Treatment Outcomes and Prognostic Factors of Direct Pulp Capping in Permanent Teeth: A Systematic Review and Meta-analysis

Abstract

This study aimed to evaluate the overall treatment outcomes of direct pulp capping in permanent teeth and investigate the prognostic factors. MEDLINE via Ovid, EMBASE, PubMed, Cochrane Library, and manual search methods were used to select the included studies. After thorough screening, the criteria for quality assessment and data extraction were determined. Meta-analysis was performed using the random-effects model and meta-regression analysis. This systematic review included 33 studies, 11 prospective cohort studies, 9 retrospective cohort studies, and 13 randomised clinical trials. After applying the quality assessment criteria, 26 articles were included in the meta-analysis. The weighted pooled success rate was 83%, with a 95% confidence interval of 79-87% in studies that ranged from 6 months to 10 years. The meta-regression analysis showed that rubber dam isolation throughout all procedures was significantly more effective than other techniques (risk ratio=1.44; 95% confidence interval 1.06-2.16, p<0.05). This study provides evidence of successful treatment outcomes in direct pulp capping of permanent teeth, with "adequate tooth isolation" identified as a significant prognostic factor.