Objectives: The aim of the current systematic review /meta-analysis was to perform a comparison of the outcomes of Calcium Enriched Mixture (CEM) and Mineral Trioxide Aggregate (MTA) as agents for pulpotomy in primary and permanent molars.The proposed PICO question was “Whenever there is vital pulp exposure in primary and permanent molars, what are the treatment outcomes of CEM compared to MTA pulpotomy regarding clinical and radiographic success?"
Methods: We looked for published randomized clinical trials (RCTs) of the at least 12-month period; the search covered papers published up to July 2017 in PubMed (Medline) and SpringerLink databases. Meta-analysis was performed using R program 3.3.3 with specialized meta-analysis packages, namely rmeta, metaphor, and RGtk2. Data was reformulated dichotomously (success or other [healing, failure, or missing]) for the selected studies. The fixed effect model was tested, OR (Odds ratio), RR (Risk ratio), and 95% CI (Confidence interval) were calculated using the formulated raw dichotomous data of the selected studies. The heterogeneity among studies was assessed using standard chi- square test and Woolf's test. Mantel-Haenszel fixed-effect method was used to compute OR for the fixed model. The level of significance was at 0.05.
Results: Four hundred forty-nine articles were gathered. Two reviewers screened the articles, and three RCTs were included in the study. After the assessment, three RCTs were suitable for meta-analysis tested by Mantel Haenszel method. Statistically, the insignificant difference was found between the success rate of CEM compared to MTA, with OR=0.92(95% CI, 0.57-1.49). RR= 0.94 (95% CI, 0.66-1.35). Test for heterogeneity showed p-values (0.4241, 0.4455)
Conclusions: Systematic review /meta-analysis of the chosen RCTs showed that CEM pulpotomy in human teeth presented insignificant but superior clinical and radiographic success compared to those treated with MTA. Good quality and homogeneity of the included RCTs were yielded.