Non-Cochrane · intervention · PM42245173
Clinical outcomes of vital pulp therapy versus root canal treatment in immature permanent teeth with pulpal involvement: a meta-analysis.
Gu Siji, Yang Yuyun · Frontiers in pediatrics · 2026 · PubMed · doi:10.3389/fped.2026.1754580
Findings
Population Immature permanent teeth with pulpal involvement
14 findings
| Vital pulp therapy (pulpotomy or pulp capping) | Root canal treatment | Overall treatment success (clinical and radiographic) Follow-up >=24 months · Follow-up duration >=24 months | OR 2.03 [1.21, 3.41] GRADE not reported Studies not reported |
| Vital pulp therapy (pulpotomy or pulp capping) | Root canal treatment | Overall treatment success (clinical and radiographic) Longest follow-up (at least 12 months) · Sensitivity analysis: excluding observational cohort with traumatic pulp exposure | OR 2.03 [1.18, 3.49] GRADE not reported Studies not reported |
| Vital pulp therapy (pulpotomy or pulp capping) | Root canal treatment | Determinants of VPT effectiveness (meta-regression) Covariate: Immature tooth (Yes = 1) | Meta-regression coefficient (log OR) 0.62 [0.11, 1.13] GRADE not reported Studies not reported |
| Vital pulp therapy (pulpotomy or pulp capping) | Root canal treatment | Overall treatment success (clinical and radiographic) Longest follow-up (at least 12 months) | OR 1.37 [1.06, 1.78] GRADE not reported 3 studies |
| Vital pulp therapy (pulpotomy or pulp capping) | Root canal treatment | Determinants of VPT effectiveness (meta-regression) Covariate: Follow-up duration (per month) | Meta-regression coefficient (log OR) 0.03 [0.01, 0.05] GRADE not reported Studies not reported |
| Vital pulp therapy (pulpotomy or pulp capping) | Root canal treatment | Determinants of VPT effectiveness (meta-regression) Covariate: Hydraulic bioceramic material | Meta-regression coefficient (log OR) 0.48 [-0.03, 0.99] GRADE not reported Studies not reported |
| Vital pulp therapy (pulpotomy or pulp capping) | Root canal treatment | Determinants of VPT effectiveness (meta-regression) Covariate: Caries etiology (vs. trauma) | Meta-regression coefficient (log OR) 0.51 [-0.08, 1.11] GRADE not reported Studies not reported |
| Vital pulp therapy (pulpotomy or pulp capping) | Root canal treatment | Determinants of VPT effectiveness (meta-regression) Covariate: RCT design (vs. cohort) | Meta-regression coefficient (log OR) 0.41 [-0.15, 0.98] GRADE not reported Studies not reported |
| Vital pulp therapy (pulpotomy or pulp capping) | Root canal treatment | Overall treatment success (clinical and radiographic) Longest follow-up (at least 12 months) · Sensitivity analysis: omitting the PMTA/CEM pulpotomy trial | OR 1.74 [1.01, 3.03] GRADE not reported Studies not reported |
| Vital pulp therapy (pulpotomy or pulp capping) | Root canal treatment | Overall treatment success (clinical and radiographic) Follow-up <12 months · Follow-up duration <12 months | OR 1.41 [0.79, 2.51] GRADE not reported Studies not reported |
| Vital pulp therapy (pulpotomy or pulp capping) | Root canal treatment | Determinants of VPT effectiveness (meta-regression) Covariate: Complete/coronal pulpotomy | Meta-regression coefficient (log OR) 0.57 [0.04, 1.10] GRADE not reported Studies not reported |
| Vital pulp therapy (pulpotomy or pulp capping) | Root canal treatment | Overall treatment success (clinical and radiographic) Longest follow-up (at least 12 months) · Tooth maturity: immature teeth | OR 3.01 [1.43, 6.33] GRADE not reported Studies not reported |
| Complete or coronal pulpotomy | Root canal treatment | Overall treatment success (clinical and radiographic) Longest follow-up (at least 12 months) · VPT type: complete/coronal pulpotomy | OR 2.47 [1.11, 5.51] GRADE not reported Studies not reported |
| Vital pulp therapy (pulpotomy or pulp capping) | Root canal treatment | Overall treatment success (clinical and radiographic) Longest follow-up (at least 12 months) · Etiology of pulpal involvement (caries vs trauma; stratum not specified in text) | OR 2.12 [1.05, 4.28] GRADE not reported Studies not reported |
Included primary studies 8
Open in Studies| Study | Year | Also included by | Outcomes it informs here | Trial data |
|---|---|---|---|---|
| Asgary 2022 Outcomes of root canal therapy or full pulpotomy using two endodontic biomaterials in mature permanent teeth: a randomized controlled trial. PMID:34854987 | 2022 | 3 other reviews | Overall treatment success (clinical and radiographic) | not extracted yet |
| Alyahya 2024 Optimal outcomes of pulpotomy in young patients: Long-term prospects for permanent molars with signs and symptoms indicative of… PMID:38901324 | 2024 | this review only | Overall treatment success (clinical and radiographic) | not extracted yet |
| Asgary 2014 Two-year results of vital pulp therapy in permanent molars with irreversible pulpitis: an ongoing multicenter randomized clinical trial. PMID:23712823 | 2014 | this review only | Overall treatment success (clinical and radiographic) | not extracted yet |
| Babasidou 2025 Selective caries removal and management of exposed pulp in fully developed and immature teeth with reversible pulpitis: a… PMID:40423766 | 2025 | this review only | not stated | not extracted yet |
| Kalantzis 2024 The management of deep carious lesions and the exposed pulp in fully developed and immature teeth with irreversible pulpitis: a… PMID:38844571 | 2024 | this review only | not stated | not extracted yet |
| Lee 2023 Endodontic treatments on permanent teeth in pediatric patients aged 6-12 years old. PMID:37404642 | 2023 | this review only | not stated | not extracted yet |
| Shahmohammadi 2021 Treatment Outcomes of Permanent Immature Teeth with Crown Fracture: A Retrospective Cohort Study. PMID:34478786 | 2021 | this review only | Overall treatment success (clinical and radiographic) | not extracted yet |
| Zheng 2025 Outcomes of partial pulpotomy in permanent molars of children with irreversible pulpitis: A prospective cohort study. PMID:39255508 | 2025 | this review only | Overall treatment success (clinical and radiographic) | 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 | Patients with immature permanent teeth (incomplete root formation, open apices) with pulpal involvement from caries, trauma, restorative procedures or mixed etiology | Immature and mixed-maturity permanent teeth with irreversible pulpitis or traumatic pulp exposure (n=482 teeth in 5 studies with tooth-level data) |
| Intervention | Vital pulp therapy: direct or indirect pulp capping, partial, cervical, full or coronal pulpotomy; any biomaterial | Partial, cervical, complete or coronal pulpotomy with MTA, CEM, PMTA or premixed bioceramic materials |
| Comparison | Conventional root canal treatment, including apexification or apical barrier procedures | Conventional root canal treatment |
| Outcomes | Primary: overall treatment success (composite clinical and radiographic). Secondary: clinical success, radiographic success, tooth survival, complications | Overall treatment success (OR, n=3 comparative studies pooled) |
| Study designs | Randomized controlled trials, prospective and retrospective cohorts, case-control studies | 8 studies included (2 RCTs, 3 clinical cohorts, 3 non-comparative); 5 with tooth-level data |
| Timing | Longest follow-up of at least 12 months | Follow-up 6 to 24 months in controlled studies; over 10 years in one cohort |