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| Title |
Mineral Trioxide Aggregate: A Superior Alternative To Formocresol |
| Clinical Question |
Does the use of mineral trioxide aggregate (MTA) as a vital pulp therapeutic medicament display clinically superior success rates when compared to formocresol (FC) in deciduous pulpotomies? |
| Clinical Bottom Line |
Mineral trioxide aggregate shows superior success rates when compared to FC as a vital pulp therapeutic medicament in deciduous pulpotomies. |
| Best Evidence |
(you may view more info by clicking on the PubMed ID link) |
| PubMed ID |
Author / Year |
Patient Group |
Study type
(level of evidence) |
| #1) 18534173 | Ng/2008 | Patients with carious primary molars exhibiting reversible coronal pulpitis | Evidence based review Meta-Analysis | | Key results | Direct meta-analysis of 5 studies with 147 FCp (Formocresol Pulpotomies) and 152 MTAp (Mineral Trioxide Pulpotomies) showed mean clinical success rates of 90.8% (± 5.1) and 97.6% (± 2.5) and mean radiographic success rates of 85.4% (± 5.7) and 96.8% (± 3.3) for FCp and MTAp, respectively. It was found that MTAp was 3.11 times more clinically successful than FCp with p=0.03 and a CI=1.09-8.85 and 4.50 times more radiographically successful than FCp with p=0.002 and a CI=1.79-11.42. | | #2) 17138165 | Peng/2006 | Primary molar teeth with vital pulp exposed by caries or trauma | Meta-Analysis | | Key results | At a 95% confidence interval, it was shown that MTA performed superiorly to FC with higher clinical (CI=0.11-0.90) and radiographic (CI=0.13-0.74) success as well as a lower incidence of internal root resorption (CI=0.11-0.77) in primary molar pulpotomies (P<.05). There was no statistically significant difference in pulp canal obliteration. | | #3) 18615986 | Fuks/2008 | 6-8 yr old patients with primary molars in need of pulpotomy | Review | | Key results | MTA performed better than FC in all studies that were reviewed. It was the author’s recommendation that MTA be considered as an alternative to FC. It was noted that the high cost of MTA is a prohibitive reason for using MTA in pediatric clinics. | |
| Evidence Search |
Search ("mineral trioxide aggregate "[Substance Name] AND "formocresol "[Substance Name]) AND "Pulpotomy"[Mesh] Limits: Randomized Controlled TrialSearch ("mineral trioxide aggregate "[Substance Name] AND "formocresol "[Substance Name]) AND "Pulpotomy"[Mesh] Limits: Review, Search ("mineral trioxide aggregate "[Substance Name] AND "formocresol "[Substance Name]) AND "Pulpotomy"[Mesh] Limits: Meta-Analysis, Search ("mineral trioxide aggregate "[Substance Name] AND "formocresol "[Substance Name]) AND "Pulpotomy"[Mesh] |
Comments on
The Evidence |
The two meta-analyses where deemed valid. The review however is not a systematic review, but does present the findings of many valid RCTs regarding the subject. |
| Applicability |
The evidence for comparisons of MTA to FC are fairly well documented in primary molars, however, evidence in non-molar teeth is limited at best. |
| Specialty/Discipline |
(Endodontics) (General Dentistry) (Pediatric Dentistry) (Restorative Dentistry) |
| Keywords |
Mineral Trioxide Aggregate; Formocresol; Pulpotomy
|
| ID# |
571 |
| Date of submission: |
03/31/2010 |
| E-mail |
lankford@livemail.uthscsa.edu |
| Author |
Adam Lankford |
| Co-author(s) |
|
| Co-author(s) e-mail |
|
| Faculty mentor/Co-author |
Maria Mendez Cervantes, DDS |
| Faculty mentor/Co-author e-mail |
CervantesMen@uthscsa.edu |
Basic Science Rationale
(Mechanisms that may account for and/or explain the clinical question, i.e. is the answer to the clinical question consistent with basic biological, physical and/or behavioral science principles, laws and research?) |
post a rationale |
| None available | |
|
Comments and Evidence-Based Updates on the CAT
(FOR PRACTICING DENTISTS', FACULTY, RESIDENTS and/or STUDENTS COMMENTS ON PUBLISHED CATs) |
post a comment |
by Jerin Jacob, Keyur Bhagat, Daniel Beruvides (San Antonio, TX) on 01/07/2013
A RCT was done by Srinivasan et. al., in 2011 (PMID# 22048576) on 100 deciduous mandibular molars on patients ranging from 4-6 years old. The results of this study support the conclusions of this CAT indicating that MTA, when compared to FC, is more superior. | |
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