Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

77 questions · 97 findings · 15 reviews

No studies found 1 · 1%GRADE not reported 49 · 50.5%Very low 7 · 7.2%Low 18 · 18.6%Moderate 22 · 22.7%High 0 · 0%

Hydraulic calcium silicate cements (HCSC; MTA or Biodentine) vs Calcium hydroxide (CH)

Overall success (composite of clinical and radiographic success) · Vital permanent teeth (mature or immature) with deep or extremely deep caries and asymptomatic pulp or reversible pulpitis, undergoing…

At 36-month follow-up, HCSC show higher odds of clinical and radiographic success than CaOH (OR 2.34, 95% CI 1.43 to 3.84; ungraded subgroup).

3 findings 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

Pulpotomy with Calcium Enriched Mixture (CEM) 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

CEM and calcium hydroxide did not differ significantly in pulpotomy success (indirect comparison); ungraded.

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

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

Calcium phosphate agent (e.g., CPP-ACP, Ca/P-PILP, niobophosphate) vs Calcium-based agent

Immediate (24 h) resin-dentin bond strength (MPa) · Artificial caries-affected dentin (ACAD) in extracted permanent human teeth (in vitro)

In the Etch-and-Rinse adhesive + chemical ACAD protocol network, Calcium Phosphate vs Calcium showed no significant difference in 24 h bond strength (MD 0.596, 95% CI -7.289 to 8.482; Low certainty).

2 findings from 1 review

Calcium phosphate vs control

Immediate (24 h) resin-dentin bond strength (MPa) · permanent human teeth with artificial caries-affected dentin

Calcium phosphate minus Control was -21.209 MPa (95% CI -25.954 to -16.463) at 24 h.

2 findings from 1 review

Calcium-based agent vs Fluoride agent (e.g., NaF/SDF/KF/CaF2)

Immediate (24 h) resin-dentin bond strength (MPa) · Artificial caries-affected dentin (ACAD) in extracted permanent human teeth (in vitro)

In the Self-Etch adhesive + chemical ACAD protocol network, Calcium vs Fluorine showed no significant difference in 24 h bond strength (MD -0.523, 95% CI -5.404 to 4.358; Low certainty).

1 finding from 1 review

Calcium-based agent vs No biomimetic remineralization (control)

Immediate (24 h) resin-dentin bond strength (MPa) · Artificial caries-affected dentin (ACAD) in extracted permanent human teeth (in vitro)

In the Self-Etch adhesive + chemical ACAD protocol network, Calcium vs Control showed no significant difference in 24 h bond strength (MD -1.124, 95% CI -5.917 to 3.670; Moderate certainty).

1 finding from 1 review

CPP-ACP vs Pre-treatment (baseline, same group)

Quantitative light-induced fluorescence (QLF), fluorescence loss · Patients (mainly children) with white spot lesions (WSL)

Compared with baseline, CPP-ACP significantly improved white spot lesions on QLF (SMD -0.43, 95% CI -0.79 to -0.07; ungraded).

1 finding from 1 review

CPP-ACP vs Placebo paste without CPP-ACP (fluoride toothpaste control)

Quantitative light-induced fluorescence (QLF), fluorescence loss · Patients (mainly children) with white spot lesions (WSL)

CPP-ACP toothpaste did not differ significantly from placebo paste (fluoride control) for white spot lesion remineralization on QLF (MD 0.08, 95% CI -0.91 to 1.08; 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

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