{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T05:08:54Z","timestamp":1772168934379,"version":"3.50.1"},"update-to":[{"DOI":"10.12688\/f1000research.16142.1","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2019,6,25]],"date-time":"2019-06-25T00:00:00Z","timestamp":1561420800000}},{"DOI":"10.12688\/f1000research.16142.2","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2019,6,25]],"date-time":"2019-06-25T00:00:00Z","timestamp":1561420800000}}],"reference-count":21,"publisher":"F1000 Research Ltd","license":[{"start":{"date-parts":[[2019,6,25]],"date-time":"2019-06-25T00:00:00Z","timestamp":1561420800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["f1000research.com"],"crossmark-restriction":false},"short-container-title":["F1000Res"],"abstract":"\n Background<\/ns4:bold>\n : Early childhood caries is a serious public health problem. When caries extend to involve the pulp, various forms of pulp treatment are tried to stimulate tooth repair. Although pulpotomy is the treatment of choice for vital primary tooth pulp exposure but there is a trend among many dentists to perform pulpectomies \u00a0in vital primary incisors. This study aimed to assess the effect of pulpotomy and pulpecomy in treatment of carious vital pulp exposure in primary incisors.\n <\/ns4:p>\n \n Methods:<\/ns4:bold>\n We searched Pubmed and Cochrane library databases up to March, 2018, OpenGrey for grey literature and\n ClinicalTrials.gov<\/ns4:ext-link>\n for ongoing trials. Randomized controlled trials were included and assessed with Cochrane risk of bias tool . Primary outcomes were clinical failure and radiological failure.\u00a0The effect sizes were calculated as risk ratios with 95%CI using the Mantel-Haenszel method.\n <\/ns4:p>\n \n Results:<\/ns4:bold>\n Four trials were identified for qualitative assessment, only three trials were included in meta-analysis after exclusion of one trial due to its high risk of bias. The pooled results of the longest follow up period for clinical failure showed no statistically significant difference between pulpotomy and pulpectomy. The relative risk (RR) was e 2.69, 95% CI 0.76 to 9.58 for clinical failure.\u00a0For radiographic failure, the sensitivity analysis showed RR 0.45, 95% CI 0.25 to 0.83 with a higher risk for radiographic failure in pulpectomy. The evidence was limited by the small number of trials included in the meta-analysis.\n <\/ns4:p>\n \n Conclusions:<\/ns4:bold>\n Both pulpotomy and pulpectomy can be used successfully in the treatment of vital pulp exposure in primary incisors. Further high quality studies comparing between pulpotomy and pulpectomy in primary incisors with longer follow up period till exfoliation time are needed.\n <\/ns4:p>","DOI":"10.12688\/f1000research.16142.3","type":"journal-article","created":{"date-parts":[[2019,6,25]],"date-time":"2019-06-25T08:39:09Z","timestamp":1561451949000},"page":"1560","update-policy":"https:\/\/doi.org\/10.12688\/f1000research.crossmark-policy","source":"Crossref","is-referenced-by-count":4,"title":["Pulpotomy versus pulpectomy in the treatment of vital pulp exposure in primary incisors. A systematic review and meta-analysis."],"prefix":"10.12688","volume":"7","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3868-2978","authenticated-orcid":false,"given":"Lamia","family":"Gadallah","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mahmoud","family":"Hamdy","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1924-2582","authenticated-orcid":false,"given":"Adel","family":"El Bardissy","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohamed","family":"Abou El Yazeed","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2560","published-online":{"date-parts":[[2019,6,25]]},"reference":[{"key":"ref-1","doi-asserted-by":"publisher","first-page":"29-38","DOI":"10.4103\/0976-9668.107257","article-title":"Early childhood caries update: A review of causes, diagnoses, and treatments.","volume":"4","author":"H Colak","year":"2013","journal-title":"J Nat Sci Biol Med."},{"key":"ref-2","doi-asserted-by":"publisher","first-page":"38-50","DOI":"10.1111\/j.1752-7325.1996.tb02394.x","article-title":"Description and epidemiology of nursing caries.","volume":"56","author":"A Milnes","year":"1996","journal-title":"J Public Health Dent."},{"key":"ref-3","first-page":"710-4","article-title":"Prevalence of early childhood caries among 3-5 year old pre-schoolers in schools of Marathahalli, Bangalore.","volume":"9","author":"S Singh","year":"2012","journal-title":"Dent Res J (Isfahan)."},{"key":"ref-4","doi-asserted-by":"publisher","first-page":"412-419","DOI":"10.7537\/marslsj080111.52","article-title":"Dental Caries Prevalence among a group of Egyptian Nurseries Children.","volume":"8","author":"M El-Yazeed","year":"2011","journal-title":"Life Sci J."},{"key":"ref-5","doi-asserted-by":"publisher","first-page":"73","DOI":"10.1186\/s12903-016-0267-z","article-title":"Prevalence of early childhood caries and enamel defects in four and five-year old Qatari preschool children.","volume":"16","author":"A Alkhtib","year":"2016","journal-title":"BMC Oral Health."},{"key":"ref-6","first-page":"83-7","article-title":"Prevalence of Early Childhood Caries Among Preschool Children in Johannesburg, South Africa.","volume":"83","author":"K Mothupi","year":"2016","journal-title":"J Dent Child (Chic)."},{"key":"ref-7","doi-asserted-by":"publisher","first-page":"146-151","DOI":"10.4103\/0976-237X.72779","article-title":"Comparative investigation of clinical\/radiographical signs of mineral trioxide aggregate and formocresol on pulpotomized primary molars.","volume":"1","author":"S Hugar","year":"2010","journal-title":"Contemp Clin Dent."},{"key":"ref-8","article-title":"Guideline on Pulp Therapy for Primary and Immature Permanent Teeth","year":"2014"},{"key":"ref-9","first-page":"112-9","article-title":"Pulpotomy versus pulpectomy for carious vital primary incisors: randomized controlled trial.","volume":"34","author":"B Howley","year":"2012","journal-title":"Pediatr Dent."},{"key":"ref-10","first-page":"31-5","article-title":"Current trends in pulp therapy: a survey analyzing pulpotomy techniques taught in pediatric dental residency programs.","volume":"80","author":"L Walker","year":"2013","journal-title":"J Dent Child (Chic)."},{"key":"ref-11","first-page":"173-186","article-title":"Use of Vital Pulp Therapies in Primary Teeth with Deep Caries Lesions.","volume":"39","year":"2017","journal-title":"REFERENCE MANUAL."},{"key":"ref-12","doi-asserted-by":"publisher","first-page":"365-9","DOI":"10.17796\/jcpd.35.4.1377v06621143233","article-title":"Endoflas, zinc oxide eugenol and metapex as root canal filling materials in primary molars--a comparative clinical study.","volume":"35","author":"P Subramaniam","year":"2011","journal-title":"J Clin Pediatr Dent."},{"key":"ref-13","doi-asserted-by":"publisher","first-page":"CD003220","DOI":"10.1002\/14651858.CD003220.pub3","article-title":"Pulp treatment for extensive decay in primary teeth.","volume":"5","author":"V Sma\u00efl-Faugeron","year":"2018","journal-title":"Cochrane Database Syst Rev."},{"key":"ref-14","doi-asserted-by":"publisher","first-page":"CD003220","DOI":"10.1002\/14651858.CD003220.pub2","article-title":"Pulp treatment for extensive decay in primary teeth.","author":"V Sma\u00efl-Faugeron","year":"2014","journal-title":"Cochrane Database Syst Rev."},{"key":"ref-15","first-page":"34-38","article-title":"Comparison of Ferric Sulfate Combined Mineral Trioxide Aggregate Pulpotomy and Zinc Oxide Eugenol Pulpectomy of Primary Maxillary Incisors: An 18-month Randomized, Controlled Trial.","volume":"39","author":"T Nguyen","year":"2017","journal-title":"Pediatr Dent."},{"key":"ref-16","doi-asserted-by":"publisher","first-page":"e51908","DOI":"10.1371\/journal.pone.0051908","article-title":"Development of a core set of outcomes for randomized controlled trials with multiple outcomes--example of pulp treatments of primary teeth for extensive decay in children.","volume":"8","author":"V Sma\u00efl-Faugeron","year":"2013","journal-title":"PLoS One."},{"key":"ref-17","article-title":"Dataset 1 in: Pulpotomy versus pulpectomy in the treatment of vital pulp exposure in primary incisors. A systematic review and meta-analysis.","author":"L Gadallah","year":"2018","journal-title":"F1000Research."},{"key":"ref-18","article-title":"Cochrane Handbook for Systematic Reviews of Interventions","year":"2011"},{"key":"ref-19","article-title":"Review Manager (RevMan) [Computer program]","year":"2014"},{"key":"ref-20","doi-asserted-by":"publisher","first-page":"211-4","DOI":"10.17796\/jcpd.32.3.ghk26v4554790074","article-title":"A clinical study of formocresol pulpotomy versus root canal therapy of vital primary incisors.","volume":"32","author":"N Aminabadi","year":"2008","journal-title":"J Clin Pediatr Dent."},{"key":"ref-21","first-page":"34-8","article-title":"Outcomes of vital primary incisor ferric sulfate pulpotomy and root canal therapy.","volume":"70","author":"M Casas","year":"2004","journal-title":"J Can Dent Assoc."}],"container-title":["F1000Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/f1000research.com\/articles\/7-1560\/v3\/xml","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/f1000research.com\/articles\/7-1560\/v3\/pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/f1000research.com\/articles\/7-1560\/v3\/iparadigms","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2019,6,25]],"date-time":"2019-06-25T08:39:12Z","timestamp":1561451952000},"score":1,"resource":{"primary":{"URL":"https:\/\/f1000research.com\/articles\/7-1560\/v3"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,6,25]]},"references-count":21,"URL":"https:\/\/doi.org\/10.12688\/f1000research.16142.3","relation":{"has-review":[{"id-type":"doi","id":"10.5256\/f1000research.21668.r50364","asserted-by":"object"}]},"ISSN":["2046-1402"],"issn-type":[{"value":"2046-1402","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,6,25]]},"assertion":[{"value":"Indexed","URL":"https:\/\/f1000research.com\/articles\/7-1560\/v3#article-reports","order":0,"name":"referee-status","label":"Referee status","group":{"name":"current-referee-status","label":"Current Referee Status"}},{"value":"10.5256\/f1000research.17628.r39650, Mariem O. Wassel, Department of Pediatric Dentistry and Dental Public Health, Faculty\u00a0of\u00a0Dentistry, Ain Shams University, Cairo, Egypt, 07 Nov 2018, version 1, 1 approved, 1 approved with reservations","URL":"https:\/\/f1000research.com\/articles\/7-1560\/v1#referee-response-39650","order":0,"name":"referee-response-39650","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"Lamia Gadallah<\/b>; \nPosted: 08 Nov 2018<\/i>; Thank you Dr. Mariem very much for reviewing our study. As for the protocol registration, yes it was registered in the Evidence based Committee of Cairo University as the preliminary step of my Ph.D. in 2014.","URL":"https:\/\/f1000research.com\/articles\/7-1560\/v3#referee-comment-4206","order":1,"name":"referee-comment-4206","label":"Referee Comment","group":{"name":"article-reports","label":"Article Reports"}},{"value":"10.5256\/f1000research.17628.r41014, Armin Shirvani, Iranian Center for Endodontic Research, Research Institute of Dental Sciences, Faculty of Medical Education, Shahid Beheshti University of Medical Sciences, Tehran, Iran, 03 Dec 2018, version 1, 1 approved, 1 approved with reservations","URL":"https:\/\/f1000research.com\/articles\/7-1560\/v1#referee-response-41014","order":2,"name":"referee-response-41014","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"Lamia Gadallah<\/b>; \nPosted: 09 Dec 2018<\/i>; Dear Dr. Armin, Many thanks for reviewing our study and for your valuable comments.Concerning your first comment on the exclusion of Howley et al. study from the clinical failure meta-analysis, we returned to Cochrane handbook for systematic reviews of "intervention that stated that". The standard practice in meta-analysis of odds ratios and risk ratios is to exclude studies from meta-analysis where there are no events in both arms. This is because such studies do not provide any indication of either the direction or magnitude of the relative treatment effect"Actually the Revman program that we used for meta-analysis does not accept any decimals in the events in risk ratio as dichotomous outcomes.As for the heterogeneity in the radiographic evaluation, we performed a sensitivity analysis and it was due to one outlying study so we performed the meta-analysis both with and without this study and we stated that the results should be interpreted with caution.","URL":"https:\/\/f1000research.com\/articles\/7-1560\/v3#referee-comment-4292","order":3,"name":"referee-comment-4292","label":"Referee Comment","group":{"name":"article-reports","label":"Article Reports"}},{"value":"10.5256\/f1000research.19128.r49412, Marcela Bara\u00fana Magno, Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil, 19 Jun 2019, version 2, indexed","URL":"https:\/\/f1000research.com\/articles\/7-1560\/v2#referee-response-49412","order":4,"name":"referee-response-49412","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"The author(s) declared that no grants were involved in supporting this work","order":5,"name":"grant-information","label":"Grant Information"},{"value":"This is an open access article distributed under the terms of the Creative Commons Attribution Licence, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.Data associated with the article are available under the terms of the Creative Commons Zero \"No rights reserved\" data waiver (CC0 1.0 Public domain dedication).","order":0,"name":"copyright-info","label":"Copyright"}]}}