Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

232 questions · 289 findings · 30 reviews · Oral Health

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%

Pulpotomy (full or partial) vs Pulpectomy

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

No statistically significant difference in radiographic failure between pulpotomy and pulpectomy in the main analysis (RR 0.79, 95% CI 0.25 to 2.42), with considerable heterogeneity (I2=76%; ungraded).

2 findings from 1 review

Pulpotomy (full or partial) vs Pulpectomy

Pain · Children with carious vital pulp exposure in primary incisors

No statistically significant difference in pain between pulpotomy and pulpectomy (RR 2.06, 95% CI 0.31 to 13.8; ungraded).

1 finding from 1 review

Pulpotomy (full or partial) vs Pulpectomy

Pulp canal obliteration · Children with carious vital pulp exposure in primary incisors

Pulp canal obliteration was reported narratively (mainly in the pulpotomy group) and was not pooled.

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 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

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

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

Dentin bridge formation · Patients with carious pulp exposure in permanent teeth undergoing partial pulpotomy

Evidence on dentin bridge formation for calcium hydroxide versus MTA is weak and imprecise, with no material shown superior (4 RCTs, not pooled; ungraded).

1 finding from 1 review

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

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

In immature teeth, the effect of MTA versus calcium hydroxide on success is very uncertain (OR 2.22, 95% CI 0.13-36.67; very low certainty).

1 finding from 1 review

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

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

For direct pulp capping, MTA probably achieves higher clinical and radiographic success than calcium hydroxide (OR 3.10, 95% CI 1.66-5.79; moderate certainty).

1 finding from 1 review

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

Overall success (composite of clinical and radiographic success) · Patients with carious pulp exposure in permanent teeth of mixed/unspecified root maturation

In mixed-maturation teeth, the effect of MTA versus calcium hydroxide on success is very uncertain (OR 1.11, 95% CI 0.17-7.11; very low certainty).

1 finding from 1 review

Biodentine vs Mineral trioxide aggregate (MTA)

Tooth discoloration · Patients with carious pulp exposure in permanent teeth undergoing DPC or pulpotomy

More tooth discoloration was observed with MTA than with Biodentine, but odds ratios were implausibly large and not pooled (3 RCTs; 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 immature permanent teeth

The effect of MTA versus CH in immature teeth is very uncertain (very low certainty).

1 finding from 1 review

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

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

For pulpotomy, whether MTA improves success over calcium hydroxide is uncertain (OR 2.36, 95% CI 0.47-11.75; low certainty; CI includes no effect).

1 finding from 1 review

Calcium hydroxide (CH) vs Biodentine

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

Biodentine appeared to perform better than calcium hydroxide for success, but the evidence was not pooled (2 RCTs; ungraded).

1 finding from 1 review

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

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

In mature teeth, MTA probably achieves higher clinical and radiographic success than calcium hydroxide (OR 3.34, 95% CI 1.81-6.17; moderate certainty).

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 permanent teeth undergoing direct pulp capping

MTA increases clinical and radiographic success versus CH after direct pulp capping (moderate certainty).

1 finding from 1 review

Calcium hydroxide (CH) 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 achieved higher clinical and radiographic success than calcium hydroxide overall (OR 2.94, 95% CI 1.96-4.49; low certainty), but this unadjusted estimate pools clinically heterogeneous DPC and pulpotomy studies.

1 finding from 1 review

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

Continued root formation / root development · Patients with carious pulp exposure in permanent teeth (predominantly immature) undergoing DPC or pulpotomy

Evidence on continued root formation for calcium hydroxide versus MTA is weak and inconclusive (3 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 permanent teeth with mixed root development

The effect of MTA versus CH in teeth with mixed root development is very uncertain (very low certainty).

1 finding 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