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What do systematic reviews say?

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Evidence found and GRADE certainty

27 questions · 44 findings · 4 reviews · Endodontics and dental trauma

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

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 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

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

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

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
Show 1 more finding

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

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 closed (mature) root apex due to carious pulp exposure

In closed-apex teeth, pooled pulpotomy success was 83% (95% CI 69-91%); significantly lower than open apex (z=2.33, p=0.02); 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 symptomatic irreversible pulpitis due to carious pulp exposure

In symptomatic irreversible pulpitis, pooled pulpotomy success was 84% (95% CI 72-92%); not significantly different from asymptomatic (z=-1.34, p=0.18); ungraded.

1 finding from 1 review

Partial pulpotomy (PP) with calcium hydroxide vs No comparator

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 calcium hydroxide had a pooled success rate of 34.3%.

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 immediate (same-visit) permanent restoration vs No comparator

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

Immediate permanent restoration was associated with a pooled success rate of 89.9%.

1 finding from 1 review

Partial pulpotomy with permanent restoration after 7-14 days vs No comparator

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

Permanent restoration after 7-14 days was associated with a pooled success rate of 73.6%.

1 finding from 1 review