Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

79 questions · 103 findings · 7 reviews

No studies found 2 · 1.9%GRADE not reported 81 · 78.6%Very low 8 · 7.8%Low 6 · 5.8%Moderate 5 · 4.9%High 1 · 1%

Full pulpotomy vs Partial pulpotomy

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

The three-study meta-analysis found no significant difference between full and partial pulpotomy after 1 year.

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 (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

Full pulpotomy vs Partial pulpotomy

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

Full pulpotomy showed a non-significant trend toward higher success than partial pulpotomy in mature teeth with irreversible pulpitis (ungraded).

1 finding from 1 review

Pulpotomy with Biodentine vs Pulpotomy with Calcium Enriched Mixture (CEM)

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

Biodentine had a significantly higher pulpotomy success rate than CEM (indirect comparison; numeric estimate not available); ungraded.

1 finding from 1 review

Pulpotomy with Biodentine vs Pulpotomy with calcium hydroxide (Ca(OH)2)

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

Biodentine had a significantly higher pulpotomy success rate than calcium hydroxide (indirect comparison; numeric estimate not available); ungraded.

1 finding from 1 review

Pulpotomy with Biodentine vs Pulpotomy with mineral trioxide aggregate (MTA)

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

Biodentine had a significantly higher pulpotomy success rate than MTA (indirect comparison; numeric estimate not available); ungraded.

1 finding from 1 review

Pulpotomy with Calcium Enriched Mixture (CEM) vs Pulpotomy with calcium hydroxide (Ca(OH)2)

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

CEM and calcium hydroxide did not differ significantly in pulpotomy success (indirect comparison); ungraded.

1 finding from 1 review

Pulpotomy with mineral trioxide aggregate (MTA) vs Pulpotomy with Calcium Enriched Mixture (CEM)

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

MTA and CEM did not differ significantly in pulpotomy success (indirect comparison); ungraded.

1 finding from 1 review

Pulpotomy with mineral trioxide aggregate (MTA) vs Pulpotomy with calcium hydroxide (Ca(OH)2)

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

MTA had a significantly higher pulpotomy success rate than calcium hydroxide (indirect comparison; numeric estimate not available); ungraded.

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

Mineral trioxide aggregate (MTA) pulpotomy dressing vs Platelet-rich fibrin (PRF)

Overall success (composite of clinical and radiographic success) · Immature (young) permanent teeth with open apex and vital pulp exposed to dental caries or trauma, in children aged 6-14 years

A single RCT found no difference in pulpotomy success between MTA and platelet-rich fibrin (both 100% through 24 months; not pooled; ungraded).

1 finding from 1 review

Mineral trioxide aggregate (MTA) pulpotomy dressing vs Calcium hydroxide (CH)

Overall success (composite of clinical and radiographic success) · Immature (young) permanent teeth with open apex and vital pulp exposed to dental caries or trauma, in children aged 6-14 years

MTA and calcium hydroxide had similar clinical and radiographic pulpotomy success at 6 months (RR 1.00, 95% CI 0.94 to 1.06; 2 RCTs; ungraded).

2 findings from 1 review

Mineral trioxide aggregate (MTA) pulpotomy dressing vs Calcium-enriched mixture (CEM)

Overall success (composite of clinical and radiographic success) · Immature (young) permanent teeth with open apex and vital pulp exposed to dental caries or trauma, in children aged 6-14 years

A single RCT found no difference in pulpotomy success between MTA and calcium-enriched mixture (both 100% at 6 and 12 months; not pooled; ungraded).

1 finding from 1 review