Evidence map›Paper›PMID 41339865›Full record

SynthesisBMC oral health2025

Partial pulpotomy for carious pulp exposure in adult mature permanent teeth: a systematic review and meta-analysis.

Sakha Abdelkhader, Garrit Koller, Jing Kang, Francesco Mannocci

Abstract readSystematic ReviewMeta-Analysis
In one paragraph

Synthesis in BMC oral health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Sakha AbdelkhaderDepartment of Endodontics, Centre for Oral, Clinical and Translational Sciences, Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, UK. Sakha.abdelkhader@kcl.ac.uk.ORCID 0009-0005-0252-8217
Garrit KollerDepartment of Endodontics, Centre for Oral, Clinical and Translational Sciences, Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, UK.
Jing KangDepartment of Endodontics, Centre for Oral, Clinical and Translational Sciences, Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, UK.
Francesco MannocciDepartment of Endodontics, Centre for Oral, Clinical and Translational Sciences, Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, UK. Francesco.Mannocci@kcl.ac.uk.ORCID 0000-0002-0560-1054

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundDeep carious lesions often lead to pulp exposure, highlighting the need for effective pulp preservation strategies. While root canal treatment was the conventional approach, alternatives like partial pulpotomy (PP) showed high success rates in maintaining pulp vitality. This review aimed to assess the success rates of PP in vital, mature teeth with carious pulp exposure, particularly focusing on adults aged 18 and older, as recent research is limited.

methodsThis systematic review (PROSPERO ID: CRD42024494545) examines the success rate of partial pulpotomy in adult mature permanent teeth with carious pulp exposure after at least one year of follow-up. The PICO framework outlines the population (adults with mature teeth), intervention (partial pulpotomy), comparators (various capping materials and pulp therapies), and outcome (success rates). Databases used for research included PubMed, ScienceDirect, Cochrane Library, and Embase. Inclusion criteria focused on RCTs and observational studies from 2000 to 2025 involving adults with deep carious pulp exposure, while exclusion criteria eliminated animal studies, case reports, and studies on primary teeth. Quality assessment tools included the Cochrane RoB 2 tool for RCTs and the Newcastle-Ottawa Scale for observational studies. Mesh terms used included ("pulpotomy" OR "pulp therapy") AND ( "mature" OR "adults") OR ("carious" OR "Pulp exposure").

resultsThe search yielded six randomized controlled trials reported in eight records and three observational studies from 42,320 records, highlighting significant success rate differences among capping materials. PP using Calcium hydroxide (CH) had a mean success rate of 34.3% (95% CI: [24.93%, 43.67%]), while tri-calcium silicate materials (MTA and Biodentine) achieved 86.8% (95% CI: [83.78%, 89.82%]), resulting in a 52.5% mean difference. Timing of restoration also influenced outcomes: immediate restorations had a success rate of 89.9%, whereas delays reduced rates significantly. Meta-regression indicated tri-calcium silicate use increased success by 37% (P = 0.0002), while each day of delay decreased success by 0.088 (P = 0.023). Further analysis found no significant difference between pulpotomy and full pulpotomy (pooled effect estimate: -0.77) CI: [-1.62 to 0.09].

conclusionPartial pulpotomy (PP) is an effective treatment for carious pulp exposure in adults, with success largely dependent on the material used; tri-calcium silicate cements are preferred over calcium hydroxide.

trial registrationThis systematic review, registered with PROSPERO (ID: CRD42024494545). CLINICAL IMPLICATIONS: Although PP is a successful clinical treatment affected by material choice and restoration timing, it is crucial to report and study age-related considerations to enhance clinical decision-making among practitioners.

Indexed as

Dental CariesDental Pulp ExposurePulpotomyAdultDental Pulp CappingDentition, PermanentHumansAdultsCarious exposureClinical outcomePartial pulpotomyVital pulp therapy

Identifiers

PMID41339865
PMCPMC12781594

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.