Efficacy Of Calcium Silicate Material For Vital Pulp Therapy In Cariously Exposed Pulps Of Primary And Permanent Teeth :a Meta-analysis

ObjectivesThis study aims to systematically evaluate the efficacy of Calcium silicate material for vital pulp therapy in cariously exposed pulps of primary and permanent teeth.Methods:Databases including PubMed,Sciencedirect,The Cochrane Library,Web Of Science,CBM CNKI,VIP Data and Wan Fang Data were searched to identify suitable clinical trials on Calcium silicate material for vital pulp therapy in cariously exposed pulps of primary and permanent teeth from inception to January 2019.Two reviewers screened literature independently according to the inclusion and exclsion criteria strictly,extracted data and then We analyze data and draw forest plot by Revman 5.3software.The effect indexes were or and 95% CI.Publication bias was evaluated by the funnel plot.Results:1.The efficacy of pulp-capping agent of mineral trioxide aggregate(MTA)and calcium hydroxideThere were 6 primary teeth therapy studies and 13 permanent teeth therapy studies among 19 studies that fulfilled the inclusion criteria.The results of meta-analysis of primary teeth therapy showed that the 6-month clinical(OR=3.99;95%CI:1.58-10.07)and radiographic success rates(OR=7.19;95%CI :2.62-19.78)showed that MTA vs.calcium hydroxide did differ statistically,the12-month clinical(OR=2.39;95%CI:1.32-4.36)and radiographic success rates(OR=4.07;95%CI : 1.87-8.86)showed that MTA vs.calcium hydroxide did differ statistically,the success rates of MTA is higher than calcium hydroxide.The results ofmeta-analysis of permanent teeth therapy revealed there were statistically significant differences between the MTA and the calcium hydroxide in the 6,12 months success rates,respectively(OR=4.39;95%CI:2.61-7.41;OR=3.49;95%CI:1.85-6.59).2.The efficacy of pulp-capping agent of mineral trioxide aggregate(MTA)and calcium silicate materialsThere were 11 primary teeth therapy studies and 8 permanent teeth therapy studies among 19 studies.The results of meta-analysis of primary teeth treatment group showed that the 6-month clinical(OR=1.76;95%CI:0.41-7.59)and radiographic success rates(OR=2.56;95%CI : 1.00-6.52)showed that MTA vs.calcium silicate materials did not differ statistically;the 12-month clinical(OR=1.24;95%CI:0.41-3.70)and radiographic success rates(OR=1.94;95%CI : 0.92-4.12)showed that MTA compare to calcium hydroxide did not statistically significant.The meta-analysis results of permanent teeth treatment group revealed that the success rates(OR=0.81;95%CI:0.37-1.74)of MTA were not statistically significant compare to new calcium silicate materials.Conclusions:1.MTA has better clinical efficacy than calcium hydroxide in the treatment of cariously exposed pulps teeth,and the use of tricalcium silicate is recommended for pulp-capping agent in vital pulp therapy.2.There is no superiority of MTA over calcium silicate materials,this result suggests the new material of calcium silicate is likely as a potential pulp-capping medicament in carious teeth.