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Is pulpotomy a promising modality in treating permanent teeth? An umbrella review

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Abstract

Emerging evidence suggests the use of less invasive therapy such as pulpotomy in treating permanent teeth with pulp exposure and signs of pulpitis. Hence, this umbrella review aims to evaluate the available systematic reviews on pulpotomy treated permanent teeth. Articles published between January 1970 and May 2021 were searched in ten electronic databases and five textbooks. Only systematic reviews published in English that examined the use of pulpotomy on either carious or traumatic pulpal exposed in mature or immature permanent teeth with signs of pulpitis were selected. The Corrected Covered Areas (CCAs) were calculated to identify the overlap in primary studies, whereas the AMSTAR 2 assessment tool was used to analyze the risk of bias in each included review. Nine systematic reviews were chosen of which two systematic reviews focused solely on coronal pulpotomy, one on partial pulpotomy, and the remaining focused on both coronal and partial pulpotomies. Overall, only two reviews were rated as ‘High Quality’. Umbrella analyses showed that both coronal and partial pulpotomies revealed overall high success rates ranging from 88.5% to 90.6%. However, the currently available evidence on the effects of different pulpal medicaments and restorative materials on the success rate of pulpotomy were still inconclusive. Pulpotomy can be regarded as a promising modality in treating mature and immature permanent teeth with carious pulpal exposure or signs of pulpitis. Nonetheless, further high-quality clinical trials with long-term follow-up and better control of confounding factors are warranted in the future.

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Funding

The present study was self-funded by all authors.

Author information

Authors and Affiliations

  1. Department of Dental Materials, Faculty of Dentistry, Asian Institute of Medicine, Science and Technology (AIMST) University, 08100, Bedong, Kedah, Malaysia

    Galvin Sim Siang Lin

  2. Bayan Lepas Dental Clinic, Ministry of Health Malaysia, 11900, Bayan Lepas, Penang, Malaysia

    Yun Qing Yew

  3. Seberang Jaya Dental Clinic, Ministry of Health Malaysia, 13700, Butterworth, Penang, Malaysia

    Hern Yue Lee

  4. Gunung Rapat Dental Clinic, Ministry of Health Malaysia, 31350, Ipoh, Perak, Malaysia

    Ting Low

  5. Kuah Dental Clinic, Ministry of Health Malaysia, 07000, Langkawi, Kedah, Malaysia

    Manushantini Pillai Muralitharan Pillai

  6. Bachok Dental Clinic, Ministry of Health Malaysia, 16300, Bachok, Kelantan, Malaysia

    Thittikkon Suvanpratum Laer

  7. Department of Paediatric Dentistry & Orthodontics, Faculty of Dentistry, Universiti Malaya, 50603, Kuala Lumpur, Malaysia

    Sharifah Wade’ah Wafa Syed Saadun Tarek Wafa

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  1. Galvin Sim Siang Lin
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  7. Sharifah Wade’ah Wafa Syed Saadun Tarek Wafa
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by Galvin Sim Siang Lin, Yun Qing Yew, Hern Yue Lee, Ting Ting Low, Manushantini Pillai Muralitharan Pillai, and Thittikkon Suvanpratum Laer. The first draft of the manuscript was written by Galvin Sim Siang Lin and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Galvin Sim Siang Lin.

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Lin, G.S.S., Yew, Y.Q., Lee, H.Y. et al. Is pulpotomy a promising modality in treating permanent teeth? An umbrella review. Odontology 110, 393–409 (2022). https://doi.org/10.1007/s10266-021-00661-w

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  • DOI: https://doi.org/10.1007/s10266-021-00661-w

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