Evaluation of vital pulp therapy with Biodentine in young permanent teeth: a systematic review and meta-analysis

Background: Vital pulp therapy (VPT) is essential for preserving the vitality of young permanent teeth. This systematic review and meta-analysis aimed to compare the efficacy of Biodentine with other bio-ceramic materials, specifically evaluating clinical success, radiographic success and tooth discoloration outcomes. Methods: A comprehensive literature search was performed in PubMed, Embase, Web of Science and The Cochrane Library databases for randomized controlled trials (RCTs) comparing Biodentine with other bio-ceramic materials in VPT for permanent teeth until 01 November 2024. Two independent reviewers screened studies based on predefined inclusion and exclusion criteria. Eligible RCTs were assessed for risk of bias, following data were extracted and the meta-analysis was performed. Results: A total of 8 RCTs met the inclusion criteria. The meta-analysis revealed that clinical success rates for Biodentine were 99.38% at 6 months, 94.20% at 12 months and 87.38% at 18 months. Other bio-ceramic materials achieved clinical success rates of 98.15%, 92.59% and 88.35% at the same time intervals. Radiographically, Biodentine demonstrated an overall success rate of 93.87%, compared to 91.04% for other bio-ceramic materials. No significant differences were observed in clinical or radiographic success rates between Biodentine and other materials over 6–18 months of follow-up (p > 0.05). However, Biodentine exhibited a significantly lower tooth discoloration rate compared to mineral trioxide aggregate (MTA) at the final follow-up (p < 0.05). Conclusions: Biodentine showed clinical and radiographic success rates comparable to other bio-ceramic materials in VPT for young permanent teeth, with the added advantage of significantly reducing the incidence of tooth discoloration. The PROSPERO Registration: number CRD42024599307.

Biodentine; Calcium silicate; Dental pulp capping; Meta-analysis; Pulpotomy; Pulp capping and pulpectomy agents

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