Success of endodontic management of compromised first permanent molars in children: A systematic review

Background: Endodontic therapies may be required in the management of compromised first permanent molar teeth; their success in children, however, is unknown. Aim: To determine the success of endodontic therapies used on first permanent molar teeth in children aged sixteen and under. Design: MEDLINE, Embase, Cochrane library, CENTRAL, Clinicaltrials.gov, and the ISRCTN registry as well as relevant paediatric, endodontic, and traumatology journal were searched using a detailed search strategy. References of included studies were hand-searched. A PICOS question was formulated: (P): children aged sixteen and under; (I): endodontic therapies (not pulp capping) on a first permanent molar tooth; (C): no treatment; (O): clinical success of endodontic therapy; and (S): all study types included. Bias was assessed using the Cochrane and Robins-I risk tools. Quality of evidence was assessed using the GRADE approach. Significant heterogeneity precluded meta-analysis. Results: 4172 studies were retrieved and eleven were included in the narrative review. Partial and coronal pulpotomies have high success rates in the short term and long term. Limited evidence is available for conventional pulpectomy or regenerative techniques. Conclusions: Partial and coronal pulpotomies are successful endodontic therapies for use in a compromised child's first permanent molar.