Review suggests direct pulp capping with MTA more effective than calcium hydroxide

Area of Science:

• Dentistry
• Endodontics
• Dental Materials

Background:

• Direct pulp capping is a dental procedure to preserve pulp vitality.
• Mineral trioxide aggregate (MTA) and calcium hydroxide (CH) are commonly used capping agents.
• Evidence comparing their efficacy is crucial for clinical decision-making.

Purpose of the Study:

• To compare the clinical success rates of MTA versus CH in direct pulp capping.
• To evaluate the inflammatory response and dentin bridge formation associated with MTA and CH.

Main Methods:

• Systematic review and meta-analysis of randomized controlled trials (RCTs) and retrospective non-randomized trials (RNTs).
• Searched PubMed, Cochrane Library, Embase, and Web of Knowledge databases.
• Assessed risk of bias using Cochrane risk of bias tool and Methodological Index for Non-randomised Studies.

Main Results:

• MTA demonstrated significantly higher success rates than CH in both RCTs (OR=2.26) and RNTs (OR=2.88).
• MTA groups showed significantly less pulpal inflammation (OR=4.56) and more predictable hard dentin bridge formation (OR=3.56) compared to CH.
• Thirteen studies involving 405-526 teeth were included in the meta-analysis.

Conclusions:

• MTA is associated with superior clinical outcomes in direct pulp capping compared to CH.
• MTA offers advantages in reducing pulpal inflammation and promoting dentin repair.
• MTA represents a potentially more effective alternative to CH for direct pulp capping procedures.