Indirect pulp capping versus pulpotomy for treating deep carious lesions approaching the pulp in primary teeth: a systematic review

Authors:

ABSTRACT

Aim

To assess dental practice regarding the use of indirect pulp capping or pulpotomy in children with deep carious lesions
approaching the pulp in primary teeth and to compare the efficacy of the two pulp treatments.

Methods

Study design: Systematic
review. We searched the Cochrane Library, PubMed via MEDLINE, and EMBASE as well as the reference lists of included reports and
ClinicalTrials.gov (for ongoing trials). Eligible studies were surveys of dental practice sent to dentists regarding the use of indirect pulp
capping and pulpotomy in children with deep carious lesions approaching the pulp in primary teeth and any type of clinical study. Two
review authors independently extracted data and assessed risk of bias in duplicate.

Results

Of the 481 potentially eligible articles, 11
were included in the review: 8 described surveys of dental practice, 1 a non-randomised study, and 2 ongoing randomised trials. The
surveys of dental practice showed an overall increase in the teaching and practice of indirect pulp capping in primary teeth. The non-
randomised study found a statistically significant difference in favour of indirect pulp capping for clinical and radiological success at 3
years but with high overall risk of bias. CONCLUSIONS: Despite the success rate of indirect pulp capping for treating deep carious
lesions approaching the pulp in primary teeth, practitioners still hesitate to practice this technique because of lack of evidence and
studies on this topic. Thus, for strong evidence, investigators are encouraged to conduct randomised trials comparing the efficacy of
indirect pulp capping and pulpotomy for treating deep carious lesions approaching the pulp in primary teeth.

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