Treatment Outcomes and Prognostic Factors of Direct Pulp Capping in Permanent Teeth: A Systematic Review and Meta-Analysis

Abstract

OBJECTIVE: The objectives of this study were (i) to assess the overall treatment outcomes of direct pulp capping in permanent teeth and (ii) to investigate and identify the prognostic factors. METHODS: For the selection of included studies, MEDLINE via Ovid, EMBASE, PubMed, Cochrane Library, and manual search methods were used. After thorough screening, the quality assessment and data extraction criteria were established. RESULTS: This systematic review is comprised of 33 studies, including 11 prospective cohort studies, 9 retrospective cohort studies, and 13 randomized clinical trials. After applying the quality assessment criteria, 26 articles were included in the meta-analysis. The weighted pooled success rate was 83% with a 95% confidence interval between 79-87%. Meta-regression analysis indicated that rubber dam isolation in all treatment steps was significantly more effective than other techniques (risk ratio=1.44; 95% confidence interval 1.06-2.16, p<0.05). CONCLUSION: This study provides evidence of successful treatment outcomes using direct pulp capping in permanent teeth, with 'adequate tooth isolation" identified as a significant prognostic factor.