Clinical success of vital pulp therapy for pulp-exposed permanent teeth: a systematic review and meta-analysis

Pusa et al., 2025 | J Oral Sci | Meta Analysis

Citation

Pusa Natthanon, Chailertvanitkul Pattama, ... Samaksamarn Thalerngsak. Clinical success of vital pulp therapy for pulp-exposed permanent teeth: a systematic review and meta-analysis. J Oral Sci. 2025-Jul-16;67(3):107-115. doi:10.2334/josnusd.24-0452

Abstract

PURPOSE: To compare the clinical success of different forms of vital pulp therapy using various pulp-capping materials. METHODS: Two independent researchers selected relevant articles from databases, extracted data, evaluated bias risk, and performed meta-analysis. Among 337 studies retrieved, 21 with a total of 1,816 participants and 1,948 treated permanent teeth were eligible and selected for 17 types of comparison. Meta-analysis was conducted for only six of these 17 comparisons. RESULTS: Among the six comparisons, the success of direct pulp capping with mineral trioxide aggregate (MTA) was significantly higher than that using calcium hydroxide (relative risk = 1.21, 95% confidence interval = 1.02-1.42, P = 0.03). There was no significant difference in the success of direct pulp capping between mineral trioxide aggregate and biodentine, nor between partial pulpotomy and full pulpotomy for either type of pulp capping material. CONCLUSION: The use of MTA for direct pulp capping appears to yield significantly better clinical success than the use of calcium hydroxide.

Key Findings

Among the six comparisons, the success of direct pulp capping with mineral trioxide aggregate (MTA) was significantly higher than that using calcium hydroxide (relative risk = 1.21, 95% confidence interval = 1.02-1.42, P = 0.03). There was no significant difference in the success of direct pulp capping between mineral trioxide aggregate and biodentine, nor between partial pulpotomy and full pulpotomy for either type of pulp capping material.

Outcomes Measured

Requires manual extraction

Population

Field	Value
Population	See abstract
Sample Size	1816
Age Range	See abstract
Condition	See abstract

MeSH Terms

Humans
Dental Pulp Capping
Calcium Compounds
Dentition, Permanent
Silicates
Calcium Hydroxide
Aluminum Compounds
Pulp Capping and Pulpectomy Agents
Oxides
Dental Pulp Exposure
Drug Combinations
Pulpotomy
Treatment Outcome

Evidence Classification

Level: Meta Analysis
Publication Types: Journal Article, Systematic Review, Meta-Analysis
Vertical: calcium

Provenance

PMID: 40518287
DOI: 10.2334/josnusd.24-0452
PMCID: Not in PMC
Verified: 2026-04-09 via PubMed E-utilities API

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