Treatment Outcomes of Using Bioceramic Materials in Vital Pulp Therapy of permanent Teeth: A Systematic Review
Abstract
Abstract
Introduction: The aims of this systematic review were to 1) summarise and appraise the
available published information on the treatment outcomes of using various bioceramic
materials in vital pulp therapy (VPT) of permanent teeth, focusing on direct pulp capping, full
and partial pulpotomies and 2) outline any prognostic factors identified in the literature that
could influence the treatment outcome.
Materials and Methods: An electronic search of the relevant literature published in peerreviewed
journals from January 2010 up to July 2020 in PubMed and EMBASE, Ovid
MEDLINE(R) and Cochrane databases was conducted. The quality of all the included studies
was critically appraised using the Downs and Black checklist and the randomised controlled
trials risk of bias tool in the Cochrane Handbook for Systematic Reviews of Interventions.
Results: Thirteen studies met the inclusion criteria. The majority of the studies identified
were randomised controlled trials (n=9). Two were retrospective, and two were prospective
studies. Seven studies investigated the outcomes of using bioceramic materials in direct pulp
capping of permanent human teeth, two were on partial pulpotomy, and four studies
reported on the outcomes of complete pulpotomy. The overall evidence was found to be
insufficient to assess whether it is more advantageous to use mineral trioxide aggregate
(MTA) based materials, Biodentine or calcium-enriched mixture (CEM) over the other in VPT.
Conclusion: Based on our review synthesis, MTA based materials, Biodentine and CEM
show positive treatment outcomes when used in VPT. However, there is an insufficient
scientific basis to affirm whether it is more advantageous to use one over the other in VPT of
permanent teeth. Moreover, no generalised prognostic clinical factors were identified.