ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM
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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) 18534173Ng/2008 Patients with carious primary molars exhibiting reversible coronal pulpitisEvidence based review Meta-Analysis
Key resultsDirect 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) 17138165Peng/2006 Primary molar teeth with vital pulp exposed by caries or traumaMeta-Analysis
Key resultsAt 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) 18615986Fuks/2008 6-8 yr old patients with primary molars in need of pulpotomyReview
Key resultsMTA 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 Trial Search ("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: 03/31/2010spacer
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
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Comments on the CAT
(FOR PRACTICING DENTISTS' and/or FACULTY COMMENTS ON PUBLISHED CATs)
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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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