Mineral trioxide aggregate as a pulpotomy medicament: An evidence-based assessment

Objective: The principles of evidence-based dentistry were used to compare the clinical and radiographic successes of four pulpotomy medicaments in human primary molars. Methods: Electronic databases were searched and sieved for randomised clinical trials comparing the clinical and radiographic successes of mineral trioxide aggregate (MTA), formocresol (FC), ferric sulfate (FS) and calcium hydroxide (CH) pulpotomies. Data were extracted and common odds ratios (CORs) were derived by fixed effects meta-analysis (MA). Results: Direct MA found MTA was significantly more successful clinically (COR = 3.11; 95% CI = 1.09 – 8.85; p = 0.03) and radiographically (COR = 4.50; CI = 1.78 – 11.42; p = 0.002) than FC. Indirect MAs found MTA was significantly more successful radiographically (COR = 4.69; CI = 1.70 – 12.95; p = 0.003) than FS, and significantly more successful clinically (COR = 6.48; CI = 1.75 – 24.0; p = 0.005) and radiographically (COR = 10.47; CI = 3.35 – 32.76; p = 0.00005) than CH. Conclusions: Current evidence suggests MTA compared with FC and CH as a pulpotomy medicament results in significantly higher clinical and radiographic successes in all time periods up to exfoliation. Mineral trioxide aggregate compared with FS as a pulpotomy medicament results in significantly higher radiographic success in all time periods up to exfoliation. (This study was supported by a grant from the The University of Melbourne School of Dental Science Research Committee.)