Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

678 questions · 854 findings · 51 reviews · Dental caries

No studies found 38 · 4.4%GRADE not reported 675 · 79%Very low 61 · 7.1%Low 47 · 5.5%Moderate 32 · 3.7%High 1 · 0.1%

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

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

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

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

Mineral trioxide aggregate (MTA) pulpotomy dressing vs Abscess remedy (AR)

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 higher pulpotomy success with MTA than abscess remedy (100% vs 80%; statistically significant, P<0.05; not pooled; ungraded).

1 finding from 1 review

Mineral trioxide aggregate (MTA) pulpotomy dressing vs Triple antibiotic paste (TAP)

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 3-arm RCT found no difference in pulpotomy success between MTA and triple antibiotic paste (both 100%; not pooled; ungraded).

1 finding 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

Ledermix (corticosteroid/antibiotic pulp-capping cement) vs Calcium hydroxide (CH)

Clinical success (survival free of symptoms) at 24 months · Adults with asymptomatic teeth with vital carious pulp exposures
1 finding from 1 review
  • Shovelton 1971 (Analysis 1.1): 275 teeth followed for 2 years (235 at 6 months, 160 at 12 months, 85 analysed at 24 months). Success rates 50% to 80%. Ledermix and calcium hydroxide had the highest success rates,…
    1 study · 275 participants
    GRADE not reported

Ledermix (corticosteroid/antibiotic pulp-capping cement) vs Glycerrhetinic acid/antibiotic mixture

Clinical success (survival free of symptoms) at 24 months · Adults with asymptomatic teeth with vital carious pulp exposures
1 finding from 1 review
  • Shovelton 1971 (Analysis 1.1): 275 teeth followed for 2 years (235 at 6 months, 160 at 12 months, 85 analysed at 24 months). Success rates 50% to 80%. Ledermix and calcium hydroxide had the highest success rates,…
    1 study · 275 participants
    GRADE not reported

Ledermix (corticosteroid/antibiotic pulp-capping cement) vs Zinc oxide and eugenol (ZOE)

Clinical success (survival free of symptoms) at 24 months · Adults with asymptomatic teeth with vital carious pulp exposures
1 finding from 1 review
  • Shovelton 1971 (Analysis 1.1): 275 teeth followed for 2 years (235 at 6 months, 160 at 12 months, 85 analysed at 24 months). Success rates 50% to 80%. Ledermix and calcium hydroxide had the highest success rates,…
    1 study · 275 participants
    GRADE not reported

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

Partial pulpotomy with permanent restoration after more than 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 more than 14 days was associated with a pooled success rate of 23.2%.

1 finding from 1 review

Partial pulpotomy with tri-calcium silicate material (MTA or Biodentine) 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 MTA or Biodentine had a pooled success rate of 86.8%.

1 finding from 1 review