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What do systematic reviews say?

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Evidence found and GRADE certainty

175 questions · 246 findings · 11 reviews · Endodontics and dental trauma

No studies found 7 · 2.8%GRADE not reported 216 · 87.8%Very low 8 · 3.3%Low 9 · 3.7%Moderate 5 · 2%High 1 · 0.4%

Platelet-rich fibrin (PRF) graft vs Calcium hydroxide (CH)

Overall success (composite of clinical and radiographic success) · Mature permanent teeth with irreversible pulpitis and carious pulp exposure (treated with full pulpotomy)

Platelet-rich fibrin and calcium hydroxide showed no significant difference in success (ungraded; effect size not reported).

1 finding from 1 review

Indirect restorations (crowns, fixed partial dentures, inlays/onlays/veneers) vs None (single-group incidence)

Pulp necrosis · Vital teeth restored with indirect restorations

Pulp necrosis incidence among treated by prosthodontists was 1.87% (subgroup analysis; not GRADE-rated).

23 findings from 1 review
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Tooth location

Pulp necrosis · Vital teeth

One study reported a 7.1% incidence in mandibular posterior teeth.

8 findings from 1 review
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Mineral trioxide aggregate (MTA) vs Calcium hydroxide (CH)

Overall success (composite of clinical and radiographic success) · Patients with carious pulp exposure in permanent teeth undergoing pulpotomy

The effect of MTA versus CH after pulpotomy is uncertain (low certainty).

1 finding from 1 review

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

Overall success (composite of clinical and radiographic success) · Patients with carious pulp exposure in immature permanent teeth undergoing pulpotomy

The two trials of PRF versus MTA for success gave contradictory results and were not pooled (ungraded).

1 finding from 1 review

Indirect restoration placement by undergraduate students vs None (single-group incidence)

Pulp necrosis · Vital teeth

The pooled incidence with undergraduate students was 5.68%.

2 findings from 1 review

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

Overall success (composite of clinical and radiographic success) · Patients with carious pulp exposure in permanent teeth undergoing pulpotomy

MTA and CEM performed comparably for clinical and radiographic success (2 RCTs, not pooled; ungraded).

1 finding from 1 review

Pre-operative caries fillings or crowns vs Intact teeth

Pulp necrosis · Vital teeth

One study reported a 13% incidence in teeth with pre-operative caries fillings or crowns.

2 findings from 1 review