Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

306 questions · 333 findings · 14 reviews · Dental caries

No studies found 29 · 8.7%GRADE not reported 198 · 59.5%Very low 50 · 15%Low 31 · 9.3%Moderate 25 · 7.5%High 0 · 0%

Formocresol (FC) pulpotomy vs Calcium hydroxide pulpectomy

Outcome not reported · Children with extensive decay involving the dental pulp in primary teeth

The review found no eligible studies for this question.

1 finding from 1 review

Ferric sulphate (FS) + mineral trioxide aggregate (MTA) vs Zinc oxide and eugenol (ZOE) pulpectomy

Clinical failure · Children with extensive decay involving the dental pulp in primary teeth

Ferric sulphate/MTA pulpotomy showed no clear difference in clinical failure compared with zinc oxide and eugenol (ZOE) pulpectomy; GRADE not reported.

1 finding from 1 review

Ferric sulphate (FS) + mineral trioxide aggregate (MTA) vs Zinc oxide and eugenol (ZOE) pulpectomy

Radiological failure · Children with extensive decay involving the dental pulp in primary teeth

Ferric sulphate/MTA pulpotomy showed no clear difference in radiological failure compared with zinc oxide and eugenol (ZOE) pulpectomy; GRADE not reported.

1 finding from 1 review

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

Ferric sulphate (FS)/zinc oxide and eugenol (ZOE) pulpotomy vs Sedanol (ZOE) pulpectomy

Radiological failure · Children with extensive decay involving the dental pulp in primary teeth

Ferric sulphate (FS)/zinc oxide and eugenol (ZOE) pulpotomy showed no clear difference in radiological failure compared with sedanol (ZOE) pulpectomy; GRADE not reported.

1 finding from 1 review

3Mix (ciprofloxacin + metronidazole + minocycline) pulpotomy vs 3Mix pulpectomy

Clinical failure · Children with extensive decay involving the dental pulp in primary teeth

3Mix (ciprofloxacin + metronidazole + minocycline) pulpotomy showed no clear difference in clinical failure compared with 3Mix pulpectomy; GRADE not reported.

1 finding from 1 review

3Mix (ciprofloxacin + metronidazole + minocycline) pulpotomy vs 3Mix pulpectomy

Radiological failure · Children with extensive decay involving the dental pulp in primary teeth

3Mix (ciprofloxacin + metronidazole + minocycline) pulpotomy showed no clear difference in radiological failure compared with 3Mix pulpectomy; GRADE not reported.

1 finding from 1 review

Ledermix (corticosteroid/antibiotic pulp-capping cement) vs Calcium hydroxide (CH)

Clinical success (survival free of symptoms) at 24 months · Adults with asymptomatic teeth with vital carious pulp exposures
1 finding from 1 review
  • Shovelton 1971 (Analysis 1.1): 275 teeth followed for 2 years (235 at 6 months, 160 at 12 months, 85 analysed at 24 months). Success rates 50% to 80%. Ledermix and calcium hydroxide had the highest success rates,…
    1 study · 275 participants
    GRADE not reported

Ledermix (corticosteroid/antibiotic pulp-capping cement) vs Glycerrhetinic acid/antibiotic mixture

Clinical success (survival free of symptoms) at 24 months · Adults with asymptomatic teeth with vital carious pulp exposures
1 finding from 1 review
  • Shovelton 1971 (Analysis 1.1): 275 teeth followed for 2 years (235 at 6 months, 160 at 12 months, 85 analysed at 24 months). Success rates 50% to 80%. Ledermix and calcium hydroxide had the highest success rates,…
    1 study · 275 participants
    GRADE not reported

Ledermix (corticosteroid/antibiotic pulp-capping cement) vs Zinc oxide and eugenol (ZOE)

Clinical success (survival free of symptoms) at 24 months · Adults with asymptomatic teeth with vital carious pulp exposures
1 finding from 1 review
  • Shovelton 1971 (Analysis 1.1): 275 teeth followed for 2 years (235 at 6 months, 160 at 12 months, 85 analysed at 24 months). Success rates 50% to 80%. Ledermix and calcium hydroxide had the highest success rates,…
    1 study · 275 participants
    GRADE not reported

Conditioning and sealing with an adhesive resin (smear-removing bonding system) vs Conventional calcium hydroxide lining

Maintenance of pulp vitality (freedom from pulpal breakdown) up to 36 months · Healthy adults with asymptomatic posterior permanent teeth with deep caries and a vital (non-exposed) pulp requiring restoration
1 finding from 1 review
  • Whitworth 2005: 602 teeth randomised; 39 emergency recalls over the 36 months after restoration, with pulp breakdown associated with 16 teeth. The authors concluded that "dentists should be confident that pulps will be…
    1 study · 602 participants
    GRADE not reported

Laser (Er:YAG, Er,Cr:YSGG, or Nd:YAG) vs Conventional mechanical caries removal (standard drill; handpiece with a bur)

Pulpal inflammation or necrosis · Children, adolescents and adults with caries in deciduous and permanent teeth (age 3.5 to 84 years)

It is very uncertain whether laser (Er:YAG, Er,Cr:YSGG, or Nd:YAG) changes pulpal inflammation or necrosis compared with conventional mechanical caries removal (standard drill; handpiece… (very low certainty).

3 findings from 1 review

Repair of a defective resin composite restoration in a permanent molar or premolar tooth (with resin composite) vs Replacement of a defective resin composite restoration in a permanent molar or premolar tooth (with resin composite)

Presence of clinical symptoms (pain, swelling, diagnosis of pulpitis, abscess formation) · Adults (16 years or over) with one or more defective resin composite restoration(s) in a molar or premolar tooth/teeth

The review found no eligible studies for this question.

1 finding from 1 review

Repair of a defective amalgam restoration in a permanent molar or premolar tooth (with amalgam) vs Replacement of a defective amalgam restoration in a permanent molar or premolar tooth (with amalgam)

Presence of clinical symptoms (pain, swelling, diagnosis of pulpitis, abscess formation) · Adults (16 years or over) with one or more defective amalgam restoration(s) in a molar or premolar tooth/teeth

The review found no eligible studies for this question.

1 finding from 1 review

Partial caries removal (single stage; residual dentinal caries sealed into the tooth definitively) vs Complete caries removal

Pulp exposure during caries removal · Patients with carious teeth, affecting any tooth surface(s), in unrestored primary and permanent teeth

Partial caries removal (single stage; residual dentinal caries… probably leads to lower pulp exposure during caries removal compared with complete caries removal (moderate certainty).

1 finding from 1 review

Stepwise excavation (two-stage caries removal, re-entry after an interval) vs Complete caries removal

Pulp exposure during caries removal · Patients with carious teeth, affecting any tooth surface(s), in unrestored primary and permanent teeth

Stepwise excavation (two-stage caries removal, re-entry after an… probably leads to lower pulp exposure during caries removal compared with one stage complete caries removal (moderate certainty).

3 findings from 1 review

Stepwise excavation (two-stage caries removal, re-entry after an interval) vs Complete caries removal

Signs or symptoms of pulpal disease · Patients with carious teeth, affecting any tooth surface(s), in unrestored primary and permanent teeth

Stepwise excavation (two-stage caries removal, re-entry after an… showed no clear difference in signs or symptoms of pulpal disease compared with one stage complete caries removal (moderate certainty).

1 finding from 1 review

Partial caries removal (single stage; residual dentinal caries sealed into the tooth definitively) vs Complete caries removal

Signs or symptoms of pulpal disease · Patients with carious teeth, affecting any tooth surface(s), in unrestored primary and permanent teeth

Partial caries removal (single stage; residual dentinal caries… showed no clear difference in signs or symptoms of pulpal disease compared with complete caries removal (low certainty).

1 finding from 1 review

Resin composite restorations containing antibacterial agents vs Non-antibacterial containing composite restorations

Postoperative sensitivity, marginal adaptation, anatomic form and other clinical outcomes (USPHS restoration quality; includes tooth vitality and pulpitis) · Adults and adolescents in any age group with restorations in the permanent dentition and children with restorations in the primary dentition

The review found no eligible studies for this question.

1 finding from 1 review

No dentinal caries removal (caries sealed under a preformed metal crown or restoration without removing dentinal caries) vs Complete caries removal

Signs or symptoms of pulpal disease · Patients with carious teeth, affecting any tooth surface(s), in unrestored primary and permanent teeth

No dentinal caries removal (caries sealed under a preformed metal… showed no clear difference in signs or symptoms of pulpal disease compared with complete caries removal (moderate certainty).

1 finding from 1 review