PDF(Pubmed)
Abstract：
This meta-analysis aims to assess the success rate of pulpotomy in the treatment of permanent teeth with carious pulp exposure and to compare the efficacy of different capping materials. Randomized controlled trials were searched in PubMed, EMBASE, Web of Science, Clinicaltrial.gov, and Cochrane Library until August 31, 2023. The pooled success rate was estimated in the overall population and in subgroups. Additional analyses comparing different capping materials using odds ratio (OR) and 95% confidence interval (95%CI) were performed. The certainty of evidence was graded using the GRADE approach. A total of 25 randomized trials with an average follow-up duration ≥ 12 months were finally included. The overall success rate of pulpotomy was 86.7% (95%CI: 82.0-90.7%). The success rate was not significantly affected by root development, pulpotomy type, and follow-up duration. Teeth with irreversible pulpitis had a relatively lower success rate than teeth with normal pulp or reversible pulpitis (82.4% [95%CI: 74.6-89.0%] vs 92.0% [95%CI: 87.9-95.4%], P = 0.013). Directly compared to conventional calcium hydroxide, mineral trioxide aggregate (88.2% vs 79.1%, OR = 2.41, 95%CI: 1.28-4.51, P = 0.006) and Biodentine (97.5% vs 82.9%, OR = 6.03, 95%CI: 0.97-37.6, P = 0.054) had higher successful rates. No significant difference between MTA and other biomaterials was found. The results were graded as very low to low certainty of evidence. In conclusion, pulpotomy is an effective treatment of permanent teeth with carious pulp exposure. Mineral trioxide aggregate and Biodentine can be recommended with more favorable outcomes as capping materials.
摘要：
这项荟萃分析旨在评估牙髓切除术治疗龋齿牙髓暴露的成功率，并比较不同盖帽材料的疗效。在PubMed中搜索了随机对照试验，EMBASE,WebofScience,临床试验.gov,和科克伦图书馆，直到2023年8月31日。在总体人群和亚组中估计合并成功率。使用比值比（OR）和95％置信区间（95CI）对不同的封顶材料进行了其他分析。使用分级方法对证据的确定性进行分级。最终纳入25项平均随访时间≥12个月的随机试验。牙髓切除术的总成功率为86.7%(95CI:82.0～90.7%)。成功率受根系发育影响不显著，牙髓切除术类型,和后续持续时间。与正常牙髓或可逆性牙髓炎的牙齿相比，不可逆牙髓炎的牙齿成功率相对较低（82.4％[95CI：74.6-89.0％]vs92.0％[95CI：87.9-95.4％]，P=0.013)。与传统的氢氧化钙相比，三氧化矿物骨料（88.2%对79.1%，OR=2.41，95CI：1.28-4.51，P=0.006）和生物牙本质（97.5％vs82.9％，OR=6.03，95CI：0.97-37.6，P=0.054）的成功率较高。MTA和其他生物材料之间没有发现显着差异。结果被分级为证据的极低到低确定性。总之,牙髓切除术是龋齿牙髓暴露的有效治疗方法。可以推荐矿物三氧化物聚集体和Biodentine作为封盖材料具有更有利的结果。
