Xavier Maria Teresa, Costa Ana Luísa, Ramos João Carlos, Caramês João, Marques Duarte, Martins Jorge N R
Centre for Innovation and Research in Oral Sciences (CIROS), Institute of Paediatric and Preventive Dentistry, Faculty of Medicine, University of Coimbra, 3000-075 Coimbra, Portugal.
Instituto de Implantologia, 1070-064 Lisboa, Portugal.
Materials (Basel). 2024 Aug 28;17(17):4264. doi: 10.3390/ma17174264.
Vital pulp therapy aims to preserve the vitality of dental pulp exposed due to caries, trauma, or restorative procedures. The aim of the present review was to evaluate the clinical, radiographic, and histological outcomes of different calcium silicate-based cements used in vital pulp therapy for both primary and permanent teeth. The review included 40 randomized controlled trials from a search across PubMed, LILACS, and the Cochrane Collaboration, as well as manual searches and author inquiries according to specific inclusion and exclusion criteria. A critical assessment of studies was conducted, and after data extraction the results were submitted to a quantitative statistical analysis using meta-analysis. The studies, involving 1701 patients and 3168 teeth, compared a total of 18 different calcium silicate-based cements in both dentitions. The qualitative synthesis showed no significant differences in short-term outcomes (up to 6 months) between different calcium silicate-based cements in primary teeth. ProRoot MTA and Biodentine showed similar clinical and radiographic success rates at 6 and 12 months. In permanent teeth, although the global results appeared to be well balanced, ProRoot MTA generally seemed to perform better than other calcium silicate-based cements except for Biodentine, which had comparable or superior results at 6 months. Meta-analyses for selected comparisons showed no significant differences in clinical and radiographic outcomes between ProRoot MTA and Biodentine over follow-up periods. The present review highlights the need for standardized definitions of success and follow-up periods in future studies to better guide clinical decisions. Despite the introduction of new calcium silicate-based cements aiming to address limitations of the original MTA. ProRoot MTA and Biodentine remain the most used and reliable materials for vital pulp therapy, although the results did not deviate that much from the other calcium silicate-based cements. Further long-term studies are required to establish the optimal CSC for each clinical scenario in both dentitions.
活髓治疗旨在保留因龋齿、外伤或修复操作而暴露的牙髓活力。本综述的目的是评估用于乳牙和恒牙活髓治疗的不同硅酸钙基水门汀的临床、影像学和组织学结果。该综述纳入了通过检索PubMed、LILACS和Cochrane协作网以及根据特定纳入和排除标准进行的手工检索和作者问询获得的40项随机对照试验。对研究进行了严格评估，数据提取后，使用荟萃分析对结果进行了定量统计分析。这些研究涉及1701名患者和3168颗牙齿，共比较了18种不同的硅酸钙基水门汀在两种牙列中的情况。定性综合分析表明，乳牙中不同硅酸钙基水门汀在短期结果（长达6个月）方面无显著差异。ProRoot MTA和Biodentine在6个月和12个月时显示出相似的临床和影像学成功率。在恒牙中，尽管总体结果似乎平衡良好，但除了Biodentine在6个月时结果相当或更优外，ProRoot MTA通常似乎比其他硅酸钙基水门汀表现更好。选定比较的荟萃分析表明，在随访期间，ProRoot MTA和Biodentine在临床和影像学结果方面无显著差异。本综述强调未来研究需要对成功和随访期进行标准化定义，以更好地指导临床决策。尽管引入了旨在解决原始MTA局限性的新型硅酸钙基水门汀，但ProRoot MTA和Biodentine仍然是活髓治疗中使用最广泛且可靠的材料，尽管其结果与其他硅酸钙基水门汀的差异不大。需要进一步的长期研究来确定两种牙列中每种临床情况的最佳硅酸钙基水门汀。
