Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

116 questions · 119 findings · 8 reviews · Endodontics and dental trauma

No studies found 60 · 50.4%GRADE not reported 50 · 42%Very low 5 · 4.2%Low 2 · 1.7%Moderate 2 · 1.7%High 0 · 0%

Compomer (C) vs Amalgam, RMGIC, HVGIC, composite resin, bulk-fill composite resin, another compomer, or alternative caries management

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

Compomer had an annual failure rate of 0-14.7% (7 RCTs), comparable to amalgam/RMGIC/composite and better than high-viscosity GIC; low quality of evidence (ungraded).

1 finding from 1 review

Mineral trioxide aggregate (MTA) vs Super ethoxybenzoic acid (Super-EBA)

Treatment success rate · Patients needing retrograde filling in root canal therapy (orthograde root canal filling or retreatment not possible; periapical surgery…

Mineral trioxide aggregate (MTA) showed no clear difference in success rate at 4 years compared with super ethoxybenzoic acid (Super-EBA); GRADE not reported.

1 finding from 1 review

Mineral trioxide aggregate (MTA) vs Intermediate restorative material (IRM)

Success rate (radiographically‐assessed healing of cyst healing based on the Neer/Cole rating system) · Patients needing retrograde filling in root canal therapy (orthograde root canal filling or retreatment not possible; periapical surgery…

Mineral trioxide aggregate (MTA) showed no clear difference in success rate at 2 years compared with intermediate restorative material (IRM); GRADE not reported.

1 finding from 1 review

Calcium hydroxide cement (Dycal) vs Zinc oxide and eugenol (ZOE)

Clinical symptoms at 12 months · Adults (aged 20 to 60 years, mean 27) with deep carious lesions in permanent teeth (indirect or direct pulp capping, or complete caries…
1 finding from 1 review
  • Pulp management for caries in adults: maintaining pulp vitality 2007 · Cochrane All outcomes
    12 months · Complete caries removal
    Analysis 2.2 (clinical symptoms at 12 months following complete caries removal, Dycal vs Cavitec). Fitzgerald 1991: 151 teeth in 55 patients (analysis at tooth level, not patient level); substantial attrition (11 teeth…
    1 study · 151 participants
    GRADE not reported

Life (calcium hydroxide pulp-capping material) vs Zinc oxide and eugenol (ZOE)

Clinical symptoms at 12 months · Adults (aged 20 to 60 years, mean 27) with deep carious lesions in permanent teeth (indirect or direct pulp capping, or complete caries…
1 finding from 1 review
  • Pulp management for caries in adults: maintaining pulp vitality 2007 · Cochrane All outcomes
    12 months · Complete caries removal
    Analysis 2.2 (clinical symptoms at 12 months following complete caries removal, Life vs Cavitec). Fitzgerald 1991: 151 teeth in 55 patients (analysis at tooth level, not patient level); substantial attrition (11 teeth…
    1 study · 151 participants
    GRADE not reported

Life (calcium hydroxide pulp-capping material) vs Dycal (calcium hydroxide pulp-capping material)

Clinical symptoms at 12 months · Adults (aged 20 to 60 years, mean 27) with deep carious lesions in permanent teeth (indirect or direct pulp capping, or complete caries…
3 findings from 1 review
  • Pulp management for caries in adults: maintaining pulp vitality 2007 · Cochrane All outcomes
    12 months · Complete caries removal
    Analysis 2.2 (clinical symptoms at 12 months following complete caries removal, Life vs Dycal). Fitzgerald 1991: 151 teeth in 55 patients (analysis at tooth level, not patient level); substantial attrition (11 teeth…
    1 study · 151 participants
    GRADE not reported
  • Pulp management for caries in adults: maintaining pulp vitality 2007 · Cochrane All outcomes
    12 months · Indirect pulp capping
    Analysis 2.1 (clinical symptoms at 12 months following indirect pulp capping, Life vs Dycal). Fitzgerald 1991: 151 teeth in 55 patients (analysis at tooth level, not patient level); substantial attrition (11 teeth lost…
    1 study · 151 participants
    GRADE not reported
  • Pulp management for caries in adults: maintaining pulp vitality 2007 · Cochrane All outcomes
    12 months · Direct pulp capping
    Analysis 2.3 (clinical symptoms at 12 months following direct pulp capping, Life vs Dycal). Fitzgerald 1991: 151 teeth in 55 patients (analysis at tooth level, not patient level); substantial attrition (11 teeth lost…
    1 study · 151 participants
    GRADE not reported

Full pulpotomy vs Partial pulpotomy

Overall success (composite of clinical and radiographic success) · Adults aged 18 years or older with mature permanent teeth and carious pulp exposure

The three-study meta-analysis found no significant difference between full and partial pulpotomy after 1 year.

1 finding from 1 review

Partial pulpotomy with permanent restoration after 7-14 days 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

Permanent restoration after 7-14 days was associated with a pooled success rate of 73.6%.

1 finding from 1 review

Partial pulpotomy with tri-calcium silicate material (MTA or Biodentine) 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 MTA or Biodentine had a pooled success rate of 86.8%.

1 finding from 1 review

Partial pulpotomy with one additional day before permanent restoration vs Partial pulpotomy with one fewer day before permanent restoration

Overall success (composite of clinical and radiographic success) · Adults aged 18 years or older with mature permanent teeth and carious pulp exposure

Each additional day before permanent restoration was associated with a 0.088% decrease in success in meta-regression.

1 finding from 1 review

Partial pulpotomy with permanent restoration after more than 14 days 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

Permanent restoration after more than 14 days was associated with a pooled success rate of 23.2%.

1 finding from 1 review

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 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

Tri-calcium silicate use was associated with a 37% increase in partial-pulpotomy success in meta-regression.

1 finding from 1 review

Single-visit root canal treatment vs Multiple-visit root canal treatment (two or more visits)

Post-treatment pain within 1 week (from first session) · People aged 10 years or above requiring root canal treatment; permanent teeth with completely formed apex and without internal resorption

Single-visit root canal treatment probably leads to higher post-treatment pain within 1 week (from first session) compared with multiple-visit root canal treatment (two or more visits) (moderate certainty).

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

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

Single-visit root canal treatment vs Multiple-visit root canal treatment (two or more visits)

Patient‐reported pain intensity or pain relief (VAS, NRS or categorical scale) · People aged 10 years or above requiring root canal treatment; permanent teeth with completely formed apex and without internal resorption

Single-visit root canal treatment showed no clear difference in postoperative pain in the immediate postobturation period (up to 72… compared with multiple-visit root canal treatment (two or more visits) (low certainty).

1 finding from 1 review