Effectiveness of mineral trioxide aggregate and its modifications in inducing dentin bridge formation during pulp capping: A systematic review
Shanmugapriya Karunakaran, N. Praveen, K. E. Selvandran, Ashok Leburu, K. Madhuram, Anup Kumar
Abstract
To comprehensively evaluate and compare the effectiveness of mineral trioxide aggregate (MTA) and its modifications in inducing dentin bridge formation during pulp capping procedures. This systematic review followed the Preferred Reporting Items for Systematic reviews and Meta Analyses guidelines and was registered in the PROSPERO platform. PubMed-Medline, Scopus, Embase, Lilacs, and Google Scholar were searched until June 1, 2024. Three reviewers independently extracted data using a prepiloted extraction sheet. The quality of randomized controlled trials (RCTs) was assessed using the ROB 2.0 tool, while quasi-experimental studies were evaluated using the JBI tool. The search yielded 152 studies, of which 9 studies (7 RCTs, 1 in vivo study, and 1 prospective clinical trial) met the inclusion criteria. The primary outcomes assessed included clinical success, radiographic success, dentin bridge formation, and dentin bridge thickness. The review found that MTA and its modifications effectively induced dentin bridge formation, with some modified formulations demonstrating improved handling properties, faster setting times, and reduced discoloration compared to conventional MTA. MTA and its modifications effectively promote dentin bridge formation in pulp capping procedures. Enhancing the properties of MTA through modifications can improve its clinical effectiveness by addressing some limitations of the conventional material. However, standardized methodologies in future studies are needed to improve the comparability and reproducibility of findings.