlays/veneers) vs None (single-group incidence)
Pulp necrosis · Vital teeth restored with indirect restorations · Follow-up ≤5 to >10 years, University clinics and dental practices, multiple countries, Glass ionomer (GIC) permanent cement
Pulp necrosis incidence among glass ionomer (gic) permanent cement was 5.33% (subgroup analysis; not GRADE-rated).
Incidence and influential factors in pulp necrosis and periapical pathosis following indirect restorations:… (2023) All outcomes
Proportion 5.33 [2.56, 9.03]182 participantsGRADE not reported
Indirect restorations (crowns, fixed partial dentures, inlays/onlays/veneers) vs None (single-group incidence)
Pulp necrosis · Vital teeth restored with indirect restorations · Follow-up ≤5 to >10 years, University clinics and dental practices, multiple countries, Objective pulp-status assessment
Pulp necrosis incidence among objective pulp-status assessment was 5.66% (subgroup analysis; not GRADE-rated).
Incidence and influential factors in pulp necrosis and periapical pathosis following indirect restorations:… (2023) All outcomes
Proportion 5.66 [3.71, 7.99]6581 participantsGRADE not reported
Indirect restorations (crowns, fixed partial dentures, inlays/onlays/veneers) vs None (single-group incidence)
Pulp necrosis · Vital teeth restored with indirect restorations · Follow-up ≤5 to >10 years, University clinics and dental practices, multiple countries, Fixed partial dentures (FPD)
Pulp necrosis incidence among fixed partial dentures (fpd) was 5.01% (subgroup analysis; not GRADE-rated).
Incidence and influential factors in pulp necrosis and periapical pathosis following indirect restorations:… (2023) All outcomes
Proportion 5.01 [2.76, 7.88]15 studies · 4674 participantsGRADE not reported

Findings are shown side by side, never pooled across reviews.

The reviews

ReviewSearched up toIncluded studiesAMSTAR 2
Incidence and influential factors in pulp necrosis and periapical pathosis following indirect restorations: a systematic review and…
2023 All outcomes
December 2022 (initial search October 2021, updated December 2022)68Not applicable

The same intervention and outcome, asked in another population or against another comparator.

How reviews are matched to this question

Reviews word the same question differently. Four decision models (TypeSafe's Jev, Liquid AI's d1-ultra, SubQ Snap and Baseten's Elephant) judged each wording of the population, intervention, comparator and outcome against the others; two wordings count as the same when at least three of them agree and none clearly disagrees, and findings count as this question only when all four elements match. Timing, setting and subgroup never split a question: they are shown on each finding.