Pinto Karem Paula, da Silva Gabriela Ribeiro, Ferreira Cláudio Malizia Alves, Sassone Luciana Moura, da Silva Emmanuel João Nogueira Leal
Department of Integrated Clinical Procedures, School of Dentistry, Rio de Janeiro State University (UERJ), Rio de Janeiro, RJ, Brazil.
Departament of Endodontics, Grande Rio University (UNIGRANRIO), Rio de Janeiro, RJ, Brazil.
Restor Dent Endod. 2024 Sep 6;49(4):e34. doi: 10.5395/rde.2024.49.e34. eCollection 2024 Nov.
This systematic review and meta-analysis aimed to evaluate the success rate of direct pulp capping (DPC) on permanent teeth, comparing the use of MTA with calcium hydroxide and calcium silicate-based cements. A systematic search was carried out in 4 databases until July 2023. The selection was based on PICOS criteria and only randomized clinical trials were included. The risk of bias was assessed using RoB-2 tool, and meta-analyses were performed using RevMan 5.3 software. The overall quality of evidence was determined using the GRADE tool. Thirteen studies were included. Meta-analyses indicated significantly higher success rate for DPC using MTA compared to calcium hydroxide, while no significant difference was observed between MTA and Biodentine, showing a success rate from 80% to 100% even after 3 years of follow-up. Five studies were classified as having high risk of bias and the GRADE assessment revealed low certainty of evidence. DPC is highly effective for permanent teeth when using MTA or Biodentine. There is a need for future well-designed randomized clinical trials to evaluate the efficacy of DPC using newer bioceramic materials.
本系统评价和荟萃分析旨在评估恒牙直接盖髓术（DPC）的成功率，比较使用矿物三氧化物凝聚体（MTA）与氢氧化钙和硅酸钙基水门汀的情况。截至2023年7月，在4个数据库中进行了系统检索。选择基于PICOS标准，仅纳入随机临床试验。使用RoB-2工具评估偏倚风险，并使用RevMan 5.3软件进行荟萃分析。使用GRADE工具确定证据的总体质量。纳入了13项研究。荟萃分析表明，与氢氧化钙相比，使用MTA进行DPC的成功率显著更高，而MTA与生物活性玻璃陶瓷（Biodentine）之间未观察到显著差异，即使在随访3年后，成功率仍在80%至100%之间。5项研究被归类为具有高偏倚风险，GRADE评估显示证据的确定性较低。使用MTA或Biodentine时，DPC对恒牙非常有效。未来需要设计良好的随机临床试验来评估使用新型生物陶瓷材料进行DPC的疗效。
