Pulp Survival of Cracked Teeth with Normal Pulp or Reversible Pulpitis After External Splinting: A Systematic Review...

Area of Science:

• Dental Traumatology
• Endodontics
• Restorative Dentistry

Background:

• Cracked teeth with normal pulp or reversible pulpitis present a clinical challenge.
• External splinting is a management option for these teeth.
• Assessing pulp survival is crucial for treatment success.

Purpose of the Study:

• To systematically review and meta-analyze the pulp survival rate of cracked teeth managed with external splinting.
• To evaluate factors influencing pulp survival in these cases.

Main Methods:

• Systematic literature search across multiple databases up to January 2025.
• Inclusion of clinical studies with a minimum 12-month follow-up.
• Risk of bias and quality of evidence assessment using established methodologies.
• Random-effects model for pooled survival rate estimation.

Main Results:

• 10 studies including 711 cracked teeth were analyzed.
• The pooled pulp survival rate at 12 months was 85% (95% CI: 79%-91%), with significant heterogeneity.
• Higher survival rates were observed without orthodontic banding (89%) and with direct approaches (89%).
• Risk of bias was moderate, and quality of evidence was very low.

Conclusions:

• External splinting demonstrates a favorable 1-year pulp survival rate for cracked teeth with reversible pulpitis.
• Considerable heterogeneity in treatment protocols exists.
• High-quality comparative studies are needed to standardize treatment approaches.