[Evaluation of five dentistry procedures (3 reports) : atraumatic restorative treatment, therapeutic sealing, silver diamine fluoride application, preformed paediatric crown, therapeutic pulpotomy in mature permanent teeth]

Nahmias F, David DJ, Low E, Carbonneil C
Record ID 32018014888
French
Original Title: Évaluation d'actes d’odontologie conservatrice, coiffe pédodontique, pulpotomie thérapeutique
Authors' objectives: The evaluation aimed to provide the French national health insurance system with an opinion, on whether to include these procedures in the list of funded procedures, in line with the objectives of the 2023 dental agreement. Some of these procedures are less invasive than a conventional approach. This approach is more conservative and less traumatic for dental tissue. It also takes into account the specific needs of certain patients, such as the elderly, very young children, and those with disabilities.
Authors' results and conclusions: In general, the systematic reviews analysed for these procedures either demonstrated no significant differences in efficacy compared to standard treatments, or showed that standard treatments produced better results. No major adverse effects or complications associated with these procedures were reported in the literature. However, the certainty of the analysed data was low to very low due to a high risk of bias of the studies and small population sizes. The clinical practice guidelines analysed, however, included these procedures, which were based primarily on expert opinion.
Authors' recommendations: These five procedures have been approved by the French National Authority for Health (HAS) as valid treatments. Its assessment determined the indications and contexts of use, contraindications, materials to be used, surgical protocol and follow-up methods for each procedures. Four favourable opinions were issued for atraumatic restorative treatment, therapeutic sealing, the placement of preformed paediatric crowns, and therapeutic pulpotomy on mature permanent teeth. However, regarding the application of silver diamine fluoride (SDF), the HAS was unable to issue an opinion, as currently no SDF products authorised in France for stopping dental caries (medical device or medicinal product).
Authors' methods: The evaluation method consisted of : 1) A critical analysis of synthesised literature, including clinical practice guidelines and systematic reviews, was conducted using systematic searches and selection based on explicit criteria, 2) Gathering the collective of stakeholders on a draft assessment report containing the literature analysis and the conclusions, 3) Submitting a synthesis of these elements, to the HAS Board of Directors for validation.
Authors' identified further research: Providing funding for these procedures will encourage a more preventive approach to oral and dental healthcare, promoting the use of less invasive and less traumatic methods, particularly for vulnerable patients or those with limited access to dental care.
Details
Project Status: Completed
URL for project: https://www.has-sante.fr/jcms/p_3785074/fr/traitement-des-caries-dentaires-la-has-recommande-le-remboursement-de-4-actes
Year Published: 2025
URL for published report: https://www.has-sante.fr/jcms/p_3784577/fr/evaluation-d-actes-d-odontologie-conservatrice-coiffe-pedodontique-pulpotomie-therapeutique
Requestor: The national health insurance system ; patients ; dental surgeons, stomatologists
English language abstract: There is no English language summary available
Publication Type: Mini HTA
Country: France
MeSH Terms
  • Dental Care
  • Dental Prosthesis
  • Dental Pulp
  • Dental Restoration Repair
  • Dental Atraumatic Restorative Treatment
  • Dental Caries
  • Dental Caries Susceptibility
  • Fluorides, Topical
  • Cariostatic Agents
  • Crowns
  • Dental Restoration, Permanent
  • Pulpotomy
  • Adult
  • Child
  • Pit and Fissure Sealants
Keywords
  • Conservative dentistry
  • non invasive dentistry
  • minimally invasive dentistry
  • temporisation
  • paediatric dentistry
  • endodontics
Contact
Organisation Name: Haute Autorité de Santé
Contact Address: 2 avenue du Stade de France, 93218 Saint-Denis La Plaine Cedex, France. Tel: +33 01 55 93 71 88; Fax: +33 01 55 93 74 35;
Contact Name: has.seap.secretariat@has-sante.fr
Contact Email: has.seap.secretariat@has-sante.fr
Copyright: <p>Haute Autorite de Sante/French National Authority for Health (HAS)</p>
This is a bibliographic record of a published health technology assessment from a member of INAHTA or other HTA producer. No evaluation of the quality of this assessment has been made for the HTA database.