Hard tissue barrier formation after pulp capping?

Abstract

DATA SOURCES: Searches for relevant studies were made using Medline and the Cochrane Controlled Trials Register (CENTRAL). Reference lists of identified articles were searched. STUDY SELECTION: Studies selected were those carried out on human teeth, with or without caries, that were treated using a pulp-capping procedure and where the hard tissue and pulp were analysed with the aid of a microscope. Reviews of pulp capping were searched for references. DATA EXTRACTION AND SYNTHESIS: The authors independently extracted the data and assessed the level of evidence of each publication as high, moderate or low. Based on this, the evidence grade of the conclusions was rated as strong, moderately strong, limited or insufficient. RESULTS: Of 107 studies identified, 21 met the selection criteria. No study had a high level of evidence, one study was moderate and 20 studies provided a low level of evidence. There was heterogeneity between the studies and therefore no meta-analysis was performed. The majority of studies on pulp capping using calcium hydroxide-based materials reported formation of hard tissue bridging: studies on other pulp capping materials such as bonding agents presented inferior results. CONCLUSIONS: Although the majority of studies using calcium hydroxide-based materials reported hard tissue bridging, the quality of the available evidence is low. There is a need for more high-quality studies.