Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

480 questions · 559 findings · 16 reviews · Endodontics and dental trauma

No studies found 75 · 13.4%GRADE not reported 394 · 70.5%Very low 39 · 7%Low 36 · 6.4%Moderate 14 · 2.5%High 1 · 0.2%

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

Formocresol (FC) pulpotomy vs Calcium hydroxide pulpectomy

Outcome not reported · Children with extensive decay involving the dental pulp in primary teeth

The review found no eligible studies for this question.

1 finding from 1 review

Pulp-status assessment method

Pulp necrosis · Vital teeth

The pooled incidence with radiographic assessment was 4.95%.

2 findings from 1 review

Ferric sulphate (FS) + mineral trioxide aggregate (MTA) vs Zinc oxide and eugenol (ZOE) pulpectomy

Clinical failure · Children with extensive decay involving the dental pulp in primary teeth

Ferric sulphate/MTA pulpotomy showed no clear difference in clinical failure compared with zinc oxide and eugenol (ZOE) pulpectomy; GRADE not reported.

1 finding from 1 review

Ferric sulphate (FS) + mineral trioxide aggregate (MTA) vs Zinc oxide and eugenol (ZOE) pulpectomy

Radiological failure · Children with extensive decay involving the dental pulp in primary teeth

Ferric sulphate/MTA pulpotomy showed no clear difference in radiological failure compared with zinc oxide and eugenol (ZOE) pulpectomy; GRADE not reported.

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

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

Life (calcium hydroxide pulp-capping material) vs Dycal (calcium hydroxide pulp-capping material)

Clinical symptoms at 12 months · Adults (aged 20 to 60 years, mean 27) with deep carious lesions in permanent teeth (indirect or direct pulp capping, or complete caries…
3 findings from 1 review
  • Pulp management for caries in adults: maintaining pulp vitality 2007 · Cochrane All outcomes
    12 months · Complete caries removal
    Analysis 2.2 (clinical symptoms at 12 months following complete caries removal, Life vs Dycal). Fitzgerald 1991: 151 teeth in 55 patients (analysis at tooth level, not patient level); substantial attrition (11 teeth…
    1 study · 151 participants
    GRADE not reported
  • Pulp management for caries in adults: maintaining pulp vitality 2007 · Cochrane All outcomes
    12 months · Indirect pulp capping
    Analysis 2.1 (clinical symptoms at 12 months following indirect pulp capping, Life vs Dycal). Fitzgerald 1991: 151 teeth in 55 patients (analysis at tooth level, not patient level); substantial attrition (11 teeth lost…
    1 study · 151 participants
    GRADE not reported
  • Pulp management for caries in adults: maintaining pulp vitality 2007 · Cochrane All outcomes
    12 months · Direct pulp capping
    Analysis 2.3 (clinical symptoms at 12 months following direct pulp capping, Life vs Dycal). Fitzgerald 1991: 151 teeth in 55 patients (analysis at tooth level, not patient level); substantial attrition (11 teeth lost…
    1 study · 151 participants
    GRADE not reported

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 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

Ferric sulphate (FS)/zinc oxide and eugenol (ZOE) pulpotomy vs Sedanol (ZOE) pulpectomy

Radiological failure · Children with extensive decay involving the dental pulp in primary teeth

Ferric sulphate (FS)/zinc oxide and eugenol (ZOE) pulpotomy showed no clear difference in radiological failure compared with sedanol (ZOE) pulpectomy; GRADE not reported.

1 finding from 1 review

3Mix (ciprofloxacin + metronidazole + minocycline) pulpotomy vs 3Mix pulpectomy

Clinical failure · Children with extensive decay involving the dental pulp in primary teeth

3Mix (ciprofloxacin + metronidazole + minocycline) pulpotomy showed no clear difference in clinical failure compared with 3Mix pulpectomy; GRADE not reported.

1 finding from 1 review

3Mix (ciprofloxacin + metronidazole + minocycline) pulpotomy vs 3Mix pulpectomy

Radiological failure · Children with extensive decay involving the dental pulp in primary teeth

3Mix (ciprofloxacin + metronidazole + minocycline) pulpotomy showed no clear difference in radiological failure compared with 3Mix pulpectomy; GRADE not reported.

1 finding 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