Systematic review and meta analysis of first and second generation bioceramic materials in primary dentition pulpotomies

Abstract Calcium silicate-based materials are considered the gold standard in vital pulp therapy due to their ability to induce favorable repair responses. Mineral trioxide aggregate (MTA), a first-generation bioceramic cement, has demonstrated high clinical and radiographic success rates but is ass...

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Main Authors: João Albernaz Neves, Luísa Bandeira Lopes, Marta Alves Duarte, José João Mendes, Tiago Pimentel
Format: Article
Language:English
Published: Nature Portfolio 2025-05-01
Series:Scientific Reports
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Online Access:https://doi.org/10.1038/s41598-025-00868-9
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author João Albernaz Neves
Luísa Bandeira Lopes
Marta Alves Duarte
José João Mendes
Tiago Pimentel
author_facet João Albernaz Neves
Luísa Bandeira Lopes
Marta Alves Duarte
José João Mendes
Tiago Pimentel
author_sort João Albernaz Neves
collection DOAJ
description Abstract Calcium silicate-based materials are considered the gold standard in vital pulp therapy due to their ability to induce favorable repair responses. Mineral trioxide aggregate (MTA), a first-generation bioceramic cement, has demonstrated high clinical and radiographic success rates but is associated with disadvantages such as coronal discoloration, difficult handling, and long setting time. To address these issues, second-generation bioceramic cements were developed with improved chemical composition, radiopacifiers, and handling properties. This systematic review followed the PRISMA guidelines and included a comprehensive search of PubMed, MEDLINE, CENTRAL, Web of Science, SciELO, LILACS, and TRIP databases from 2011 up to August 2023. Two independent reviewers conducted study selection, data extraction, and risk of bias assessment using the Cochrane RoB 2 tool. Meta-analysis was performed using a random-effects model to compare the clinical and radiographic success rates of first- and second-generation bioceramics in pulpotomies of primary teeth, with heterogeneity assessed using the I2 statistic. A total of 14 studies were included, involving 1128 primary molars from 637 children. The meta-analysis revealed no statistically significant differences in clinical or radiographic success rates between first- and second-generation bioceramics across follow-up periods of up to 24 months. Both first- and second-generation bioceramics demonstrate comparable clinical and radiographic success in pulpotomies of primary teeth. The choice of material should be guided by clinical considerations and practitioner preference, as no significant differences in outcomes were observed.
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spelling doaj-art-7001bae6860e49118faa5fdf1a3ffbcb2025-08-20T03:10:17ZengNature PortfolioScientific Reports2045-23222025-05-0115111310.1038/s41598-025-00868-9Systematic review and meta analysis of first and second generation bioceramic materials in primary dentition pulpotomiesJoão Albernaz Neves0Luísa Bandeira Lopes1Marta Alves Duarte2José João Mendes3Tiago Pimentel4Clinical Research Unit (CRU), Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Egas Moniz School of Health and ScienceClinical Research Unit (CRU), Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Egas Moniz School of Health and ScienceClinical Research Unit (CRU), Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Egas Moniz School of Health and ScienceClinical Research Unit (CRU), Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Egas Moniz School of Health and ScienceFaculty of Dentistry, Oral & Craniofacial Sciences, King’s College LondonAbstract Calcium silicate-based materials are considered the gold standard in vital pulp therapy due to their ability to induce favorable repair responses. Mineral trioxide aggregate (MTA), a first-generation bioceramic cement, has demonstrated high clinical and radiographic success rates but is associated with disadvantages such as coronal discoloration, difficult handling, and long setting time. To address these issues, second-generation bioceramic cements were developed with improved chemical composition, radiopacifiers, and handling properties. This systematic review followed the PRISMA guidelines and included a comprehensive search of PubMed, MEDLINE, CENTRAL, Web of Science, SciELO, LILACS, and TRIP databases from 2011 up to August 2023. Two independent reviewers conducted study selection, data extraction, and risk of bias assessment using the Cochrane RoB 2 tool. Meta-analysis was performed using a random-effects model to compare the clinical and radiographic success rates of first- and second-generation bioceramics in pulpotomies of primary teeth, with heterogeneity assessed using the I2 statistic. A total of 14 studies were included, involving 1128 primary molars from 637 children. The meta-analysis revealed no statistically significant differences in clinical or radiographic success rates between first- and second-generation bioceramics across follow-up periods of up to 24 months. Both first- and second-generation bioceramics demonstrate comparable clinical and radiographic success in pulpotomies of primary teeth. The choice of material should be guided by clinical considerations and practitioner preference, as no significant differences in outcomes were observed.https://doi.org/10.1038/s41598-025-00868-9BioceramicsDeciduous teethMineral trioxide aggregatePulpotomy
spellingShingle João Albernaz Neves
Luísa Bandeira Lopes
Marta Alves Duarte
José João Mendes
Tiago Pimentel
Systematic review and meta analysis of first and second generation bioceramic materials in primary dentition pulpotomies
Scientific Reports
Bioceramics
Deciduous teeth
Mineral trioxide aggregate
Pulpotomy
title Systematic review and meta analysis of first and second generation bioceramic materials in primary dentition pulpotomies
title_full Systematic review and meta analysis of first and second generation bioceramic materials in primary dentition pulpotomies
title_fullStr Systematic review and meta analysis of first and second generation bioceramic materials in primary dentition pulpotomies
title_full_unstemmed Systematic review and meta analysis of first and second generation bioceramic materials in primary dentition pulpotomies
title_short Systematic review and meta analysis of first and second generation bioceramic materials in primary dentition pulpotomies
title_sort systematic review and meta analysis of first and second generation bioceramic materials in primary dentition pulpotomies
topic Bioceramics
Deciduous teeth
Mineral trioxide aggregate
Pulpotomy
url https://doi.org/10.1038/s41598-025-00868-9
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