{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,29]],"date-time":"2025-12-29T16:57:39Z","timestamp":1767027459463,"version":"3.48.0"},"reference-count":50,"publisher":"MJS Publishing, Medical Journals Sweden AB","license":[{"start":{"date-parts":[[2025,12,29]],"date-time":"2025-12-29T00:00:00Z","timestamp":1766966400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["BIiD"],"abstract":"<jats:p>Aim: This systematic review appraised clinical trials that evaluated the efficacy of various protective liners on preserving pulp vitality after selective caries removal.\nMethods: This systematic review adhered to the Preferred Reporting Items for Systematic Review and Meta-analysis principles. The Population, Intervention, Comparison, Outcome and Study Design (PICOS)strategy was intended to encompass individuals with deep carious lesions in permanent teeth. Studies comparing the efficacy of calcium hydroxide with glass ionomer cement (GIC) or resin-modified glass ionomer (RMGIC) or mineral trioxide aggregate (MTA) or Biodentine or Theracal on pulp vitality after selective caries removal having 1 year of follow-up were included.\nResults: After full-text analysis, eight studies (n = 8 trials, 678 teeth) were included. The results of meta-analysis of seven studies indicated that there was no statistically significant difference between RMGIC and calcium hydroxide (risk ratio [RR] = 0.98; 95% Confidence limits (CL) = 0.92 to 1.06; P = 0.68), Biodentine and calcium hydroxide (RR = 1.05; 95% CL = 0.94 to 1.18; P = 0.40), Theracal and calcium hydroxide (RR = 1.02 ; 95% CL = 0.97 to 1.07; P = 0.48) and MTA and calcium hydroxide (RR = 1.13; 95% CL = 0.95 to 1.34; P = 0.17). Sensitivity analysis also showed no significant difference between Theracal and calcium hydroxide. Heterogeneity was moderate for comparison between MTA and calcium hydroxide (I\u00b2 = 54%). Two studies were with low risk of bias, and six studies were classified as having some concerns. Evidence ranged from very low to moderate.\nConclusion: There were no differences in clinical outcomes between RMGIC and calcium hydroxide, Biodentine and calcium hydroxide, Theracal and calcium hydroxide and MTA and calcium hydroxide. Thus, the findings suggest that treatment success is not significantly influenced by the type of protective liner employed.<\/jats:p>","DOI":"10.2340\/biid.v12.45221","type":"journal-article","created":{"date-parts":[[2025,12,29]],"date-time":"2025-12-29T16:53:01Z","timestamp":1767027181000},"source":"Crossref","is-referenced-by-count":0,"title":["A systematic review and meta-analysis evaluating the success of different protective liners after performing selective caries removal"],"prefix":"10.2340","volume":"12","author":[{"given":"Vaishnavi","family":"Patankar","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ashish K.","family":"Jain","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rahul D.","family":"Rao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laresh N.","family":"Mistry","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Deepakkumar","family":"Langade","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1183","published-online":{"date-parts":[[2025,12,29]]},"reference":[{"key":"137228","doi-asserted-by":"crossref","unstructured":"Frencken JE, Peters MC, Manton DJ, Leal SC, Gordan VV, Eden E. 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Biology of selective caries removal: a systematic scoping review protocol. BMJ Open. 2022;12:e061119. https:\/\/doi.org\/10.1136\/bmjopen-2022-061119","DOI":"10.1136\/bmjopen-2022-061119"},{"key":"137232","doi-asserted-by":"crossref","unstructured":"Maltz M, Jardim JJ, Mestrinho HD, Yamaguti PM, Podest\u00e1 K, Moura MS, et al. Partial removal of carious dentine: a multicenter randomized controlled trial and 18-month follow-up results. Caries Res. 2013;47:103\u20139. https:\/\/doi.org\/10.1159\/000344013","DOI":"10.1159\/000344013"},{"key":"137233","doi-asserted-by":"crossref","unstructured":"Figundio N, Lopes P, Tedesco TK, Fernandes JCH, Fernandes GVO, Mello-Moura ACV. Deep carious lesions management with stepwise, selective, or non-selective removal in permanent dentition: a systematic review of randomized clinical trials. Healthcare (Basel). 2023;11:2338. https:\/\/doi.org\/10.3390\/healthcare11162338","DOI":"10.3390\/healthcare11162338"},{"key":"137234","doi-asserted-by":"crossref","unstructured":"Fraser J, MacInnes A. Which caries removal method to select? Evid Based Dent. 2024;25:29\u201330. https:\/\/doi.org\/10.1038\/s41432-024-00973-0","DOI":"10.1038\/s41432-024-00973-0"},{"key":"137235","doi-asserted-by":"crossref","unstructured":"Yao Y, Luo A, Hao Y. Selective versus stepwise removal of deep carious lesions: a meta-analysis of randomized controlled trials. J Dent Sci. 2023;18:17\u201326. https:\/\/doi.org\/10.1016\/j.jds.2022.07.021","DOI":"10.1016\/j.jds.2022.07.021"},{"key":"137236","doi-asserted-by":"crossref","unstructured":"Estrela C, Holland R. Calcium hydroxide: study based on scientific evidences. J Appl Oral Sci. 2003;11:269\u201382. https:\/\/doi.org\/10.1590\/S1678-77572003000400002","DOI":"10.1590\/S1678-77572003000400002"},{"key":"137237","doi-asserted-by":"crossref","unstructured":"Arandi NZ. Calcium hydroxide liners: a literature review. Clin Cosmet Investig Dent. 2017;9:67\u201372. https:\/\/doi.org\/10.2147\/CCIDE.S141381","DOI":"10.2147\/CCIDE.S141381"},{"key":"137238","doi-asserted-by":"crossref","unstructured":"Sidhu SK, Nicholson JW. A review of glass-ionomer cements for clinical dentistry. J Funct Biomater. 2016;7:16. https:\/\/doi.org\/10.3390\/jfb7030016","DOI":"10.3390\/jfb7030016"},{"key":"137239","doi-asserted-by":"crossref","unstructured":"Palmer G, Anstice HM, Pearson GJ. The effect of curing regime on the release of hydroxethyl methacylate (HEMA) from resin-modified glass-ionomer cements. 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Res Synth Methods. 2019;10(3): 1\u201332. https:\/\/doi.org\/10.1002\/jrsm.1313","DOI":"10.1002\/jrsm.1313"},{"key":"137249","doi-asserted-by":"crossref","unstructured":"Higgins J, Green S, eds. Cochrane handbook for systematic reviews of interventions. 2008. p. S38.","DOI":"10.1002\/9780470712184"},{"key":"137250","doi-asserted-by":"crossref","unstructured":"Sterne JAC, Egger M, Moher D. Addressing reporting biases. In: Cochrane handbook for systematic reviews of interventions. Julian PT Higgins and Sally Green, Cochrane Book Series, Chichester. 2008. p. 297\u2013333.","DOI":"10.1002\/9780470712184.ch10"},{"key":"137251","doi-asserted-by":"crossref","unstructured":"Singh S, Mittal S, Tewari S. Effect of different liners on pulpal outcome after partial caries removal: a preliminary 12 months randomised controlled trial. Caries Res. 2019;53:547\u201354. https:\/\/doi.org\/10.1159\/000499131","DOI":"10.1159\/000499131"},{"key":"137252","doi-asserted-by":"crossref","unstructured":"Kaul S, Kumar A, Jasrotia A, Gorkha K, Kumari S, Jeri SY. Comparative analysis of biodentine, calcium hydroxide, and 2% chlorhexidine with resin-modified glass ionomer cement as indirect pulp capping materials in young permanent molars. J Contemp Dent Pract. 2021;22:511\u20136. https:\/\/doi.org\/10.5005\/jp-journals-10024-3084","DOI":"10.5005\/jp-journals-10024-3084"},{"key":"137253","doi-asserted-by":"crossref","unstructured":"Rahman B, Goswami M. Comparative evaluation of indirect pulp therapy in young permanent teeth using biodentine and theracal: a randomized clinical trial. J Clin Pediatr Dent. 2021;45:158\u201364. https:\/\/doi.org\/10.17796\/1053-4625-45.3.3","DOI":"10.17796\/1053-4625-45.3.3"},{"key":"137254","doi-asserted-by":"crossref","unstructured":"Betamar N. 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Oper Dent. 1984 Spring;9:57\u201368."},{"key":"137263","doi-asserted-by":"crossref","unstructured":"Phillips RW, Crim G, Swartz ML, Clark HE. Resistance of calcium hydroxide preparations to solubility in phosphoric acid. J Prosthet Dent. 1984;52:358\u201360. https:\/\/doi.org\/10.1016\/0022-3913(84)90444-X","DOI":"10.1016\/0022-3913(84)90444-X"},{"key":"137264","doi-asserted-by":"crossref","unstructured":"Laurent P, Camps J, About I. Biodentine (TM) induces TGF-b1 release from human pulp cells and early dental pulp mineralization. Int Endod J. 2012;45:439\u201348. https:\/\/doi.org\/10.1111\/j.1365-2591.2011.01995.x","DOI":"10.1111\/j.1365-2591.2011.01995.x"},{"key":"137265","doi-asserted-by":"crossref","unstructured":"Selvendran KE, Ahamed AS, Krishnamurthy M, Kumar VN, Raju VG. Comparison of three different materials used for indirect pulp capping in permanent molars: an in vivo study. 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Comparative evaluations of shear bond strength of mineral trioxide aggregate, Biodentine, and calcium-enriched mixture to bulk-fill flowable composite using three different adhesive systems: an in vitro study. J Conserv Dent Endod. 2024;27:706\u201313. https:\/\/doi.org\/10.4103\/JCDE.JCDE_192_24","DOI":"10.4103\/JCDE.JCDE_192_24"},{"key":"137269","doi-asserted-by":"crossref","unstructured":"Tsujimoto M, Tsujimoto Y, Ookubo A, Shiraishi T, Watanabe I, Yamada S, et al. Timing for composite resin placement on mineral trioxide aggregate. J Endod 2013;39:1167\u201370. https:\/\/doi.org\/10.1016\/j.joen.2013.06.009","DOI":"10.1016\/j.joen.2013.06.009"},{"key":"137270","doi-asserted-by":"crossref","unstructured":"Akter R, Moral MA, Asaduszaman M, Hossain M. The radiographic outcome of biodentine and calcium hydroxide as indirect pulp capping agent in the management of deep caries. 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