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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%

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 and closed (mature) root apex due to carious pulp exposure

In closed-apex teeth, pooled pulpotomy success was 83% (95% CI 69-91%); significantly lower than open apex (z=2.33, p=0.02); ungraded.

1 finding from 1 review

Composite resin with a beveled cavity margin vs Composite resin with no bevel (butt-joint margin)

Restoration failure · Children with carious primary teeth

No comparative effect estimate was reported; no bevel had twice the failure rate in the review narrative.

1 finding from 1 review

Hall technique vs Compomer restoration or non-restorative caries treatment

Restoration failure · Children with carious primary teeth

No comparative effect estimate was reported; the review reports this three-arm comparison but tabulates only compomer failure.

1 finding from 1 review

Metal-free single crowns (full-contour zirconia) vs Composite strip crown

Restoration failure · Children with carious primary teeth

No comparative effect estimate was reported; failure rates were 3.3% and 15%.

1 finding from 1 review

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

Restoration failure · Children with carious primary teeth

No comparative effect estimate was reported; etch-and-rinse had a higher tabulated failure rate.

1 finding from 1 review

Pulpotomy with mineral trioxide aggregate (MTA) 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

MTA had a significantly higher pulpotomy success rate than calcium hydroxide (indirect comparison; numeric estimate not available); ungraded.

1 finding from 1 review

Composite resin vs High-viscosity GIC and bulk-fill composite resins

Restoration failure · Children with carious primary teeth

No comparative effect estimate was reported; tabulated failure rates ranged from 0% to 2.9%.

1 finding from 1 review

Glass carbomer vs Resin-modified glass-ionomer cement + composite resin (modified open-sandwich restoration)

Restoration failure · Children with carious primary teeth

No comparative effect estimate was reported; glass carbomer had the highest tabulated failure range.

1 finding from 1 review

Glass carbomer restoration (placed after drilling) vs Composite resin or RMGIC

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

Glass carbomer had very high failure rates (up to 46.2%) in a single RCT, far worse than composite resin or RMGIC; low quality of evidence (ungraded).

1 finding from 1 review

GIC with cavity conditioner vs GIC without cavity conditioner

Restoration failure · Children with carious primary teeth

No comparative effect estimate was reported; the review states cavity conditioner did not improve success.

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 symptomatic irreversible pulpitis due to carious pulp exposure

In symptomatic irreversible pulpitis, pooled pulpotomy success was 84% (95% CI 72-92%); not significantly different from asymptomatic (z=-1.34, p=0.18); ungraded.

1 finding from 1 review

Amalgam vs Preformed metal crown (PMC)

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

Preformed metal crowns had a low annual failure rate (2.4%) in primary molars after pulpotomy, lower than amalgam in the same trial (single high-risk-of-bias RCT; low quality of evidence; not GRADE-rated).

2 findings from 1 review

HVGIC bilayer insertion and surface coating protocols vs Alternative HVGIC insertion and surface coating protocols

Restoration failure · Children with carious primary teeth

No comparative effect estimate was reported; bilayer placement and nanofilled coating were described as improving survival.

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

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

Overall success (composite of clinical and radiographic success) · Immature (young) permanent teeth with open apex and vital pulp exposed to dental caries or trauma, in children aged 6-14 years

A single RCT found no difference in pulpotomy success between MTA and platelet-rich fibrin (both 100% through 24 months; not pooled; ungraded).

1 finding from 1 review

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

Overall success (composite of clinical and radiographic success) · Immature (young) permanent teeth with open apex and vital pulp exposed to dental caries or trauma, in children aged 6-14 years

MTA and calcium hydroxide had similar clinical and radiographic pulpotomy success at 6 months (RR 1.00, 95% CI 0.94 to 1.06; 2 RCTs; ungraded).

2 findings from 1 review

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

Overall success (composite of clinical and radiographic success) · Immature (young) permanent teeth with open apex and vital pulp exposed to dental caries or trauma, in children aged 6-14 years

A single RCT found no difference in pulpotomy success between MTA and calcium-enriched mixture (both 100% at 6 and 12 months; not pooled; ungraded).

1 finding from 1 review