Success of Primary Teeth Pulpotomy Using Calcium Silicate Cements: A Systematic Review and Meta-Analysis of Randomized Clinical Trials.

Purpose: The purpose of this systematic review and meta-analysis was to assess the success of pulpotomies performed on primary teeth using mineral trioxide aggregate (MTA) and other calcium-silicate-based cements (CSC). Methods: A comprehensive search was conducted in six electronic databases. The selection of studies was guided by PICOS criteria and included only randomized clinical trials that evaluated the success of pulpotomy in primary teeth using MTA, compared with other CSC materials. Risk of bias was assessed using the RoB-2 tool, and meta-analyses were conducted using RevMan © 5.3 software. The GRADE tool was used to determine the certainty of evidence. Results: The initial search re- trieved 662 studies, resulting in 27 included studies. Although there was significantly higher radiographic success for MTA after 12 months versus Biodentine TM, the 24-month follow-up showed no significant difference. Also, no significant difference was observed between MTA and Portland cement (24 months) or TheraCal® (12 months). Seventeen studies were classified as having a high risk of bias, and the GRADE assessment revealed an overall low level of evidence. Conclusions: Pulpotomies using mineral trioxide aggregate, Biodentine TM, Portland cement, or TheraCal® are highly effective for managing primary teeth. The certainty of evidence supporting these findings remains low, and future work should focus on conducting better-designed long-term studies.