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Evidence found and GRADE certainty

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

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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%

Pulp-status assessment method

Pulp necrosis · Vital teeth

The pooled incidence with radiographic assessment was 4.95%.

2 findings from 1 review

Biodentine vs Mineral trioxide aggregate (MTA)

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

MTA and Biodentine performed comparably for clinical and radiographic success (5 RCTs, not pooled; ungraded).

1 finding from 1 review

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

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

MTA increases clinical and radiographic success versus CH in mature teeth (moderate certainty).

1 finding from 1 review

Selective caries removal (SCR) + composite resin vs Complete caries removal (CCR) + composite resin

Restoration failure · Children with carious primary teeth after vital or non-vital pulp therapy

In one RCT, selective caries removal had a 3.44 higher probability of failure than complete caries removal.

1 finding from 1 review

Composite strip crowns with composite, fiber, or reverse metal posts vs Alternative post type

Restoration failure · Children with carious primary teeth after vital or non-vital pulp therapy

In one RCT, composite strip crowns with composite posts had an annual failure rate of 2.3% after 1 year.

1 finding from 1 review

Resin-modified glass-ionomer cement (RMGIC) restoration vs Amalgam, compomer, composite resin, or glass carbomer

Treatment failure (annual failure rate) · Children with previously unrestored, vital carious lesions in primary teeth (no pulp therapy); aged 1.5-11 years

RMGIC had an annual failure rate of 1.9-16.9% (4 RCTs), lower than amalgam and similar to compomer/composite; low quality of evidence (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 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 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

Compomer (C) vs Resin composite restoration

Treatment failure (annual failure rate) · Children with carious primary molars treated by pulpotomy (vital pulp therapy)

Compomer restorations had an annual failure rate of 8.9% in primary molars after pulpotomy, higher than composite resin in the same trial (single high-risk-of-bias RCT; low quality of evidence; not GRADE-rated).

2 findings from 1 review

Composite resin vs Light-cured compomer (polyacid-modified composite resin)

Restoration failure · Children with carious primary teeth after vital or non-vital pulp therapy

In one RCT, composite resin had an annual failure rate of 0% after 2 years.

1 finding from 1 review

Composite resin with etch-and-rinse (total-etch) adhesion vs Composite resin with self-etch adhesion (same universal adhesive)

Treatment failure (annual failure rate) · Children with moderately deep dentine caries in primary molars, no pulp therapy

Etch-and-rinse adhesion failed more than self-etch (19.5% vs 7.0% annual failure) in one RCT; low quality of evidence (ungraded).

1 finding from 1 review

Amalgam restoration vs Composite resin, compomer, conventional glass-ionomer cement, or resin-modified GIC (head-to-head RCT comparators)

Treatment failure (annual failure rate) · Children with previously unrestored, vital carious lesions in primary teeth (no pulp therapy); aged 1.5-11 years

Amalgam restorations in primary teeth showed a wide annual failure rate (1-28%) across 4 RCTs; the evidence is of low quality (high risk of bias; ungraded).

1 finding from 1 review

Composite strip crown (CSC) with a post (microhybrid composite resin, Amelogen) vs Post type: composite post (CP) vs fibre post (FP) vs reverse metal post (RMP)

Treatment failure (annual failure rate) · Children with severely decayed maxillary primary incisors treated by pulpectomy (non-vital pulp therapy)

Composite strip crowns with composite posts had a low annual failure rate (2.3%) in maxillary primary incisors after pulpectomy (single high-risk-of-bias RCT; low quality of evidence; not GRADE-rated).

3 findings from 1 review