Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

305 questions · 313 findings · 5 reviews · Endodontics and dental trauma

No studies found 68 · 21.7%GRADE not reported 178 · 56.9%Very low 31 · 9.9%Low 27 · 8.6%Moderate 9 · 2.9%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

Extra-oral pulp extirpation at day 0 vs Intra-oral pulp extirpation at day 7

Radiographic resorption (proxy measure for periodontal healing) at 12 months · People with avulsed and replanted permanent (front) teeth

It is very uncertain whether extra-oral pulp extirpation at day 0 changes radiographic resorption (proxy measure for periodontal healing) at… compared with intra-oral pulp extirpation at day 7 (very low certainty).

1 finding from 1 review

Hyperbaric oxygen (following replantation) vs control

Pulpal healing at 12 months · People with avulsed and replanted permanent (front) teeth

It is very uncertain whether hyperbaric oxygen (following replantation) changes pulpal healing at 12 months compared with control (very low certainty).

1 finding from 1 review

Systemic antibiotic (oral penicillin 500 mg) plus analgesic vs Placebo plus analgesic

Total number of ibuprofen tablets · Adults over 18 years presenting with a single tooth with a clinical diagnosis of irreversible pulpitis

Systemic antibiotic (oral penicillin 500 mg) plus analgesic showed no clear difference in total number of ibuprofen tablets compared with placebo plus analgesic (low certainty).

1 finding from 1 review

Systemic antibiotic (oral penicillin 500 mg) plus analgesic vs Placebo plus analgesic

Patient-reported pain intensity (sum of pain intensity difference (SPID) and sum of pain percussion intensity difference (SPPID)) · Adults over 18 years presenting with a single tooth with a clinical diagnosis of irreversible pulpitis
1 finding from 1 review
  • Antibiotic use for irreversible pulpitis 2019 · Cochrane All outcomes
    7 days
    Corresponding risk (Antibiotics): The in between-group differences (median +/- IQR) in SPID for the penicillin group were 6.0 +/- 10.5, and for placebo 6.0 +/- 9.5. The SPPID for the penicillin group was 3.5 +/- 7.5…
    1 study · 40 participants
    Low

Systemic antibiotic (oral penicillin 500 mg) plus analgesic vs Placebo plus analgesic

Total number of paracetamol (acetaminophen) with codeine (Tylenol) tablets · Adults over 18 years presenting with a single tooth with a clinical diagnosis of irreversible pulpitis

Systemic antibiotic (oral penicillin 500 mg) plus analgesic showed no clear difference in total number of paracetamol (acetaminophen) with codeine (Tylenol)… compared with placebo plus analgesic (low certainty).

1 finding from 1 review

Glutaraldehyde + zinc oxide and eugenol (ZOE) vs Full strength formocresol (FC)

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

Glutaraldehyde + zinc oxide and eugenol (ZOE) showed no clear difference in clinical failure compared with full strength formocresol (FC); GRADE not reported.

1 finding from 1 review