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Dental pulp necrosis

MedGen UID:
8306
•Concept ID:
C0011407
•
Disease or Syndrome
Synonyms: Dental Pulp Necroses; Dental Pulp Necrosis; Necroses, Dental Pulp; Necroses, Pulp; Necrosis, Dental Pulp; Necrosis, Pulp; Pulp Necroses; Pulp Necroses, Dental; Pulp Necrosis; Pulp Necrosis, Dental
SNOMED CT: Pulp necrosis (42711005); Necrosis of the pulp (42711005); Putrescent pulpitis (42711005); Pulpal necrosis (42711005); Dead pulp (42711005); Devitalized pulp (42711005); Necrotic pulp (42711005)
 
Monarch Initiative: MONDO:0001326

Definition

Death of pulp tissue with or without bacterial invasion. When the necrosis is due to ischemia with superimposed bacterial infection, it is referred to as pulp gangrene. When the necrosis is non-bacterial in origin, it is called pulp mummification. [from MONDO]

Term Hierarchy

CClinical test,  RResearch test,  OOMIM,  GGeneReviews,  VClinVar  
  • CROGVDental pulp necrosis

Professional guidelines

PubMed

Treatment Outcome of Regenerative Endodontic Procedures for Necrotic Immature and Mature Permanent Teeth: A Systematic Review and Meta-Analysis Based on Randomised Controlled Trials.
Li J, Zheng L, Daraqel B, Liu J, Hu Y
Oral Health Prev Dent 2023 May 17;21:141-152. doi: 10.3290/j.ohpd.b4100877. PMID: 37195330
Effectiveness of endodontic tissue engineering in treatment of apical periodontitis: A systematic review.
Widbiller M, Knüttel H, Meschi N, Durán-Sindreu Terol F
Int Endod J 2023 Oct;56 Suppl 3:533-548. Epub 2022 Jun 23 doi: 10.1111/iej.13784. PMID: 35699668
A Novel Treatment Decision Tree and Literature Review of Retrograde Peri-Implantitis.
Sarmast ND, Wang HH, Soldatos NK, Angelov N, Dorn S, Yukna R, Iacono VJ
J Periodontol 2016 Dec;87(12):1458-1467. Epub 2016 Aug 6 doi: 10.1902/jop.2016.160219. PMID: 27498713

Recent clinical studies

Etiology

Review of guidance for the selection of regenerative endodontics, apexogenesis, apexification, pulpotomy, and other endodontic treatments for immature permanent teeth.
Murray PE
Int Endod J 2023 Mar;56 Suppl 2:188-199. Epub 2022 Aug 15 doi: 10.1111/iej.13809. PMID: 35929348
Regenerative Endodontic Procedures for the Treatment of Necrotic Mature Teeth with Apical Periodontitis: A Systematic Review and Meta-analysis of Randomized Controlled Trials.
Glynis A, Foschi F, Kefalou I, Koletsi D, Tzanetakis GN
J Endod 2021 Jun;47(6):873-882. Epub 2021 Mar 31 doi: 10.1016/j.joen.2021.03.015. PMID: 33811981
Cell-Based Regenerative Endodontics for Treatment of Periapical Lesions: A Randomized, Controlled Phase I/II Clinical Trial.
Brizuela C, Meza G, Urrejola D, Quezada MA, Concha G, Ramírez V, Angelopoulos I, Cadiz MI, Tapia-Limonchi R, Khoury M
J Dent Res 2020 May;99(5):523-529. Epub 2020 Mar 23 doi: 10.1177/0022034520913242. PMID: 32202965
Correlation between clinical and histologic pulp diagnoses.
Ricucci D, Loghin S, Siqueira JF Jr
J Endod 2014 Dec;40(12):1932-9. Epub 2014 Oct 12 doi: 10.1016/j.joen.2014.08.010. PMID: 25312886
Factors affecting the long-term results of endodontic treatment.
Sjogren U, Hagglund B, Sundqvist G, Wing K
J Endod 1990 Oct;16(10):498-504. doi: 10.1016/S0099-2399(07)80180-4. PMID: 2084204

Diagnosis

Current Management of Dens Evaginatus Teeth Based on Pulpal Diagnosis.
Lerdrungroj K, Banomyong D, Songtrakul K, Porkaew P, Nakornchai S
J Endod 2023 Oct;49(10):1230-1237. Epub 2023 Jul 26 doi: 10.1016/j.joen.2023.07.017. PMID: 37506764
Regenerative Endodontics by Cell Homing: A Review of Recent Clinical trials.
Yan H, De Deus G, Kristoffersen IM, Wiig E, Reseland JE, Johnsen GF, Silva EJNL, Haugen HJ
J Endod 2023 Jan;49(1):4-17. Epub 2022 Oct 18 doi: 10.1016/j.joen.2022.09.008. PMID: 36270575
Expert consensus on regenerative endodontic procedures.
Wei X, Yang M, Yue L, Huang D, Zhou X, Wang X, Zhang Q, Qiu L, Huang Z, Wang H, Meng L, Li H, Chen W, Zou X, Ling J
Int J Oral Sci 2022 Dec 1;14(1):55. doi: 10.1038/s41368-022-00206-z. PMID: 36450715Free PMC Article
Clinical Perspectives of Pulp Regeneration.
Schmalz G, Widbiller M, Galler KM
J Endod 2020 Sep;46(9S):S161-S174. doi: 10.1016/j.joen.2020.06.037. PMID: 32950188
Correlation between clinical and histologic pulp diagnoses.
Ricucci D, Loghin S, Siqueira JF Jr
J Endod 2014 Dec;40(12):1932-9. Epub 2014 Oct 12 doi: 10.1016/j.joen.2014.08.010. PMID: 25312886

Therapy

Lesion sterilization and tissue repair with chloramphenicol, tetracyline, zinc oxide/eugenol paste versus conventional pulpectomy: A 36-month randomized controlled trial.
Castro M, Lima M, Lima C, Moura M, Moura J, Moura L
Int J Paediatr Dent 2023 Jul;33(4):335-345. Epub 2023 Feb 12 doi: 10.1111/ipd.13056. PMID: 36719000
Deciduous Tooth Pulp Autotransplantation for the Regenerative Endodontic Treatment of Permanent Teeth With Pulp Necrosis: A Case Series.
Cehreli ZC, Unverdi GE, Ballikaya E
J Endod 2022 May;48(5):669-674. Epub 2022 Feb 1 doi: 10.1016/j.joen.2022.01.015. PMID: 35114270
LSTR Antibiotic Paste Versus Zinc Oxide and Eugenol Pulpectomy for the Treatment of Primary Molars with Pulp Necrosis: A Randomized Controlled Trial.
Moura J, Lima M, Nogueira N, Castro M, Lima C, Moura M, Moura L
Pediatr Dent 2021 Nov 15;43(6):435-442. PMID: 34937613
Regenerative Endodontic Procedures for the Treatment of Necrotic Mature Teeth with Apical Periodontitis: A Systematic Review and Meta-analysis of Randomized Controlled Trials.
Glynis A, Foschi F, Kefalou I, Koletsi D, Tzanetakis GN
J Endod 2021 Jun;47(6):873-882. Epub 2021 Mar 31 doi: 10.1016/j.joen.2021.03.015. PMID: 33811981
Single versus multiple visits for endodontic treatment of permanent teeth.
Manfredi M, Figini L, Gagliani M, Lodi G
Cochrane Database Syst Rev 2016 Dec 1;12(12):CD005296. doi: 10.1002/14651858.CD005296.pub3. PMID: 27905673Free PMC Article

Prognosis

Review of guidance for the selection of regenerative endodontics, apexogenesis, apexification, pulpotomy, and other endodontic treatments for immature permanent teeth.
Murray PE
Int Endod J 2023 Mar;56 Suppl 2:188-199. Epub 2022 Aug 15 doi: 10.1111/iej.13809. PMID: 35929348
Regenerative Endodontic Procedures for the Treatment of Necrotic Mature Teeth with Apical Periodontitis: A Systematic Review and Meta-analysis of Randomized Controlled Trials.
Glynis A, Foschi F, Kefalou I, Koletsi D, Tzanetakis GN
J Endod 2021 Jun;47(6):873-882. Epub 2021 Mar 31 doi: 10.1016/j.joen.2021.03.015. PMID: 33811981
Clinical Perspectives of Pulp Regeneration.
Schmalz G, Widbiller M, Galler KM
J Endod 2020 Sep;46(9S):S161-S174. doi: 10.1016/j.joen.2020.06.037. PMID: 32950188
Correlation between clinical and histologic pulp diagnoses.
Ricucci D, Loghin S, Siqueira JF Jr
J Endod 2014 Dec;40(12):1932-9. Epub 2014 Oct 12 doi: 10.1016/j.joen.2014.08.010. PMID: 25312886
Factors affecting the long-term results of endodontic treatment.
Sjogren U, Hagglund B, Sundqvist G, Wing K
J Endod 1990 Oct;16(10):498-504. doi: 10.1016/S0099-2399(07)80180-4. PMID: 2084204

Clinical prediction guides

Regenerative Endodontics by Cell Homing: A Review of Recent Clinical trials.
Yan H, De Deus G, Kristoffersen IM, Wiig E, Reseland JE, Johnsen GF, Silva EJNL, Haugen HJ
J Endod 2023 Jan;49(1):4-17. Epub 2022 Oct 18 doi: 10.1016/j.joen.2022.09.008. PMID: 36270575
Regenerative Endodontic Procedures for the Treatment of Necrotic Mature Teeth with Apical Periodontitis: A Systematic Review and Meta-analysis of Randomized Controlled Trials.
Glynis A, Foschi F, Kefalou I, Koletsi D, Tzanetakis GN
J Endod 2021 Jun;47(6):873-882. Epub 2021 Mar 31 doi: 10.1016/j.joen.2021.03.015. PMID: 33811981
Clinical Perspectives of Pulp Regeneration.
Schmalz G, Widbiller M, Galler KM
J Endod 2020 Sep;46(9S):S161-S174. doi: 10.1016/j.joen.2020.06.037. PMID: 32950188
Correlation between clinical and histologic pulp diagnoses.
Ricucci D, Loghin S, Siqueira JF Jr
J Endod 2014 Dec;40(12):1932-9. Epub 2014 Oct 12 doi: 10.1016/j.joen.2014.08.010. PMID: 25312886
Factors affecting the long-term results of endodontic treatment.
Sjogren U, Hagglund B, Sundqvist G, Wing K
J Endod 1990 Oct;16(10):498-504. doi: 10.1016/S0099-2399(07)80180-4. PMID: 2084204

Recent systematic reviews

Tissue Characteristics in Endodontic Regeneration: A Systematic Review.
Minic S, Vital S, Chaussain C, Boukpessi T, Mangione F
Int J Mol Sci 2022 Sep 11;23(18) doi: 10.3390/ijms231810534. PMID: 36142446Free PMC Article
Regenerative Endodontic Procedures for the Treatment of Necrotic Mature Teeth with Apical Periodontitis: A Systematic Review and Meta-analysis of Randomized Controlled Trials.
Glynis A, Foschi F, Kefalou I, Koletsi D, Tzanetakis GN
J Endod 2021 Jun;47(6):873-882. Epub 2021 Mar 31 doi: 10.1016/j.joen.2021.03.015. PMID: 33811981
What is the best long-term treatment modality for immature permanent teeth with pulp necrosis and apical periodontitis?
Wikström A, Brundin M, Lopes MF, El Sayed M, Tsilingaridis G
Eur Arch Paediatr Dent 2021 Jun;22(3):311-340. Epub 2021 Jan 8 doi: 10.1007/s40368-020-00575-1. PMID: 33420674Free PMC Article
Pulp Revascularization or Apexification for the Treatment of Immature Necrotic Permanent Teeth: Systematic Review and Meta-Analysis.
Nicoloso GF, Goldenfum GM, Pizzol TDSD, Scarparo RK, Montagner F, de Almeida Rodrigues J, Casagrande L
J Clin Pediatr Dent 2019;43(5):305-313. doi: 10.17796/1053-4625-43.5.1. PMID: 31560588
Single versus multiple visits for endodontic treatment of permanent teeth.
Manfredi M, Figini L, Gagliani M, Lodi G
Cochrane Database Syst Rev 2016 Dec 1;12(12):CD005296. doi: 10.1002/14651858.CD005296.pub3. PMID: 27905673Free PMC Article

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