Clinical outcome of direct pulp capping with MTA or calcium hydroxide: a systematic review and meta-analysis

Direct pulp capping is one of the most common dental practices in endodontic therapy. This systematic review and meta-analysis aim to determine whether the effect of mineral trioxide aggregate (MTA) and calcium hydroxide for direct pulp capping is different, as measured by the clinical and radiographic analysis. The study list was obtained by searching PubMed, Springer Link, Scopus and Cochrane Database. Only those papers that met the inclusion criteria were analyzed. The results indicated that four studies met the inclusion criteria. Statistically significant difference was found between the success rates of MTA and calcium hydroxide treated teeth that needed direct pulp capping (P=0.002). Clinical assessments of the MTA versus calcium hydroxide for direct pulp capping suggested that MTA was superior to calcium hydroxide in direct pulp capping resulting in a lower failure rate (risk difference 0.1 [95% CI 0.04 to 0.16]). In conclusion, MTA has a higher clinical success rate for direct pulp capping comparing to calcium hydroxide, and might be a suitable replacement for calcium hydroxide.