Primary molar pulpotomy: a systematic review and network meta-analysis

source extracted confidence: high 2026-04-09
#aluminum-compounds #calcium-compounds #calcium-hydroxide #drug-combinations #ferric-compounds

Primary molar pulpotomy: a systematic review and network meta-analysis

Lin et al., 2014 | J Dent | Systematic Review

Citation

Lin Po-Yen, Chen Hsueh-Szu, ... Tu Yu-Kang. Primary molar pulpotomy: a systematic review and network meta-analysis. J Dent. 2014-Sep;42(9):1060-77. doi:10.1016/j.jdent.2014.02.001

Abstract

OBJECTIVE: Pulpotomy is a common procedure to treat asymptomatic reversible pulpitis in primary molars. The aim of this study is to undertake a systematic review and a network meta-analysis to compare the clinical and radiographic outcomes of different pulpotomy procedures in primary molars. DATA: Three authors performed data extraction independently and in duplicate using data collection forms. Disagreements were resolved by discussion. SOURCES: An electronic literature search was performed within MEDLINE (via PubMed), ScienceDirect, Web of Science, Cochrane, and ClinicalKey databases until December 2012. Medications for pulpotomy including formocresol, ferric sulfate, calcium hydroxide, and mineral trioxide aggregate (MTA), and laser pulpotomy are compared using Bayesian network meta-analyses. The outcome is the odds ratio for clinical and radiographic failure including premature tooth loss at 12 and 24 months after treatments amongst different treatment procedures. 37 studies were included in the systematic review, and 22 of them in the final network meta-analyses. After 18-24 months, in terms of treatment failure, the odds ratio for calcium hydroxide vs. formocresol was 1.94 [95% credible interval (CI): 1.11, 3.25]; 3.38 (95% CI: 1.37, 8.61) for lasers vs. formocresol; 2.16 (95% CI: 1.12, 4.31) for calcium hydroxide vs. ferric sulfate; 3.73 (95% CI: 1.27, 11.67) for lasers vs. ferric sulfate; 0.47 (95% CI: 0.26, 0.83) for MTA vs. calcium hydroxide; 3.76 (95% CI: 1.39, 10.08) for lasers vs. MTA CONCLUSIONS: After 18-24 months, formocresol, ferric sulfate, and MTA showed significantly better clinical and radiographic outcomes than calcium hydroxide and laser therapies in primary molar pulpotomies. CLINICAL SIGNIFICANCE: The network meta-analyses showed that MTA is the first choice for primary molar pulpotomies. However, if treatment cost is an issue, especially when the treated primary molars are going to be replaced by permanent teeth, ferric sulfate may be the choice.

Key Findings

After 18-24 months, formocresol, ferric sulfate, and MTA showed significantly better clinical and radiographic outcomes than calcium hydroxide and laser therapies in primary molar pulpotomies. CLINICAL SIGNIFICANCE: The network meta-analyses showed that MTA is the first choice for primary molar pulpotomies. However, if treatment cost is an issue, especially when the treated primary molars are going to be replaced by permanent teeth, ferric sulfate may be the choice.

Outcomes Measured

  • Requires manual extraction

Population

Field Value
Population See abstract
Sample Size 37
Age Range See abstract
Condition See abstract

MeSH Terms

  • Aluminum Compounds
  • Calcium Compounds
  • Calcium Hydroxide
  • Drug Combinations
  • Ferric Compounds
  • Formocresols
  • Humans
  • Laser Therapy
  • Molar
  • Oxides
  • Pulpitis
  • Pulpotomy
  • Root Canal Irrigants
  • Silicates
  • Tooth, Deciduous
  • Treatment Outcome

Evidence Classification

  • Level: Systematic Review
  • Publication Types: Comparative Study, Journal Article, Research Support, Non-U.S. Gov't, Systematic Review, Network Meta-Analysis
  • Vertical: calcium

Provenance

Source extracted via PubMed E-utilities API on 2026-04-09