Materials used for indirect pulp treatment in primary teeth: a mixed treatment comparisons meta-analysis

Abstract

This study aimed to systematically review the literature toaddress the question regarding the influence of different materialsin the clinical and radiographic success of indirect pulp treatment inprimary teeth. A literature search was carried out for articles publishedprior to January 2017 in PubMed/MEDLINE, CENTRAL, Scopus, TRIPand ClinicalTrials databases; relevant articles included randomizedclinical trials that compared materials used for indirect pulp treatmentin primary teeth. Two reviewers independently selected the studies andextracted the data. The effects of each material on the outcome (clinicaland radiographic failures) were analyzed using a mixed treatmentcomparisons meta-analysis. The ranking of treatments according totheir probability of being the best choice was also calculated. From 1,088potentially eligible studies, 11 were selected for full-text analysis, and 4were included in the meta-analysis. In all papers, calcium hydroxide linerwas used as the control group versus an adhesive system, resin-modifiedglass ionomer cement or placebo. The follow-up period ranged from24 to 48 months, with dropout rates of 0-25.7%. The material type didnot significantly affect the risk of failure of the indirect pulp treatment.However, calcium hydroxide presented a higher probability of failure. Inconclusion, there is no scientific evidence showing the superiority of anymaterial used for indirect pulp treatment in primary teeth