Albernaz Neves João, Bandeira Lopes Luísa, Alves Duarte Marta, Mendes José João, Pimentel Tiago
Clinical Research Unit (CRU), Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Egas Moniz School of Health and Science, Almada, Portugal.
Endodontics Department, Egas Moniz School of Health and Science, Almada, Portugal.
Sci Rep. 2025 May 15;15(1):16939. doi: 10.1038/s41598-025-00868-9.
Calcium silicate-based materials are considered the gold standard in vital pulp therapy due to their ability to induce favorable repair responses. Mineral trioxide aggregate (MTA), a first-generation bioceramic cement, has demonstrated high clinical and radiographic success rates but is associated with disadvantages such as coronal discoloration, difficult handling, and long setting time. To address these issues, second-generation bioceramic cements were developed with improved chemical composition, radiopacifiers, and handling properties. This systematic review followed the PRISMA guidelines and included a comprehensive search of PubMed, MEDLINE, CENTRAL, Web of Science, SciELO, LILACS, and TRIP databases from 2011 up to August 2023. Two independent reviewers conducted study selection, data extraction, and risk of bias assessment using the Cochrane RoB 2 tool. Meta-analysis was performed using a random-effects model to compare the clinical and radiographic success rates of first- and second-generation bioceramics in pulpotomies of primary teeth, with heterogeneity assessed using the I statistic. A total of 14 studies were included, involving 1128 primary molars from 637 children. The meta-analysis revealed no statistically significant differences in clinical or radiographic success rates between first- and second-generation bioceramics across follow-up periods of up to 24 months. Both first- and second-generation bioceramics demonstrate comparable clinical and radiographic success in pulpotomies of primary teeth. The choice of material should be guided by clinical considerations and practitioner preference, as no significant differences in outcomes were observed.
由于能够诱导良好的修复反应，硅酸钙基材料被认为是活髓治疗的金标准。矿物三氧化物凝聚体（MTA）作为第一代生物陶瓷水门汀，已显示出较高的临床和影像学成功率，但存在诸如冠部变色、操作困难和凝固时间长等缺点。为了解决这些问题，人们开发了第二代生物陶瓷水门汀，其化学成分、射线阻射剂和操作性能均有所改进。本系统评价遵循PRISMA指南，全面检索了2011年至2023年8月期间的PubMed、MEDLINE、CENTRAL、Web of Science、SciELO、LILACS和TRIP数据库。两名独立的评价者使用Cochrane RoB 2工具进行研究选择、数据提取和偏倚风险评估。采用随机效应模型进行荟萃分析，以比较第一代和第二代生物陶瓷在乳牙牙髓切断术中的临床和影像学成功率，并使用I统计量评估异质性。共纳入14项研究，涉及637名儿童的1128颗乳磨牙。荟萃分析显示，在长达24个月的随访期内，第一代和第二代生物陶瓷在临床或影像学成功率方面无统计学显著差异。第一代和第二代生物陶瓷在乳牙牙髓切断术中均显示出相当的临床和影像学成功率。材料的选择应根据临床考虑和从业者的偏好来指导，因为在结果方面未观察到显著差异。
