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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%

Triple antibiotic paste (TAP) vs Abscess remedy (AR)

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 higher pulpotomy success with triple antibiotic paste than abscess remedy (100% vs 80%; statistically significant, P<0.05; not pooled; ungraded).

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

Mineral trioxide aggregate (MTA) pulpotomy dressing vs Abscess remedy (AR)

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 higher pulpotomy success with MTA than abscess remedy (100% vs 80%; statistically significant, P<0.05; not pooled; ungraded).

1 finding from 1 review

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

Mineral trioxide aggregate (MTA) pulpotomy dressing vs Triple antibiotic paste (TAP)

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 3-arm RCT found no difference in pulpotomy success between MTA and triple antibiotic paste (both 100%; not pooled; ungraded).

1 finding 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