Calcium Silicate-Based Cements in Restorative Dentistry: Vital Pulp Therapy Clinical, Radiographic, and Histological Outcomes on Deciduous and Permanent Dentition-A Systematic Review and Meta-Analysis

• Published in: Materials Vol. 17; no. 17; p. 4264
• Main Authors: Xavier, Maria Teresa, Costa, Ana Luísa, Ramos, João Carlos, Caramês, João, Marques, Duarte, Martins, Jorge N R
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 01-09-2024
• Subjects: Biocompatibility; calcium silicate-based cements; Calcium silicates; Cement; Cements; Clinical trials; Content analysis; Dental pulp; Dentin; Dentistry; Forecasts and trends; Medical research; Medicine, Experimental; permanent teeth; primary teeth; Qualitative analysis; review; Statistical analysis; Success; Systematic review; Teeth; Therapy; vital pulp therapy; Canada; South Korea; Portugal; Texas; Oklahoma; Brazil; United States > US; calcium silicate-based cements; vital pulp therapy; permanent teeth; review; primary teeth
• ISSN: 1996-1944; 1996-1944
• 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.