Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

232 questions · 289 findings · 30 reviews · All outcomes

No studies found 26 · 9%GRADE not reported 199 · 68.9%Very low 33 · 11.4%Low 17 · 5.9%Moderate 12 · 4.2%High 2 · 0.7%

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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Full pulpotomy vs Partial pulpotomy

Overall success (composite of clinical and radiographic success) · Human permanent teeth with symptomatic irreversible pulpitis due to carious pulp exposure

Full pulpotomy showed a non-significant trend toward higher success than partial pulpotomy in mature teeth with irreversible pulpitis (ungraded).

1 finding from 1 review

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

Pulpotomy (full or partial) vs Pulpectomy

Tooth survival · Children with carious vital pulp exposure in primary incisors

Tooth survival was reported narratively in two trials and was not pooled.

1 finding from 1 review

Pulpotomy (full or partial) vs Pulpectomy

Pathological periapical radiolucency · Children with carious vital pulp exposure in primary incisors

Two trials reported periapical radiolucency but results were not pooled owing to considerable heterogeneity.

1 finding from 1 review

Pulpotomy (full or partial) vs Pulpectomy

Clinical failure · Children with carious vital pulp exposure in primary incisors

Pulpotomy may not differ from pulpectomy for clinical failure; no GRADE rating was reported.

1 finding from 1 review

Pulpotomy (full or partial) vs Pulpectomy

Soft tissue pathology · Children with carious vital pulp exposure in primary incisors

No statistically significant difference in soft tissue pathology between pulpotomy and pulpectomy (RR 3.11, 95% CI 0.54 to 17.7; ungraded).

1 finding from 1 review

Pulpotomy (full or partial) vs Pulpectomy

Pathological mobility · Children with carious vital pulp exposure in primary incisors

Pathological mobility was rare (one tooth in one of four trials) and was not pooled.

1 finding from 1 review

Pulpotomy (full or partial) vs Pulpectomy

Pathological root resorption · Children with carious vital pulp exposure in primary incisors

No statistically significant difference in pathological root resorption between pulpotomy and pulpectomy (RR 1.5, 95% CI 0.56 to 4.04; ungraded).

1 finding from 1 review