A meta-analysis of the clinical effects of vital pulp therapy in the treatment of irreversible pulpitis in mature permanent teeth
Objective:The present study aims to conduct a meta-analysis on the clinical effectiveness of vital pulp therapy(VPT)in the treatment of irreversible pulpitis in mature permanent teeth.Methods:Databases such as PubMed,EMbase,Web of Science,The Cochrane Library,CNKI,Wanfang,VIP and China Biology Medicine(CBM)were searched for randomized controlled trials(RCTs)comparing VPT with root canal therapy for irreversible pulpitis in mature permanent teeth,with a retrieval period from the inception of the databases to September 2024.RevMan 5.4.1 software was used for fixed-effects model analysis.Results:A total of 11 RCTs involving 2,121 permanent teeth were included.The results showed no statistical difference in success rates between VPT and root canal therapy in treating irreversible pulpitis in mature perma-nent teeth(P=0.66,I2=0%),indicating comparable long-term clinical success rates.There was also no statistical difference in patient-reported pain incidence on the 7th day after surgery between VPT and root canal therapy(P=0.91,I2=0%).When comparing the success rates of partial pulpotomy with coronal pulpotomy,no statistical difference was found(P=0.77,I2=0%).Conclusion:Current evidence suggests that VPT may be a potential feasible program for the treatment of irreversi-ble pulpitis in mature permanent teeth.Partial pulpotomy,with its minimally invasive advantage,can achieve comparable effects to coronal pulpotomy.However,this study also has certain limitations,and further high-quality clinical research is nee-ded.
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