Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

175 questions · 227 findings · 24 reviews · Dental caries

No studies found 3 · 1.3%GRADE not reported 170 · 74.9%Very low 25 · 11%Low 15 · 6.6%Moderate 12 · 5.3%High 2 · 0.9%

Selective carious tissue removal (selective excavation, SE) vs Non-selective or complete carious tissue removal

Pulp exposure during caries removal · Children (3-11 years) with symptomless, vital dentine caries in primary molars

Partial caries removal reduced the reported risk of pulp exposure versus complete caries removal in primary teeth (RR 0.24; ungraded).

1 finding from 1 review

Fluoride-containing dental care products (mainly fluoride toothpaste) vs Dietary fluoride sources (drinking water, beverages, food)

Contribution of dental care products to total fluoride exposure · Pregnant and lactating women

No study has explored the contribution of dental care products to total fluoride exposure in pregnant and lactating women.

1 finding from 1 review

Partial caries removal (single stage; residual dentinal caries sealed into the tooth definitively) vs Complete caries removal

Pulp exposure during caries removal · Patients with carious teeth, affecting any tooth surface(s), in unrestored primary and permanent teeth

Partial caries removal (single stage; residual dentinal caries… probably leads to lower pulp exposure during caries removal compared with complete caries removal (moderate certainty).

1 finding from 1 review

Stepwise excavation (two-stage caries removal, re-entry after an interval) vs Complete caries removal

Pulp exposure during caries removal · Patients with carious teeth, affecting any tooth surface(s), in unrestored primary and permanent teeth

Stepwise excavation (two-stage caries removal, re-entry after an… probably leads to lower pulp exposure during caries removal compared with one stage complete caries removal (moderate certainty).

3 findings from 1 review

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

Overall success (composite of clinical and radiographic success) · Permanent teeth with carious pulp exposure

In partial pulpotomy, MTA had significantly higher success than calcium hydroxide (OR 2.81; ungraded).

5 findings from 2 reviews · compare the 2 reviews
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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

Higher drinking-water fluoride exposure vs Null / lowest drinking-water fluoride exposure (reference)

Spine bone mineral density · Females (all ages)

Among females in low-to-moderate-risk-of-bias studies, the reported spine-BMD estimate above 2.35 mg/L water fluoride was MD 0.07 g/cm2 (95% CI 0.11 to 0.24; ungraded).

2 findings from 1 review

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 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

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

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 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 (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

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 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

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 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 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

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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