Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

27 questions · 44 findings · 4 reviews · Oral Health

No studies found 3 · 6.8%GRADE not reported 36 · 81.8%Very low 4 · 9.1%Low 0 · 0%Moderate 0 · 0%High 1 · 2.3%

Partial pulpotomy vs Full (complete) pulpotomy

Pulp sensibility (EPT/cold response) · Mature permanent (molar) teeth with deep caries and symptoms indicative of irreversible pulpitis (spontaneous pain)

Pulp sensibility (EPT/cold) responses at 1 year were more frequent after partial than full pulpotomy (single RCT; ungraded).

1 finding from 1 review

Partial pulpotomy vs Full (complete) pulpotomy

Postoperative analgesic use · Mature permanent (molar) teeth with deep caries and symptoms indicative of irreversible pulpitis (spontaneous pain)

Postoperative analgesic use was similar or lower with full pulpotomy; one RCT reported significantly less analgesic use after full pulpotomy (ungraded).

1 finding from 1 review

Partial pulpotomy vs Full (complete) pulpotomy

Radiographic hard-tissue (dentine) barrier formation · Mature permanent (molar) teeth with deep caries and symptoms indicative of irreversible pulpitis (spontaneous pain)

Radiographic hard-tissue barrier formation did not differ significantly between partial and full pulpotomy (single RCT; ungraded).

1 finding from 1 review

Partial pulpotomy vs Full (complete) pulpotomy

Oral health-related quality of life · Mature permanent (molar) teeth with deep caries and symptoms indicative of irreversible pulpitis (spontaneous pain)

No included study reported oral health-related quality of life (a planned outcome), so no evidence is available.

1 finding from 1 review

Partial pulpotomy vs Full (complete) pulpotomy

Postoperative pain (VAS) · Mature permanent (molar) teeth with deep caries and symptoms indicative of irreversible pulpitis (spontaneous pain)

Postoperative pain was similar between partial and full pulpotomy in one RCT but significantly greater after partial pulpotomy in the other (ungraded).

1 finding from 1 review

Partial pulpotomy vs Full (complete) pulpotomy

Overall success (composite of clinical and radiographic success) · Mature permanent (molar) teeth with deep caries and symptoms indicative of irreversible pulpitis (spontaneous pain)

Within two high-quality RCTs, partial and full pulpotomy achieved similar 1-year clinical/radiographic success for irreversible pulpitis (pooled 83% vs 90%), with no significant difference (high certainty).

1 finding from 1 review

Partial pulpotomy vs Full (complete) pulpotomy

Patient- and clinical-reported outcomes (tooth survival, clinical/radiographic success, pain) · Permanent teeth with deep caries and reversible pulpitis (non-spontaneous pain)

No studies compared partial versus full pulpotomy in permanent teeth with reversible pulpitis (non-spontaneous pain), so no evidence is available.

1 finding from 1 review

Partial pulpotomy vs Full (complete) pulpotomy

Patient- and clinical-reported outcomes (tooth survival, clinical/radiographic success, pain) · Asymptomatic permanent teeth with deep caries (no symptoms)

No studies compared partial versus full pulpotomy in asymptomatic permanent teeth with deep caries, so no evidence is available.

1 finding from 1 review

Partial pulpotomy (PP) with calcium hydroxide vs Direct pulp capping (DPC) with calcium hydroxide

Overall success (composite of clinical and radiographic success) · Adults (>=18 y) with mature permanent teeth, carious exposure and normal/reversibly inflamed pulp

At 1 year, partial pulpotomy and direct pulp capping (both calcium hydroxide) gave similarly low success in reversibly inflamed pulps (34.5% vs 31.8%; ungraded, single trial).

2 findings from 1 review

Partial pulpotomy with one-unit longer follow-up vs Partial pulpotomy with one-unit shorter follow-up

Overall success (composite of clinical and radiographic success) · Adults aged 18 years or older with mature permanent teeth and carious pulp exposure

In the high-risk-study-excluded sensitivity meta-regression, longer follow-up was associated with lower success.

1 finding from 1 review

Partial pulpotomy with tri-calcium silicate material (MTA or Biodentine) vs Partial pulpotomy with calcium hydroxide

Overall success (composite of clinical and radiographic success) · Adults aged 18 years or older with mature permanent teeth and carious pulp exposure

Partial pulpotomy with tri-calcium silicate cements (MTA/Biodentine) has a much higher success rate than with calcium hydroxide in adults (86.8% vs 34.3%; ungraded).

2 findings from 1 review

Partial pulpotomy with sodium hypochlorite (NaOCl) hemostatic agent vs Partial pulpotomy without NaOCl / alternative hemostatic agent

Overall success (composite of clinical and radiographic success) · Adults (>=18 y) with mature permanent teeth and deep carious pulp exposure

Using NaOCl during partial pulpotomy is associated with borderline-higher success, independent of concentration (ungraded, exploratory).

1 finding from 1 review

Partial pulpotomy with immediate (same-visit) permanent restoration vs Partial pulpotomy with delayed permanent restoration (7-14 days or >14 days)

Overall success (composite of clinical and radiographic success) · Adults (>=18 y) with mature permanent teeth and deep carious pulp exposure

Immediate permanent restoration after partial pulpotomy is associated with much higher success than delayed restoration (89.9% immediate vs 23.2% beyond 14 days; ungraded).

1 finding from 1 review

Partial pulpotomy with one additional day before permanent restoration vs Partial pulpotomy with one fewer day before permanent restoration

Overall success (composite of clinical and radiographic success) · Adults aged 18 years or older with mature permanent teeth and carious pulp exposure

Each additional day before permanent restoration was associated with a 0.088% decrease in success in meta-regression.

1 finding from 1 review

Restricted partial pulpotomy (pulp removal 2-3 mm from exposure site only) vs Extended partial pulpotomy (pulp removal 2-3 mm from entire pulp chamber with complete deroofing)

Overall success (composite of clinical and radiographic success) · Adults (18-45 y) with mature permanent molars, carious exposure and symptomatic irreversible pulpitis

Restricting the lateral extent of partial pulpotomy gives success equivalent to more extensive amputation (97.6% vs 97.5%, p>0.05; ungraded, single trial).

1 finding from 1 review

Restricted partial pulpotomy (pulp removal 2-3 mm from exposure site only) vs Extended partial pulpotomy (pulp removal 2-3 mm from entire pulp chamber with complete deroofing)

Postoperative pain and analgesic intake · Adults (18-45 y) with mature permanent molars, carious exposure and symptomatic irreversible pulpitis

Restricted partial pulpotomy causes less early postoperative pain and analgesic use than extended amputation (p<0.05; ungraded, single trial).

1 finding from 1 review

Pulpotomy (full or partial) vs None (single-arm success proportion)

Overall success (composite of clinical and radiographic success) · Permanent teeth with carious pulp exposure

Hemostasis within 6 min gave the highest success (90.4%), but the difference across hemostasis-time groups was not significant (ungraded).

13 findings from 1 review
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Pulpotomy (full or partial) vs None (single-arm pooled success proportion)

Overall success (composite of clinical and radiographic success) · Human permanent teeth with irreversible pulpitis due to carious pulp exposure

Among 6 observational studies, pooled pulpotomy success was 92.6 per 100 (95% CI 0.86-0.96), very low certainty.

4 findings from 1 review
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Pulpotomy (full or partial) vs None (single-arm pooled success proportion)

Overall success (composite of clinical and radiographic success) · Human permanent teeth with asymptomatic irreversible pulpitis due to carious pulp exposure

In asymptomatic irreversible pulpitis, pooled pulpotomy success was 91.3% (95% CI 80-96.5%); ungraded.

1 finding from 1 review

Pulpotomy (full or partial) vs None (single-arm pooled success proportion)

Overall success (composite of clinical and radiographic success) · Human permanent teeth with irreversible pulpitis and open (immature) root apex due to carious pulp exposure

In open-apex teeth, pooled pulpotomy success was 95.8% (95% CI 81-99%); significantly higher than closed apex (z=2.33, p=0.02); ungraded.

1 finding from 1 review