Methods: Electronic search of scientific papers were carried out on Entrez Pubmed and the Cochrane central Register of Controlled Trials databases using specific keywords. The search yielded 128 papers; out of which 16 relevant papers were identified and included based on predetermined inclusion criteria and the remaining 112 were irrelevant. Hand search yielded 10 articles. These 26 articles which included only case reports and case series obtained from the search formed the basis of this systematic review.
Results: Studies included are case reports and case series with an evidence level of 4 based on the evidence pyramid given by centre for evidence based medicine. Only one animal study was included with an evidence level of 5.The level of evidence is low as no randomized controlled trials are present due to ethical issues involved in trauma management and the unpredictable patient presentation. Therefore in this systematic review we have worked to bring together all the available data to provide an evidence based approach of treating crown root fractures with surgical extrusion.
Conclusions: From the existing literature we can conclude that surgical extrusion can be used successfully to treat crown root fractures, but the level of evidence is very low as the studies present are only case reports and case series.