ArticleFrontiers in pediatrics2026
Clinical outcomes of vital pulp therapy versus root canal treatment in immature permanent teeth with pulpal involvement: a meta-analysis.
Article in Frontiers in pediatrics, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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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.
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2 authors.
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Abstract
Objectives: This meta-analysis evaluated whether vital pulp therapy (VPT) provides more favorable outcomes compared with root canal treatment (RCT) in immature permanent teeth with pulpal involvement. Given the pivotal role of pulp vitality in apexogenesis, the study aimed to determine whether biologically conservative interventions offer greater clinical and radiographic success than pulpectomy-based therapies. Methods: A comprehensive search of PubMed, Embase, Cochrane Library, and Web of Science was conducted from inception to the final search date. Eligible studies included randomized controlled trials and comparative clinical cohorts evaluating VPT (partial, cervical, or complete pulpotomy; direct/indirect capping) vs. RCT in immature permanent teeth. The primary endpoint was composite clinical-radiographic success at the longest follow-up. Data were extracted at the tooth level and pooled using random-effects models to estimate odds ratios (ORs) with 95% confidence intervals (CIs). Prespecified subgroup analyses examined the effects of tooth maturity, VPT modality, biomaterial, etiology, and follow-up duration. Meta-regression explored determinants of treatment success, and trial sequential analysis (TSA) was performed to assess the sufficiency of cumulative evidence. Results: Eight studies were included qualitatively, and five contributed tooth-level data ( Conclusions: VPT was associated with favorable long-term outcomes compared with RCT in immature permanent teeth. However, because the cumulative evidence did not reach the trial sequential monitoring boundary or the required information size, the certainty of this apparent advantage remains limited. Preservation of pulp vitality may support apexogenesis and structural development, but larger comparative studies are still needed before definitive superiority can be concluded.
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