Comparative efficacy of medicaments or techniques for pulpotomy of primary molars: a network meta-analysis

Objectives We performed this network meta-analysis to determine the comparative efficacy of formocresol (FC), ferric sulfate (FS), sodium hypochlorite (NaOCl), calcium hydroxide (CH), mineral trioxide aggregate (MTA), biodentine, and laser for pulpotomy of molar teeth. Materials and methods An updated search was conducted in PubMed, Embase, and the Cochrane Library to identify relevant randomized controlled trials (RCTs) published before October 30, 2022, after screening previous meta-analyses. The Cochrane risk of bias assessment tool was used to appraise the methodological quality of included studies. Clinical and radiographic success rates were assessed as outcomes. Random network meta-analysis was performed by using STATA software (version 14.0) with network command. ResultsA total of 43 RCTs were included. Network meta-analysis indicated that CH was inferior to other medicaments and techniques in all outcomes, and MTA and biodentine was better than FC, FS, and NaOCl in terms of clinical and radiographic success rates. Results of ranking probabilities suggested that MTA ranked first in all outcomes except for clinical success at both 6 months. ConclusionsOur results suggested that MTA was associated with significant improvement in both clinical and radiographic success than other pulpotomy medicaments and techniques, with the highest probability of being the optimal option.

Automated summary

This network meta-analysis compared the efficacy of different medicaments and techniques for pulpotomy of molar teeth. The results showed that calcium hydroxide was inferior to other options, while mineral trioxide aggregate and biodentine were superior to formocresol, ferric sulfate, and sodium hypochlorite in terms of clinical and radiographic success rates. The ranking probabilities indicated that mineral trioxide aggregate was the optimal choice in most outcomes. Therefore, mineral trioxide aggregate is recommended for pulpotomy due to its significant improvement in clinical and radiographic success.