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Updated: Jan 10, 2026

Accessing the Cytotoxicity and Cell Response to Biomaterials
Published on: July 8, 2021
EFFICACY OF BIODENTINE VERSUS MINERAL TRIOXIDE AGGREGATE IN PULPOTOMY FOR PRIMARY TEETH: A SYSTEMATIC REVIEW AND
Korina Yun-Fan Lu1, Jennifer L Gibbs1, Cheng-Yu Wu2
1Department of Restorative Dentistry and Biomaterial Sciences, Harvard School of Dental Medicine, Boston, MA.
Background:
Mineral trioxide aggregate (MTA) and Biodentine, introduced in the 1990s and 2010, are routinely used in primary teeth pulpotomy, yet their relative success remains unclear.
Objectives:
This paper aims to compare Biodentine and MTA efficacy in primary teeth pulpotomy over a 6 to 24-month follow-up, assessing clinical, radiographic, and endodontic outcomes.
Materials And Methods:
Randomized controlled trials (RCTs) published from March 2010 to March 2025 comparing the efficacy of Biodentine and MTA in primary teeth pulpotomy with ≥6-month follow-up were included. Their efficacy was determined by clinical and radiographic success rates, as well as 2 endodontic outcomes of root resorption and pulp canal obliteration (PCO). A bivariate and random-effect meta-analysis determined the pooled risk ratios (RRs) of the outcomes.
Results:
Eleven RCTs comprising 649 patients and 706 primary teeth were included. Clinical success rates were comparable between Biodentine and MTA at 6 months (RR = 1.00; 95% CI: 0.98-1.02), 12 months (RR = 1.01; 95% CI: 0.97-1.04), 18 months (RR = 0.99; 95% CI: 0.95-1.04), and 24 months (RR = 1.00; 95% CI: 0.94-1.07), with no observed heterogeneity (I² = 0%). Radiographic success rates also showed no significant differences at 6 months (RR = 0.99; 95% CI: 0.97-1.02), 12 months (RR = 1.00; 95% CI: 0.96-1.03), 18 months (RR = 1.01; 95% CI: 0.94-1.09), and 24 months (RR = 1.01; 95% CI: 0.94-1.08). Root resorption and pulp canal obliteration occurred at comparable rates across over 6, 12, and ≥18 months of follow-ups.
Conclusion:
Biodentine and MTA exerted comparable success rates in primary teeth pulpotomy at follow-ups of up to 2 years.
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