Pulpotomy for irreversible pulpitis in mature permanent teeth: An overview of systematic reviews of randomized controlled trials.

IF 2.9 4区综合性期刊 Q2 MULTIDISCIPLINARY SCIENCES

Science Progress Pub Date : 2025-04-01 Epub Date: 2025-05-27 DOI:10.1177/00368504251346677

Ajay Chhabra, B Saravana Prathap, Ramya Kp, Priyanka Yadav, Himani, Sona J Parvathy, Vandana Chhabra

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Abstract

BackgroundPulpotomy is widely used in primary and immature permanent teeth, but its effectiveness in mature permanent teeth with irreversible pulpitis remains controversial.ObjectiveTo identify and evaluate the existing systematic reviews of randomized controlled trials (RCTs) assessing pulpotomy as a treatment for irreversible pulpitis in mature permanent teeth.MethodsA protocol-guided search was conducted across PubMed, ProQuest, EMBASE, and Cochrane up to March 2024, targeting systematic reviews based on RCTs. Eligibility, selection, data extraction, and risk of bias assessment were performed independently by two reviewers. Quality was assessed using the AMSTAR 2 tool.ResultsOf the 52 articles retrieved, only one systematic review met inclusion criteria. The review included four RCTs involving 874 patients. Reported clinical success rates ranged from 81.2% to 98.19%, and radiographic success ranged from 38.4% to 95%, with the highest outcomes observed for calcium-enriched mixture and mineral trioxide aggregate. The AMSTAR 2 assessment rated the systematic review as critically low quality.ConclusionCurrent evidence from systematic reviews is insufficient to definitively recommend pulpotomy for irreversible pulpitis in mature permanent teeth. However, favorable clinical outcomes and the minimally invasive, cost-effective nature of the procedure suggest that pulpotomy may serve as a practical alternative to root canal treatment in select cases. High-quality RCTs and systematic reviews are urgently needed to strengthen the evidence base.

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成熟恒牙不可逆牙髓炎的截髓术：随机对照试验的系统综述。

背景牙髓切开术广泛应用于乳牙和未成熟恒牙的治疗，但其对不可逆牙髓炎的成熟恒牙的治疗效果仍存在争议。目的识别和评价现有评价切髓术治疗成熟恒牙不可逆性牙髓炎的随机对照试验的系统综述。方法在PubMed、ProQuest、EMBASE和Cochrane中进行协议导向检索，检索截止到2024年3月，目标是基于随机对照试验的系统评价。资格、选择、数据提取和偏倚风险评估由两位审稿人独立完成。使用AMSTAR 2工具评估质量。结果在检索到的52篇文献中，只有1篇系统评价符合纳入标准。本综述纳入4项随机对照试验，涉及874例患者。报道的临床成功率为81.2%至98.19%，x线摄影成功率为38.4%至95%，其中富钙混合物和三氧化矿物聚集体的成功率最高。AMSTAR 2评估将系统评价评为极低质量。结论目前系统综述的证据不足以明确推荐对成熟恒牙不可逆性牙髓炎进行切髓术。然而，良好的临床结果和微创、成本效益的特点表明，在某些病例中，髓腔切开术可以作为根管治疗的一种实用替代方法。迫切需要高质量的随机对照试验和系统评价来加强证据基础。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Science Progress Multidisciplinary-Multidisciplinary

CiteScore

3.80

自引率

0.00%

发文量

119

期刊介绍： Science Progress has for over 100 years been a highly regarded review publication in science, technology and medicine. Its objective is to excite the readers'' interest in areas with which they may not be fully familiar but which could facilitate their interest, or even activity, in a cognate field.