Non-Cochrane · intervention · PM42087982
Decision-ready evidence for vital pulp therapy: a network meta-analysis of bioactive materials in mature permanent teeth.
Elmsmari Firas, Abdelsayed Reem B, Albasoumi Qamar, et al. · Frontiers in dental medicine · 2026 · PubMed · doi:10.3389/fdmed.2026.1780755
Findings
81 findings
| Population | ||||
|---|---|---|---|---|
| Mature (closed apex) permanent teeth with carious pulp exposure | Full pulpotomy with any bioactive material (all materials pooled) | None (pooled single-arm success proportion) | Composite clinical and radiographic success of vital pulp therapy 12 months · Clinical (dental) Unresolved: the two extractors disagree on this row. | Pooled success rate (%) 90.8 [84.4, 97.2] Moderate 4 studies |
| Mature (closed apex) permanent teeth with carious pulp exposure | Full pulpotomy with any bioactive material (all materials pooled) | None (pooled single-arm success proportion) | Composite clinical and radiographic success of vital pulp therapy 36 months · Clinical (dental) | No studies reported 3-year outcomes for full pulpotomy. No studies found 0 studies |
| Mature (closed apex) permanent teeth with carious pulp exposure | Full pulpotomy with any bioactive material (all materials pooled) | None (pooled single-arm success proportion) | Composite clinical and radiographic success of vital pulp therapy 24 months · Clinical (dental) | Pooled success rate (%) 99.1 [96.4, 100] GRADE not reported 1 study |
| Mature (closed apex) permanent teeth with carious pulp exposure | Full pulpotomy with any bioactive material (all materials pooled) | None (pooled single-arm success proportion) | Composite clinical and radiographic success of vital pulp therapy 6 months · Clinical (dental) Unresolved: the two extractors disagree on this row. | Pooled success rate (%) 96.7 [92.2, 100] Moderate 2 studies |
| Mature (closed apex) permanent teeth with carious pulp exposure | Full pulpotomy with any bioactive material (all materials pooled) | None (pooled single-arm success proportion) | Composite clinical and radiographic success of vital pulp therapy 12 months · Clinical (dental) · Material: CEM | Pooled success rate (%) 95.3 [87.9, 100] GRADE not reported 2 studies |
| Mature (closed apex) permanent teeth with carious pulp exposure | Partial pulpotomy with any bioactive material (all materials pooled) | None (pooled single-arm success proportion) | Composite clinical and radiographic success of vital pulp therapy 24 months · Clinical (dental) Unresolved: the two extractors disagree on this row. | Pooled success rate (%) 85.9 [70.8, 100] Moderate 3 studies |
| Mature (closed apex) permanent teeth with carious pulp exposure | Partial pulpotomy with any bioactive material (all materials pooled) | None (pooled single-arm success proportion) | Composite clinical and radiographic success of vital pulp therapy 6 months · Clinical (dental) · Material: MTA | Pooled success rate (%) 89.2 [80.6, 97.7] GRADE not reported 2 studies |
| Mature permanent teeth with carious pulp exposure treated by full pulpotomy | MTA | None (single pooled success proportion across arms) | Composite success (clinical and radiographic) 1 year · Clinical settings · Biomaterial subgroup: MTA Unresolved: the two extractors disagree on this row. | Subgroup diamond printed as 0.832 [0.882, 1.082] GRADE not reported 3 studies |
| Mature (closed apex) permanent teeth with carious pulp exposure | Partial pulpotomy with any bioactive material (all materials pooled) | None (pooled single-arm success proportion) | Composite clinical and radiographic success of vital pulp therapy 12 months · Clinical (dental) | Pooled success rate (%) 84.8 [67.0, 100] GRADE not reported 2 studies |
| Mature (closed apex) permanent teeth with carious pulp exposure | Partial pulpotomy with any bioactive material (all materials pooled) | None (pooled single-arm success proportion) | Composite clinical and radiographic success of vital pulp therapy 6 months · Clinical (dental) Unresolved: the two extractors disagree on this row. | Pooled success rate (%) 84.0 [73.2, 94.8] Moderate 2 studies |
| Mature (closed apex) permanent teeth with carious pulp exposure | Partial pulpotomy with any bioactive material (all materials pooled) | None (pooled single-arm success proportion) | Composite clinical and radiographic success of vital pulp therapy 12 months · Clinical (dental) · Material: MTA | Pooled success rate (%) 93 [76.8, 100] GRADE not reported 2 studies |
| Mature (closed apex) permanent teeth with carious pulp exposure | Partial pulpotomy with any bioactive material (all materials pooled) | None (pooled single-arm success proportion) | Composite clinical and radiographic success of vital pulp therapy 36 months · Clinical (dental) | Pooled success rate (%) 94.3 [86.5, 100] GRADE not reported 6 studies |
| Mature (closed apex) permanent teeth with carious pulp exposure | Partial pulpotomy with any bioactive material (all materials pooled) | None (pooled single-arm success proportion) | Composite clinical and radiographic success of vital pulp therapy 24 months · Clinical (dental) · Material: Biodentine | Pooled success rate (%) 93.6 [80.6, 100] GRADE not reported 2 studies |
| Mature (closed apex) permanent teeth with carious pulp exposure | Partial pulpotomy with any bioactive material (all materials pooled) | None (pooled single-arm success proportion) | Composite clinical and radiographic success of vital pulp therapy 24 months · Clinical (dental) · Material: MTA | Pooled success rate (%) 93.6 [85.4, 100] GRADE not reported 3 studies |
| Mature (closed apex) permanent teeth with carious pulp exposure | Direct pulp capping with any bioactive material (all materials pooled) | None (pooled single-arm success proportion) | Composite clinical and radiographic success of vital pulp therapy 6 months · Clinical (dental) · Material: CaOH | Pooled success rate (%) 74.4 [66.2, 88.6] GRADE not reported 4 studies |
| Mature (closed apex) permanent teeth with carious pulp exposure | Direct pulp capping with any bioactive material (all materials pooled) | None (pooled single-arm success proportion) | Composite clinical and radiographic success of vital pulp therapy 12 months · Clinical (dental) · Material: CaOH | Pooled success rate (%) 85.9 [69.2, 100] GRADE not reported 3 studies |
| Mature (closed apex) permanent teeth with carious pulp exposure | Direct pulp capping with any bioactive material (all materials pooled) | None (pooled single-arm success proportion) | Composite clinical and radiographic success of vital pulp therapy 36 months · Clinical (dental) · Material: MTA | Pooled success rate (%) 85.7 [79.8, 91.5] GRADE not reported 3 studies |
| Mature (closed apex) permanent teeth with carious pulp exposure | Direct pulp capping with any bioactive material (all materials pooled) | None (pooled single-arm success proportion) | Composite clinical and radiographic success of vital pulp therapy 36 months · Clinical (dental) · Material: Biodentine | Pooled success rate (%) 81.1 [72.7, 89.6] GRADE not reported 2 studies |
| Mature (closed apex) permanent teeth with carious pulp exposure | Direct pulp capping with any bioactive material (all materials pooled) | None (pooled single-arm success proportion) | Composite clinical and radiographic success of vital pulp therapy 6 months · Clinical (dental) Unresolved: the two extractors disagree on this row. | Pooled success rate (%) 89.0 [85.0, 93.1] Moderate 8 studies |
| Mature (closed apex) permanent teeth with carious pulp exposure | Direct pulp capping with any bioactive material (all materials pooled) | None (pooled single-arm success proportion) | Composite clinical and radiographic success of vital pulp therapy 24 months · Clinical (dental) | Pooled success rate (%) 100 [88.7, 100] GRADE not reported 1 study |
| Mature (closed apex) permanent teeth with carious pulp exposure | Direct pulp capping with any bioactive material (all materials pooled) | None (pooled single-arm success proportion) | Composite clinical and radiographic success of vital pulp therapy 36 months · Clinical (dental) · Material: CaOH | Pooled success rate (%) 62.8 [46.9, 78.8] GRADE not reported 2 studies |
| Mature (closed apex) permanent teeth with carious pulp exposure | Direct pulp capping with any bioactive material (all materials pooled) | None (pooled single-arm success proportion) | Composite clinical and radiographic success of vital pulp therapy 36 months · Clinical (dental) Unresolved: the two extractors disagree on this row. | Pooled success rate (%) 78.1 [70.2, 86.1] Moderate 3 studies |
| Mature (closed apex) permanent teeth with carious pulp exposure | Direct pulp capping with any bioactive material (all materials pooled) | None (pooled single-arm success proportion) | Composite clinical and radiographic success of vital pulp therapy 12 months · Clinical (dental) Unresolved: the two extractors disagree on this row. | Pooled success rate (%) 89.2 [84.5, 93.8] Moderate 7 studies |
| Mature (closed apex) permanent teeth with carious pulp exposure | Direct pulp capping with any bioactive material (all materials pooled) | None (pooled single-arm success proportion) | Composite clinical and radiographic success of vital pulp therapy 12 months · Clinical (dental) · Material: CEM | Pooled success rate (%) 88.5 [79.5, 97.4] GRADE not reported 2 studies |
| Mature (closed apex) permanent teeth with carious pulp exposure | Direct pulp capping with any bioactive material (all materials pooled) | None (pooled single-arm success proportion) | Composite clinical and radiographic success of vital pulp therapy 12 months · Clinical (dental) · Material: Biodentine | Pooled success rate (%) 92.9 [79.4, 100] GRADE not reported 3 studies |
| Mature (closed apex) permanent teeth with carious pulp exposure | Indirect pulp capping with any bioactive material (all materials pooled) | None (pooled single-arm success proportion) | Composite clinical and radiographic success of vital pulp therapy 6 months · Clinical (dental) Unresolved: the two extractors disagree on this row. | Pooled success rate (%) 93.2 [88.8, 97.6] Moderate 5 studies |
| Mature (closed apex) permanent teeth with carious pulp exposure | Indirect pulp capping with any bioactive material (all materials pooled) | None (pooled single-arm success proportion) | Composite clinical and radiographic success of vital pulp therapy 6 months · Clinical (dental) · Material: MTA | Pooled success rate (%) 94.4 [84.4, 100] GRADE not reported 3 studies |
| Mature (closed apex) permanent teeth with carious pulp exposure | Indirect pulp capping with any bioactive material (all materials pooled) | None (pooled single-arm success proportion) | Composite clinical and radiographic success of vital pulp therapy 6 months · Clinical (dental) · Material: CaOH | Pooled success rate (%) 88.1 [66.3, 100] GRADE not reported 3 studies |
| Mature (closed apex) permanent teeth with carious pulp exposure | Indirect pulp capping with any bioactive material (all materials pooled) | None (pooled single-arm success proportion) | Composite clinical and radiographic success of vital pulp therapy 6 months · Clinical (dental) · Material: Biodentine | Pooled success rate (%) 92.1 [82.8, 100] GRADE not reported 3 studies |
| Mature (closed apex) permanent teeth with carious pulp exposure | Indirect pulp capping with any bioactive material (all materials pooled) | None (pooled single-arm success proportion) | Composite clinical and radiographic success of vital pulp therapy 24 months · Clinical (dental) Unresolved: the two extractors disagree on this row. | Pooled success rate (%) 98.7 [96.1, 100] Moderate 2 studies |
| Mature (closed apex) permanent teeth with carious pulp exposure | Indirect pulp capping with any bioactive material (all materials pooled) | None (pooled single-arm success proportion) | Composite clinical and radiographic success of vital pulp therapy 12 months · Clinical (dental) Unresolved: the two extractors disagree on this row. | Pooled success rate (%) 96.8 [94.8, 98.8] Moderate 5 studies |
| Mature (closed apex) permanent teeth with carious pulp exposure | Full pulpotomy with MTA | Full pulpotomy with Biodentine | Composite clinical and radiographic success of vital pulp therapy 12 months · Clinical (dental) Unresolved: the two extractors disagree on this row. | Table 4: CrIs overlap, no clear difference; inconclusive due to imprecision Moderate Downgraded: imprecision Studies not reported |
| Mature (closed apex) permanent teeth with carious pulp exposure | Full pulpotomy with CEM | Full pulpotomy with MTA | Composite clinical and radiographic success of vital pulp therapy 12 months · Clinical (dental) Unresolved: the two extractors disagree on this row. | Table 4: CrIs overlap, no clear difference; inconclusive Moderate Studies not reported |
| Mature (closed apex) permanent teeth with carious pulp exposure | Full pulpotomy with Biodentine | Full pulpotomy with CEM | Composite clinical and radiographic success of vital pulp therapy 12 months · Clinical (dental) Unresolved: the two extractors disagree on this row. | Table 4: CrIs overlap, no clear difference; comparisons imprecise Moderate Downgraded: imprecision Studies not reported |
| Mature (closed apex) permanent teeth with carious pulp exposure | Partial pulpotomy with MTA, Biodentine or CaOH (network) | Partial pulpotomy with each other | Composite clinical and radiographic success of vital pulp therapy 6 months · Clinical (dental) Unresolved: the two extractors disagree on this row. | No statistically significant differences in performance across any of the biomaterials; all pairwise credible intervals spanned the null GRADE not reported Studies not reported |
| Mature (closed apex) permanent teeth with carious pulp exposure | Partial pulpotomy with Biodentine | Partial pulpotomy with CaOH | Composite clinical and radiographic success of vital pulp therapy 12 months · Clinical (dental) | log OR 13.7 [-1.55, 55.4] GRADE not reported Studies not reported |
| Mature permanent teeth with carious pulp exposure treated by partial pulpotomy | MTA | CaOH | Composite success (clinical and radiographic) 6 months · Clinical settings · Network meta-analysis Unresolved: the two extractors disagree on this row. | No statistically significant difference; all pairwise credible intervals spanned the null GRADE not reported Studies not reported |
| Mature (closed apex) permanent teeth with carious pulp exposure | Partial pulpotomy with Biodentine | Partial pulpotomy with MTA | Composite clinical and radiographic success of vital pulp therapy 12 months · Clinical (dental) | log OR 15.1 [0.27, 56.8] GRADE not reported Studies not reported |
| Mature permanent teeth with carious pulp exposure treated by partial pulpotomy | Biodentine | CaOH | Composite success (clinical and radiographic) 6 months · Clinical settings · Network meta-analysis Unresolved: the two extractors disagree on this row. | No statistically significant difference; all pairwise credible intervals spanned the null GRADE not reported Studies not reported |
| Mature (closed apex) permanent teeth with carious pulp exposure | Partial pulpotomy with Biodentine | Partial pulpotomy with MTA | Composite clinical and radiographic success of vital pulp therapy 24 months · Clinical (dental) Unresolved: the two extractors disagree on this row. | Meta-regression beta coefficient (success proportion) 0.003 [-0.142, 0.149] Moderate Studies not reported |
| Mature (closed apex) permanent teeth with carious pulp exposure | Partial pulpotomy with CaOH | Partial pulpotomy with MTA | Composite clinical and radiographic success of vital pulp therapy 12 months · Clinical (dental) | log OR 1.49 [-0.79, 3.85] GRADE not reported Studies not reported |
| Mature (closed apex) permanent teeth with carious pulp exposure | Partial pulpotomy with MTA | Partial pulpotomy with CaOH | Composite clinical and radiographic success of vital pulp therapy 6-12 months · Clinical (dental) Unresolved: the two extractors disagree on this row. | Table 4: CrIs overlap, no clear difference; inconclusive comparison Low Studies not reported |
| Mature permanent teeth with carious pulp exposure treated by partial pulpotomy | MTA | Biodentine | Composite success (clinical and radiographic) 6 months · Clinical settings · Network meta-analysis Unresolved: the two extractors disagree on this row. | No statistically significant difference; all pairwise credible intervals spanned the null GRADE not reported Studies not reported |
| Mature (closed apex) permanent teeth with carious pulp exposure | Direct pulp capping with MTA | Direct pulp capping with CaOH | Composite clinical and radiographic success of vital pulp therapy 6 months · Clinical (dental) Unresolved: the two extractors disagree on this row. | Network meta-analysis: MTA had better results than CaOH; estimate not reported GRADE not reported Studies not reported |
| Mature (closed apex) permanent teeth with carious pulp exposure | Direct pulp capping with MTA | Direct pulp capping with CaOH | Composite clinical and radiographic success of vital pulp therapy 6-36 months · Clinical (dental) Unresolved: the two extractors disagree on this row. | Table 4: CrIs exclude 0, favors MTA; consistent superiority of MTA supported by high-certainty evidence High Studies not reported |
| Mature (closed apex) permanent teeth with carious pulp exposure | Direct pulp capping with CaOH | Direct pulp capping with MTA | Composite clinical and radiographic success of vital pulp therapy 6 months · Clinical (dental) | Meta-regression difference in success (percentage points) -19.2 GRADE not reported Studies not reported |
| Mature (closed apex) permanent teeth with carious pulp exposure | Direct pulp capping with CaOH | Direct pulp capping with MTA | Composite clinical and radiographic success of vital pulp therapy 36 months · Clinical (dental) | Meta-regression beta coefficient (success proportion) -0.215 GRADE not reported Studies not reported |
| Mature (closed apex) permanent teeth with carious pulp exposure | Direct pulp capping with CaOH | Direct pulp capping with MTA-like materials | Composite clinical and radiographic success of vital pulp therapy 6 months · Clinical (dental) | Meta-regression difference in success (percentage points) -11.4 GRADE not reported Studies not reported |
| Mature (closed apex) permanent teeth with carious pulp exposure | Direct pulp capping with laser-assisted therapy | Direct pulp capping with Biodentine | Composite clinical and radiographic success of vital pulp therapy 6 months · Clinical (dental) Unresolved: the two extractors disagree on this row. | Network meta-analysis: laser-assisted therapy had higher success than Biodentine; estimate not reported GRADE not reported Studies not reported |
| Mature permanent teeth with carious pulp exposure treated by direct pulp capping | MTA-like materials | None (single pooled success proportion across arms) | Composite success (clinical and radiographic) 6 months · Clinical settings · Biomaterial subgroup: MTA-like Unresolved: the two extractors disagree on this row. | Pooled success rate (%) 84.3 [73.3, 84.8] GRADE not reported 3 studies |
| Mature permanent teeth with carious pulp exposure treated by direct pulp capping | MTA | None (single pooled success proportion across arms) | Composite success (clinical and radiographic) 6 months · Clinical settings · Biomaterial subgroup: MTA Unresolved: the two extractors disagree on this row. | Subgroup diamond printed as 0.826 [0.880, 0.976] GRADE not reported 7 studies |
| Mature (closed apex) permanent teeth with carious pulp exposure | Direct pulp capping with laser-assisted therapy | Direct pulp capping with CaOH | Composite clinical and radiographic success of vital pulp therapy 6 months · Clinical (dental) Unresolved: the two extractors disagree on this row. | Network meta-analysis: laser-assisted therapy had higher success than CaOH; estimate not reported GRADE not reported Studies not reported |
| Mature permanent teeth with carious pulp exposure treated by direct pulp capping | MTA | None (single pooled success proportion across arms) | Composite success (clinical and radiographic) 1 year · Clinical settings · Biomaterial subgroup: MTA | Pooled success rate (%) 92 [86.6, 97.3] GRADE not reported 7 studies |
| Mature (closed apex) permanent teeth with carious pulp exposure | Direct pulp capping with CEM | Direct pulp capping with Biodentine | Composite clinical and radiographic success of vital pulp therapy 6 months · Clinical (dental) Unresolved: the two extractors disagree on this row. | Network meta-analysis: CEM had higher success than Biodentine; estimate not reported GRADE not reported Studies not reported |
| Mature (closed apex) permanent teeth with carious pulp exposure | Direct pulp capping with CEM | Direct pulp capping with CaOH | Composite clinical and radiographic success of vital pulp therapy 6 months · Clinical (dental) Unresolved: the two extractors disagree on this row. | Network meta-analysis: CEM had higher success than CaOH; estimate not reported GRADE not reported Studies not reported |
| Mature permanent teeth with carious pulp exposure treated by direct pulp capping | Biodentine | None (single pooled success proportion across arms) | Composite success (clinical and radiographic) 6 months · Clinical settings · Biomaterial subgroup: Biodentine Unresolved: the two extractors disagree on this row. | Pooled success rate (%) 91 GRADE not reported 5 studies |
| Mature (closed apex) permanent teeth with carious pulp exposure | Direct pulp capping with MTA, CEM, Biodentine, CaOH, PRF, PRP or MTA-like (network) | Direct pulp capping with each other | Composite clinical and radiographic success of vital pulp therapy 12 months · Clinical (dental) Unresolved: the two extractors disagree on this row. | Network meta-analysis found no statistically significant difference GRADE not reported Studies not reported |
| Mature (closed apex) permanent teeth with carious pulp exposure | Direct pulp capping with Biodentine | Direct pulp capping with CaOH | Composite clinical and radiographic success of vital pulp therapy 6-36 months · Clinical (dental) Unresolved: the two extractors disagree on this row. | Table 4: borderline/narrow CrIs, favors Biodentine; likely superiority Moderate Studies not reported |
| Mature permanent teeth with carious pulp exposure treated by direct pulp capping | MTA | CaOH | Composite success (clinical and radiographic) 3 years · Clinical settings · Network meta-analysis Unresolved: the two extractors disagree on this row. | MTA significantly higher probability of success than calcium hydroxide GRADE not reported Studies not reported |
| Mature (closed apex) permanent teeth with carious pulp exposure | Direct pulp capping with MTA | Direct pulp capping with Biodentine | Composite clinical and radiographic success of vital pulp therapy All timepoints · Clinical (dental) Unresolved: the two extractors disagree on this row. | Table 4: CrIs overlap, no clear difference; cannot establish superiority Moderate Studies not reported |
| Mature (closed apex) permanent teeth with carious pulp exposure | Indirect pulp capping with Biodentine, CaOH, CSC, GIC or laser (network) | Indirect pulp capping with each other | Composite clinical and radiographic success of vital pulp therapy 12 months · Clinical (dental) Unresolved: the two extractors disagree on this row. | Network meta-analysis: no statistically significant differences detected between biomaterials; overlapping credible intervals and moderate certainty Moderate Studies not reported |
| Mature (closed apex) permanent teeth with carious pulp exposure | Indirect pulp capping with MTA | Indirect pulp capping with CaOH | Composite clinical and radiographic success of vital pulp therapy 6-12 months · Clinical (dental) Unresolved: the two extractors disagree on this row. | Table 4: CrIs overlap, no clear difference; no material advantage demonstrated Moderate Studies not reported |
| Mature (closed apex) permanent teeth with carious pulp exposure | Indirect pulp capping with Biodentine | Indirect pulp capping with CaOH | Composite clinical and radiographic success of vital pulp therapy 6-12 months · Clinical (dental) Unresolved: the two extractors disagree on this row. | Table 4: CrIs overlap, no clear difference; inconclusive comparison Moderate Studies not reported |
| Mature (closed apex) permanent teeth with carious pulp exposure | Indirect pulp capping with Biodentine | Indirect pulp capping with MTA | Composite clinical and radiographic success of vital pulp therapy 6-12 months · Clinical (dental) Unresolved: the two extractors disagree on this row. | Table 4: CrIs overlap, no clear difference; cannot establish superiority Moderate Studies not reported |
| Mature (closed apex) permanent teeth with carious pulp exposure | Indirect pulp capping with laser-assisted therapy | Indirect pulp capping with other materials | Composite clinical and radiographic success of vital pulp therapy 6 months · Clinical (dental) Unresolved: the two extractors disagree on this row. | Table 4: CrIs exclude 0, less favorable; sparse and uncertain evidence Low Studies not reported |
| Mature (closed apex) permanent teeth with carious pulp exposure | Indirect pulp capping with CEM | Indirect pulp capping with other materials | Composite clinical and radiographic success of vital pulp therapy 6 months · Clinical (dental) Unresolved: the two extractors disagree on this row. | Table 4: CrIs variable/sparse, trends favorable; based on limited evidence only Low Studies not reported |
| Mature (closed apex) permanent teeth with carious pulp exposure | Vital pulp therapy with MTA | Vital pulp therapy with CaOH | Composite clinical and radiographic success of vital pulp therapy Clinical (dental) · Sensitivity analysis: Half-Cauchy prior | log OR -1.06 GRADE not reported Studies not reported |
| Mature (closed apex) permanent teeth with carious pulp exposure | Vital pulp therapy with MTA | Vital pulp therapy with CaOH | Composite clinical and radiographic success of vital pulp therapy Clinical (dental) · Sensitivity analysis: Arm-based continuity correction Unresolved: the two extractors disagree on this row. | log OR -1.07 GRADE not reported Studies not reported |
| Mature (closed apex) permanent teeth with carious pulp exposure | Vital pulp therapy with MTA | Vital pulp therapy with CaOH | Composite clinical and radiographic success of vital pulp therapy Clinical (dental) · Sensitivity analysis: No sparse nodes | log OR -1.01 GRADE not reported Studies not reported |
| Mature (closed apex) permanent teeth with carious pulp exposure | Vital pulp therapy with MTA | Vital pulp therapy with CaOH | Composite clinical and radiographic success of vital pulp therapy Clinical (dental) · Sensitivity analysis: Base | log OR -1.10 GRADE not reported Studies not reported |
| Mature (closed apex) permanent teeth with carious pulp exposure | Vital pulp therapy with MTA | Vital pulp therapy with CaOH | Composite clinical and radiographic success of vital pulp therapy Clinical (dental) · Sensitivity analysis: Classic continuity correction | log OR -1.08 GRADE not reported Studies not reported |
| Mature (closed apex) permanent teeth with carious pulp exposure | Vital pulp therapy with MTA | Vital pulp therapy with CaOH | Composite clinical and radiographic success of vital pulp therapy Clinical (dental) · Sensitivity analysis: Beta-binomial likelihood Unresolved: the two extractors disagree on this row. | log OR -1.02 GRADE not reported Studies not reported |
| Mature (closed apex) permanent teeth with carious pulp exposure | Vital pulp therapy with Biodentine | Vital pulp therapy with CaOH | Composite clinical and radiographic success of vital pulp therapy Clinical (dental) · Sensitivity analysis: Half-Cauchy prior | log OR -0.79 GRADE not reported Studies not reported |
| Mature (closed apex) permanent teeth with carious pulp exposure | Vital pulp therapy with Biodentine | Vital pulp therapy with CaOH | Composite clinical and radiographic success of vital pulp therapy Clinical (dental) · Sensitivity analysis: Base | log OR -0.82 GRADE not reported Studies not reported |
| Mature (closed apex) permanent teeth with carious pulp exposure | Vital pulp therapy with Biodentine | Vital pulp therapy with CaOH | Composite clinical and radiographic success of vital pulp therapy Clinical (dental) · Sensitivity analysis: Beta-binomial likelihood Unresolved: the two extractors disagree on this row. | log OR -0.76 GRADE not reported Studies not reported |
| Mature (closed apex) permanent teeth with carious pulp exposure | Vital pulp therapy with Biodentine | Vital pulp therapy with CaOH | Composite clinical and radiographic success of vital pulp therapy Clinical (dental) · Sensitivity analysis: Arm-based continuity correction Unresolved: the two extractors disagree on this row. | log OR -0.80 GRADE not reported Studies not reported |
| Mature (closed apex) permanent teeth with carious pulp exposure | Vital pulp therapy with Biodentine | Vital pulp therapy with CaOH | Composite clinical and radiographic success of vital pulp therapy Clinical (dental) · Sensitivity analysis: Classic continuity correction Unresolved: the two extractors disagree on this row. | log OR -0.81 GRADE not reported Studies not reported |
| Mature (closed apex) permanent teeth with carious pulp exposure | Vital pulp therapy with Biodentine | Vital pulp therapy with CaOH | Composite clinical and radiographic success of vital pulp therapy Clinical (dental) · Sensitivity analysis: No sparse nodes | log OR -0.75 GRADE not reported Studies not reported |
| Mature permanent teeth with deep caries treated by indirect pulp capping | MTA | None (single pooled success proportion across arms) | Composite success (clinical and radiographic) 1 year · Clinical settings · Biomaterial subgroup: MTA Unresolved: the two extractors disagree on this row. | Pooled success rate (%) 98.3 GRADE not reported 2 studies |
| Mature permanent teeth with deep caries treated by indirect pulp capping | CaOH | None (single pooled success proportion across arms) | Composite success (clinical and radiographic) 1 year · Clinical settings · Biomaterial subgroup: CaOH Unresolved: the two extractors disagree on this row. | Pooled success rate (%) 99.2 GRADE not reported 3 studies |
| Mature permanent teeth with deep caries treated by indirect pulp capping | Biodentine | None (single pooled success proportion across arms) | Composite success (clinical and radiographic) 1 year · Clinical settings · Biomaterial subgroup: Biodentine Unresolved: the two extractors disagree on this row. | Pooled success rate (%) 98.7 GRADE not reported 2 studies |
Included primary studies 48
Open in Studies| Study | Year | Also included by | Outcomes it informs here | Trial data |
|---|---|---|---|---|
| Doranala et al. 2022 Microvessel reactions and NAD-NADH changes in cat brain cortex during cortical stimulation under normo- and hypercapnic conditions. PMID:202240 | 1977 | 3 other reviews | not stated | not extracted yet |
| Awawdeh et al. 2018 The induction of chromosome aberrations in mouse dictyate oocytes by X-rays and chemical mutagens. PMID:201837 | 1977 | 2 other reviews | not stated | not extracted yet |
| Uesrichai et al. 2019 [Enkephalins--endorphins- endogenous opiate agonists]. PMID:201936 | 1977 | 2 other reviews | not stated | not extracted yet |
| Arshad et al. 2019 Paradoxical effects of calcium-glucagon interaction on cardiac muscle contractility of isolated guinea pig atria. PMID:201943 | 1977 | 1 other review | not stated | not extracted yet |
| Asgary 2022 matched by author and year (probable) | NR | 1 other review | not stated | not extracted yet |
| Asgary et al. 2012 Interaction of butylated hydroxytoluene (BHT) with phospholipid bilayer membranes: effect on 22Na permeability and membrane fluidity. PMID:201255 | 1977 | 1 other review | not stated | not extracted yet |
| Awawdeh 2018 matched by author and year (probable) | NR | 1 other review | not stated | not extracted yet |
| Hegde et al. 2017 1,2,4-Triazole amino nucleosides. 1-beta-D-3'-Amino-3'-deoxyribofuranosyl-1,2,4-triazole-3-carboxamide and related nucleosides. PMID:201758 | 1977 | 1 other review | not stated | not extracted yet |
| Iyer et al. 2021 False negative bone scans in neuroblastoma metastatic to the ends of long bones. PMID:202156 | 1978 | 1 other review | not stated | not extracted yet |
| Kundzina et al. 2016 Altered biochemical properties of mitochondria in mouse mammary epithelial cells during primary culture. PMID:201649 | 1977 | 1 other review | not stated | not extracted yet |
| Parameswaran et al. 2023 [Effect of cholesterol on membrane Na,K-activated adenosine triphosphatase]. PMID:202351 | 1977 | 1 other review | not stated | not extracted yet |
| Selvendran et al. 2022 Brain energy metabolism of the conscious rat exposed to ischemic conditions. PMID:202241 | 1977 | 1 other review | not stated | not extracted yet |
| Sharaan et al. 2022 Viral pathogenesis and molecular biology. PMID:202238 | 1977 | 1 other review | not stated | not extracted yet |
| Sharma 2020 matched by author and year (probable) | NR | 1 other review | not stated | not extracted yet |
| Sharma et al. 2020 Disturbances of perinatal carbohydrate metabolism in rats exposed to methylmercury in utero. PMID:202042 | 1977 | 1 other review | not stated | not extracted yet |
| Singh 2019 matched by author and year (probable) | NR | 1 other review | not stated | not extracted yet |
| Suhag 2019 matched by author and year (probable) | NR | 1 other review | not stated | not extracted yet |
| Taha 2017 matched by author and year (probable) | NR | 1 other review | not stated | not extracted yet |
| Taha et al. 2017 The experience of schizophrenia. PMID:201754 | 1977 | 1 other review | not stated | not extracted yet |
| Uesrichai 2019 matched by author and year (probable) | NR | 1 other review | not stated | not extracted yet |
| Arshad 2019 matched by author and year (probable) | NR | this review only | not stated | not extracted yet |
| Asgary 2012 matched by author and year (probable) | NR | this review only | not stated | not extracted yet |
| Asgary et al. 2022 Peripheral polyneuropathy associated with primary malignant lymphoma of the brain. PMID:202235 | 1978 | this review only | not stated | not extracted yet |
| Cengiz 2015 matched by author and year (probable) | NR | this review only | not stated | not extracted yet |
| Cengiz and Yilmaz 2015 Effect of cold exposure on alpha-MSH and ACTH release in the rat. PMID:201553 | 1977 | this review only | not stated | not extracted yet |
| Doranala 2022 matched by author and year (probable) | NR | this review only | not stated | not extracted yet |
| Hashem 2019 matched by author and year (probable) | NR | this review only | not stated | not extracted yet |
| Hashem et al. 2019 Study into the mechanism of acetylsalicylic acid-induced bronchoconstriction. PMID:201944 | 1977 | this review only | not stated | not extracted yet |
| Hegde 2017 matched by author and year (probable) | NR | this review only | not stated | not extracted yet |
| Iyer 2021 matched by author and year (probable) | NR | this review only | not stated | not extracted yet |
| Jang 2015 matched by author and year (probable) | NR | this review only | not stated | not extracted yet |
| Jang et al. 2015 [The collum carcinoma; prevention--treatment--after care. 3. After care]. PMID:201548 | 1977 | this review only | not stated | not extracted yet |
| Kundzina 2016 matched by author and year (probable) | NR | this review only | not stated | not extracted yet |
| Parameswaran 2023 matched by author and year (probable) | NR | this review only | not stated | not extracted yet |
| Parinyaprom 2017 matched by author and year (probable) | NR | this review only | not stated | not extracted yet |
| Parinyaprom et al. 2017 Subsensitivity of dopamine-stimulated cAMP response in rat striatal and medial frontal cortex slices following treatment with dopamine… PMID:201747 | 1977 | this review only | not stated | not extracted yet |
| Peskersoy 2020 matched by author and year (probable) | NR | this review only | not stated | not extracted yet |
| Peskersoy et al. 2020 [Acute gastroenteritis caused by rotavirus. A summary of Danish studies]. PMID:202050 | 1977 | this review only | not stated | not extracted yet |
| Selvendran 2022 matched by author and year (probable) | NR | this review only | not stated | not extracted yet |
| Sharaan 2022 matched by author and year (probable) | NR | this review only | not stated | not extracted yet |
| Shobana 2022 matched by author and year (probable) | NR | this review only | not stated | not extracted yet |
| Shobana et al. 2022 Synthesis of haem and cytochrome c prosthetic group from delta-aminolaevulinate by the cell sap from rat liver. PMID:202245 | 1977 | this review only | not stated | not extracted yet |
| Singh et al. 2019 The mechanism by which the energy is released at the level of the flavoenzyme molecule during the transfer of two electrons. PMID:201952 | 1977 | this review only | not stated | not extracted yet |
| Singla 2023 matched by author and year (probable) | NR | this review only | not stated | not extracted yet |
| Singla et al. 2023 A fluorescence study of the binding of cytochrome C to mixed-phospholipid microvesicles : evidence for a preferred orientation of the… PMID:202339 | 1977 | this review only | not stated | not extracted yet |
| Suhag et al. 2019 Effect of carboxypeptidase N, aprotinin and anti-inflammatory drugs of pyrazolidine type on experimental inflammations in rats. PMID:201946 | 1978 | this review only | not stated | not extracted yet |
| Vural 2017 matched by author and year (probable) | NR | this review only | not stated | not extracted yet |
| Vural et al. 2017 Molecular orbital studies on the mechanism of drug-receptor interaction. 2. beta-Adrenergic drugs. An approach to explain the role of the… PMID:201757 | 1977 | this review only | not stated | not extracted yet |
Overlap with other reviews
Reviews that include the same primary studies are not independent evidence. Shared counts match studies by PMID, DOI or NCT, and otherwise by author and year (a probable match). Only the non-Cochrane dental reviews have study lists, so overlap with Cochrane reviews is not counted yet.
Review question
| Element | Planned (methods) | Found (results) |
|---|---|---|
| Population | Permanent teeth with carious exposure and mature (closed) apices, including symptomatic presentations | 24 RCTs in mature permanent teeth (primary NMA; 11 RCTs in immature teeth analyzed separately); 2906 teeth across 35 RCTs |
| Intervention | Vital pulp therapy (full pulpotomy, partial pulpotomy, direct pulp capping, indirect pulp capping) with any eligible pulp-capping material (MTA, Biodentine, MTA-like, Ca(OH)2, CEM, PRF/PRP, laser, GIC, RMGIC, potassium nitrate) | Full pulpotomy, partial pulpotomy, direct pulp capping, indirect pulp capping with ten biomaterial categories (MTA, MTA-like, Biodentine, Ca(OH)2, CEM, PRF, PRP, laser, GIC, RMGIC) |
| Comparison | Any head-to-head comparison of materials within the same modality | Material versus material within each modality |
| Outcomes | Primary: composite clinical and radiographic success at 6, 12, 24, 36 months; secondary: clinical success alone, failure, attrition | Composite success (clinical and radiographic); pooled success mostly above 90% across modalities and timepoints |
| Study designs | Randomized controlled trials (at least 2 parallel arms) | RCTs (n=24 mature teeth) |
| Timing | 6, 12, 24 and 36 months | 6 months, 1 year, 2 years, 3 years |
AMSTAR 2 items
Two independent extractors rated each item. Their ratings are shown side by side because they have not been reconciled yet. The overall rating follows Shea et al. 2017: one critical flaw gives Low, more than one gives Critically Low.
| Item | Extractor A | Extractor B | Agree |
|---|---|---|---|
| 1Research question includes PICO components | Yes | Yes | yes |
| 2Protocol established before the reviewcritical | Partial Yes | Partial Yes | yes |
| 3Choice of study designs explained | No | No | yes |
| 4Comprehensive literature searchcritical | No | Partial Yes | no |
| 5Study selection in duplicate | Yes | Yes | yes |
| 6Data extraction in duplicate | Yes | Yes | yes |
| 7List of excluded studies with reasonscritical | No | No | yes |
| 8Included studies described in detail | Partial Yes | Partial Yes | yes |
| 9Risk of bias assessed satisfactorilycritical | NRSI: N/A · RCT: Yes | NRSI: N/A · RCT: Yes | yes |
| 10Funding of included studies reported | No | No | yes |
| 11Appropriate meta-analysis methodscritical | NRSI: N/A · RCT: No | NRSI: N/A · RCT: No | yes |
| 12Impact of risk of bias on the pooled results | No | No | yes |
| 13Risk of bias accounted for in interpretationcritical | Yes | Yes | yes |
| 14Heterogeneity explained | Yes | Yes | yes |
| 15Publication bias investigatedcritical | Yes | Yes | yes |
| 16Conflicts of interest reported | Yes | Yes | yes |
| Overall | Critically Low | Critically Low | yes |