What do systematic reviews say?

Calcium hydroxide (CH) vs Zinc oxide and eugenol (ZOE)

Calcium hydroxide (CH) showed no clear difference in radiological failure compared with zinc oxide and eugenol (ZOE) (low certainty).

• Pulp treatment for extensive decay in primary teeth 2018 · Cochrane All outcomes

  6 months
  RR 2.50 [0.50, 12.50]
  2 studies · 110 participants
  Low

Endoflas (CH + ZOE + iodoform) vs Zinc oxide and eugenol (ZOE)

Endoflas (CH + ZOE + iodoform) showed no clear difference in radiological failure compared with zinc oxide and eugenol (ZOE) (moderate certainty).

• Pulp treatment for extensive decay in primary teeth 2018 · Cochrane All outcomes

  6 months
  RR 0.26 [0.05, 1.50]
  2 studies · 80 participants
  Moderate

Metapex (calcium hydroxide/iodoform) vs Zinc oxide and eugenol (ZOE)

Metapex (calcium hydroxide/iodoform) showed no clear difference in radiological failure compared with zinc oxide and eugenol (ZOE) (moderate certainty).

• Pulp treatment for extensive decay in primary teeth 2018 · Cochrane All outcomes

  12 months
  RR 1.00 [0.31, 3.27]
  2 studies · 62 participants
  Moderate

Metapex (calcium hydroxide/iodoform) vs Zinc oxide and propolis (ZOP)

Metapex (calcium hydroxide/iodoform) showed no clear difference in radiological failure compared with zinc oxide and propolis (ZOP); GRADE not reported.

• Pulp treatment for extensive decay in primary teeth 2018 · Cochrane All outcomes

  12 months
  RR 0.80 [0.26, 2.45]
  1 study · 32 participants
  GRADE not reported

Acetone-based total-etch adhesive vs Calcium hydroxide (CH)

• Pulp treatment for extensive decay in primary teeth 2018 · Cochrane All outcomes

  up to 24 months
  No radiological failure in any participant; not estimable
  1 study · 40 participants
  GRADE not reported

Sealapex (eugenol-free calcium hydroxide) vs Calcium hydroxide (CH)

Sealapex (eugenol-free calcium hydroxide) showed no clear difference in radiological failure compared with calcium hydroxide (CH); GRADE not reported.

• Pulp treatment for extensive decay in primary teeth 2018 · Cochrane All outcomes

  6 and 12 months
  RR 0.50 [0.10, 2.43]
  1 study · 40 participants
  GRADE not reported

Low‐level laser therapy vs Formocresol (FC)

Low-level laser therapy (LLLT) showed no clear difference in radiological failure compared with formocresol (FC); GRADE not reported.

• Pulp treatment for extensive decay in primary teeth 2018 · Cochrane All outcomes

  6 and 12 months
  RR 7.00 [0.39, 124.83]
  1 study · 30 participants
  GRADE not reported

Aloe vera vs Mineral trioxide aggregate (MTA)

Aloe vera led to higher radiological failure compared with mineral trioxide aggregate (MTA); GRADE not reported.

• Pulp treatment for extensive decay in primary teeth 2018 · Cochrane All outcomes

  6 and 12 months
  RR 28.00 [4.07, 192.79]
  1 study · 60 participants
  GRADE not reported

Portland cement (PC) vs Full strength formocresol (FC)

Portland cement (PC) showed no clear difference in radiological failure compared with full strength formocresol (FC); GRADE not reported.

• Pulp treatment for extensive decay in primary teeth 2018 · Cochrane All outcomes

  24 months
  RR 0.80 [0.23, 2.73]
  1 study · 70 participants
  GRADE not reported

Total-etching 36% phosphoric acid + acetone-based total-etch adhesive vs Non-rinse conditioner + acetone-based total-etch adhesive

It is very uncertain whether total-etching 36% phosphoric acid + acetone-based total-etch adhesive changes radiological failure compared with non-rinse conditioner + acetone-based total-etch adhesive (very low certainty).

• Pulp treatment for extensive decay in primary teeth 2018 · Cochrane All outcomes

  24 months
  RR 7.00 [0.38, 127.33]
  1 study · 40 participants
  Very low

Mineral trioxide aggregate (MTA) vs Mineral trioxide aggregate (MTA) + sodium hypochlorite (NaOCl)

Mineral trioxide aggregate (MTA) showed no clear difference in radiological failure compared with mineral trioxide aggregate (MTA) + sodium hypochlorite (NaOCl); GRADE not reported.

• Pulp treatment for extensive decay in primary teeth 2018 · Cochrane All outcomes

  6 and 12 months
  RR 0.33 [0.01, 7.88]
  1 study · 62 participants
  GRADE not reported

Mineral trioxide aggregate (MTA) vs Ferric sulphate (FS)

Mineral trioxide aggregate (MTA) showed no clear difference in radiological failure compared with ferric sulphate (FS) (low certainty).

• Pulp treatment for extensive decay in primary teeth 2018 · Cochrane All outcomes

  24 months
  RR 0.58 [0.25, 1.36]
  3 studies · 130 participants
  Low

Calcium hydroxide + sodium hypochlorite (NaOCl) vs Calcium hydroxide (CH)

Calcium hydroxide + sodium hypochlorite (NaOCl) showed no clear difference in radiological failure compared with calcium hydroxide (CH); GRADE not reported.

• Pulp treatment for extensive decay in primary teeth 2018 · Cochrane All outcomes

  12 months
  RR 0.63 [0.23, 1.70]
  1 study · 62 participants
  GRADE not reported

Self-etch adhesive + acetone-based total-etch adhesive vs Total-etching 36% phosphoric acid + acetone-based total-etch adhesive

It is very uncertain whether self-etch adhesive + acetone-based total-etch adhesive changes radiological failure compared with total-etching 36% phosphoric acid + acetone-based total-etch adhesive (very low certainty).

• Pulp treatment for extensive decay in primary teeth 2018 · Cochrane All outcomes

  24 months
  RR 0.33 [0.04, 2.94]
  1 study · 40 participants
  Very low

Sodium hypochlorite (NaOCl) vs 1:5 diluted formocresol (FC)

Sodium hypochlorite (NaOCl) showed no clear difference in radiological failure compared with 1:5 diluted formocresol (FC); GRADE not reported.

• Pulp treatment for extensive decay in primary teeth 2018 · Cochrane All outcomes

  12 months
  RR 1.86 [0.52, 6.59]
  2 studies · 150 participants
  GRADE not reported

Calcium hydroxide cement (Dycal) vs Calcium sulphate hemihydrate (DentoGen)

It is very uncertain whether calcium hydroxide cement (Dycal) changes radiological failure compared with calcium sulphate hemihydrate (DentoGen) (very low certainty).

• Pulp treatment for extensive decay in primary teeth 2018 · Cochrane All outcomes

  12 months
  RR 1.67 [0.46, 6.06]
  1 study · 40 participants
  Very low

Zinc oxide and eugenol (ZOE) vs Formocresol (FC)

Zinc oxide and eugenol (ZOE) showed no clear difference in radiological failure compared with formocresol (FC); GRADE not reported.

• Pulp treatment for extensive decay in primary teeth 2018 · Cochrane All outcomes

  24 months
  RR 1.67 [0.71, 3.89]
  1 study · 50 participants
  GRADE not reported

Diode laser vs electrosurgery

Diode laser showed no clear difference in radiological failure compared with electrosurgery (low certainty).

• Pulp treatment for extensive decay in primary teeth 2018 · Cochrane All outcomes

  6 months
  RR 0.64 [0.19, 2.18]
  2 studies · 50 participants
  Low

Non-rinse conditioner + acetone-based total-etch adhesive vs Acetone-based total-etch adhesive

It is very uncertain whether non-rinse conditioner + acetone-based total-etch adhesive changes radiological failure compared with acetone-based total-etch adhesive (very low certainty).

• Pulp treatment for extensive decay in primary teeth 2018 · Cochrane All outcomes

  12 and 24 months
  RR 3.00 [0.13, 69.52]
  1 study · 40 participants
  Very low