Sotiria Gizani1, Kyriaki Seremidi2, Eirini Stratigaki3, Huei Jinn Tong4, Monty Duggal5, Dimitrios Kloukos6. 1. Dr. Gizani is an associate professor and chair, Athens School of Dentistry, National and Kapodistrian University of Athens, Athens Greece. 2. Dr. Seremidi is a scientific collaborator, at the Department of Pediatric Dentistry, Athens School of Dentistry, National and Kapodistrian University of Athens, Athens Greece. 3. Dr. Stratigaki is a lecturer, Department of Pediatric Oral Health and Orthodontics, University Center of Dental Medicine, Basel, Switzerland;, Email: eirini.stratigaki@unibas.ch. 4. Dr. Tong is a lecturer, Discipline of Orthodontics and Paediatric Dentistry, Faculty of Dentistry, National University of Singapore, Singapore. 5. Dr. Duggal is a professor, School of Dental Medicine, Qatar University, QU Health, Doha, Qatar. 6. Dr. Kloukos is a senior lecturer/research associate, Department of Orthodontics and Dentofacial Orthopedics, School of Dental Medicine, University of Bern, Bern, Switzerland, and is head, Department of Orthodontics and Dentofacial Orthopedics, Air Force and VA General Hospital, Athens, Greece.
Abstract
Purpose: The purpose of this umbrella review was to retrieve and assess the available systematic reviews reporting on pulp treatment of vital primary teeth with deep carious lesions. Methods: A literature search was conducted on electronic bibliographic databases to locate systematic reviews reporting on vital pulp therapy techniques or medicaments with two-arm comparisons and a follow-up period of at least 24 months. Eligible reviews were selected, data were extracted, and the risk of bias was assessed using a risk of bias in systematic reviews (ROBIS) tool. The degree of overlap was evaluated by calculating the corrected covered area (CCA). Results: Nine systematic reviews that cited 96 primary studies, with a high degree of overlap (14 percent CCA) were included. Indirect pulp capping had the highest success rate (94 percent) at 24 months, followed by direct pulp capping (88.8 percent), with different medicaments not significantly affecting the outcome. Pulpotomy showed the lowest success rate (82.6 percent), with the highest quality of evidence supporting the effective application of mineral trioxide aggregate (MTA) and formocresol (FC). Conclusions: The high success rate of pulp therapy techniques for the management of deep caries in vital primary teeth is evident; nevertheless, there remains insufficient evidence to draw scientifically solid conclusions about which technique and material are superior.
Purpose: The purpose of this umbrella review was to retrieve and assess the available systematic reviews reporting on pulp treatment of vital primary teeth with deep carious lesions. Methods: A literature search was conducted on electronic bibliographic databases to locate systematic reviews reporting on vital pulp therapy techniques or medicaments with two-arm comparisons and a follow-up period of at least 24 months. Eligible reviews were selected, data were extracted, and the risk of bias was assessed using a risk of bias in systematic reviews (ROBIS) tool. The degree of overlap was evaluated by calculating the corrected covered area (CCA). Results: Nine systematic reviews that cited 96 primary studies, with a high degree of overlap (14 percent CCA) were included. Indirect pulp capping had the highest success rate (94 percent) at 24 months, followed by direct pulp capping (88.8 percent), with different medicaments not significantly affecting the outcome. Pulpotomy showed the lowest success rate (82.6 percent), with the highest quality of evidence supporting the effective application of mineral trioxide aggregate (MTA) and formocresol (FC). Conclusions: The high success rate of pulp therapy techniques for the management of deep caries in vital primary teeth is evident; nevertheless, there remains insufficient evidence to draw scientifically solid conclusions about which technique and material are superior.