A systematic review of outcome measures used in clinical trials of treatment interventions following traumatic dental injuries

Background: Traumatic dental injuries (TDI) are common, andappropriate treatment will maximize the chances of maintaining teeth infunction while safeguarding their longevity and aesthetics. Subjectively, itappears that outcome measures used in studies investigating TDI arenumerous and diverse. Objectives: To undertake a systematic review ofthe outcomes used in clinical trials of treatment interventions followingTDI. Data sources: The MEDLINE, Cochrane Central Register of Con-trolled Trials, Cochrane Database of Systematic Reviews and EMBASEdatabases were searched up to June 2014. Reference lists of eligible studieswere cross-checked to identify additional studies and strategies to identifygrey literature and ongoing trials were employed. Study selection: Twoauthors independently assessed studies for inclusion and undertook dataextraction. The study designs included were as follows: systematic reviewswith/without meta-analyses, randomized and pseudo-randomized con-trolled trials and controlled clinical trials. There were no language restric-tions. Results: Ten studies confined to two types of TDI were included:avulsion (5) and non-vital immature permanent incisor teeth (5). The out-comes reported predominantly concentrated on injury activity and thephysical consequence of injury. There was little consistency between studiesfor the length of follow up, the time points at which outcomes were evalu-ated or the methods used to measure them. Conclusions: There is signifi-cant heterogeneity in outcomes reported for TDI in the literature. Thesefindings preclude meaningful meta-analysis between studies. Future clinicalstudies need to consider collecting a more consistent and wider range ofoutcomes, which should include one or more from each of the followingdomains: health resources utilisation, adverse effects and quality of life andfamily outcome. There is a clear need for the development of a Core Out-come Set for TDI using robust and established methodology, thus optimiz-ing the value of future research.