title: Primary molar pulpotomy: a systematic review and network meta-analysis.
abstract: OBJECTIVE
  Pulpotomy is a common procedure to treat asymptomatic reversible pulpitis in primary molars. The aim of this study is to undertake a systematic review and a network meta-analysis to compare the clinical and radiographic outcomes of different pulpotomy procedures in primary molars.
  
  
  METHODS
  Three authors performed data extraction independently and in duplicate using data collection forms. Disagreements were resolved by discussion.
  
  
  METHODS
  An electronic literature search was performed within MEDLINE (via PubMed), ScienceDirect, Web of Science, Cochrane, and ClinicalKey databases until December 2012. Medications for pulpotomy including formocresol, ferric sulfate, calcium hydroxide, and mineral trioxide aggregate (MTA), and laser pulpotomy are compared using Bayesian network meta-analyses. The outcome is the odds ratio for clinical and radiographic failure including premature tooth loss at 12 and 24 months after treatments amongst different treatment procedures. 37 studies were included in the systematic review, and 22 of them in the final network meta-analyses. After 18-24 months, in terms of treatment failure, the odds ratio for calcium hydroxide vs. formocresol was 1.94 [95% credible interval (CI): 1.11, 3.25]; 3.38 (95% CI: 1.37, 8.61) for lasers vs. formocresol; 2.16 (95% CI: 1.12, 4.31) for calcium hydroxide vs. ferric sulfate; 3.73 (95% CI: 1.27, 11.67) for lasers vs. ferric sulfate; 0.47 (95% CI: 0.26, 0.83) for MTA vs. calcium hydroxide; 3.76 (95% CI: 1.39, 10.08) for lasers vs.
  After 18-24 months, formocresol, ferric sulfate, and MTA showed significantly better clinical and radiographic outcomes than calcium hydroxide and laser therapies in primary molar pulpotomies.
  
  
  CONCLUSIONS
  The network meta-analyses showed that MTA is the first choice for primary molar pulpotomies. However, if treatment cost is an issue, especially when the treated primary molars are going to be replaced by permanent teeth, ferric sulfate may be the choice.
authors: Department of Dentistry, School of Dentistry, National Yang-Ming University, Taipei, Taiwan.
authors: Po-Yen
authors: PY
authors: Lin
authors: Department of Dentistry, Taiwan Adventist Hospital, Taipei, Taiwan.
authors: Hsueh-Szu
authors: HS
authors: Chen
authors: Graduate Institute of Clinical Dentistry, School of Dentistry, National Taiwan University, Taipei, Taiwan.
authors: Yu-Hsiang
authors: YH
authors: Wang
authors: Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan; Department of Dentistry, National Taiwan University Hospital, Taipei, Taiwan. Electronic address: yukangtu@ntu.edu.tw.
authors: Yu-Kang
authors: YK
authors: Tu
mesh_terms: D017607:Aluminum Compounds / Q000627:therapeutic use; D017610:Calcium Compounds / Q000627:therapeutic use; D002126:Calcium Hydroxide / Q000627:therapeutic use; D004338:Drug Combinations; D005290:Ferric Compounds / Q000627:therapeutic use; D005566:Formocresols / Q000627:therapeutic use; D006801:Humans; D053685:Laser Therapy / Q000379:methods; D008963:Molar / Q000473:pathology*; D010087:Oxides / Q000627:therapeutic use; D011671:Pulpitis / Q000628:therapy; D011672:Pulpotomy / Q000379:methods*; D012388:Root Canal Irrigants / Q000627:therapeutic use; D017640:Silicates / Q000627:therapeutic use; D014094:Tooth, Deciduous / Q000473:pathology*; D016896:Treatment Outcome
chemical_list: D017607:Aluminum Compounds; D017610:Calcium Compounds; D004338:Drug Combinations; D005290:Ferric Compounds; D005566:Formocresols; D010087:Oxides; D012388:Root Canal Irrigants; D017640:Silicates; C086631:mineral trioxide aggregate; C031025:formocresol; C024823:ferric sulfate; D002126:Calcium Hydroxide
keywords: Network meta-analysis; Primary molar; Pulpotomy; Randomized controlled trials; Systematic review