Pulp necrosis and crown discoloration: a systematic review and meta-analysis.

BACKGROUND: The association between pulp necrosis and crown discoloration in traumatized primary teeth has not been clearly determined yet.

AIM: The study verified whether there is an association of pulp necrosis and crown discoloration in traumatized primary teeth through a systematic review and meta-analysis.

METHODS: A systematic literature search was conducted in PubMed/Medline, Lilacs/BBO, Scopus, Web of Science, Cochrane Library databases, and grey literature. A methodological quality assessment appraisal was independently conducted by two researchers. Random-effects models were employed, and heterogeneity was tested (I2 index/P ≤ 0.05).

RESULTS: Eight studies with low risk of bias were included in the analysis. A total of 1,494 traumatized primary teeth participated in the pooled meta-analysis. Diagnosis of pulp necrosis was evaluated in 1,414 teeth through clinical and/or radiographic analyses, and the analysis demonstrated a positive association (P = 0.0005/OR 8.37 [2.51, 27.90], I2  = 87%). Eighty teeth were diagnosed with pulp necrosis through endodontic access, and there was no statistically significant association (P = 0.36/OR 2.46 [0.36, 16.94], I2  = 54%). The pooled meta-analysis showed a positive association (P = 0.0003/OR 5.93 [2.24, 15.72], I2  = 83%).

CONCLUSION: The positive association between pulp necrosis and crown discoloration should be considered with caution once the diagnosis of pulp necrosis was performed by limited criteria.