Abstract
Background: Pulpal damage or exposure resulting from dental caries provides a channel for microbial contamination, potentially leading to endodontic pathology if untreated. Vital pulp therapy (VPT) represents a less invasive alternative, aiming to sustain the health and functionality of the compromised pulp. Objective: This systematic review and meta-analysis explore the clinical outcomes of resin-based materials compared to traditional materials in VPT. Materials and Methods: PRISMA guidelines were followed in the conduct of this systematic review, which was also registered in PROSPERO. (CRD42024552414). The PICO format framed the research question. Databases searched included Google Scholar, PubMed, Scopus, Wiley Online Library, and SpringerLink from January 2014 to June 2024. Inclusion criteria were randomized control trials (RCTs) on VPT using resin-based materials in permanent teeth. Exclusion criteria included non-RCTs, case reports, in vitro studies, and studies on primary teeth. Data extraction and quality assessment were performed by means of the RoB 2 tool. Meta-analysis was conducted with Jamovi 2.3.28, employing the Sidik – Jonkman model based on Standardized mean differences (SMD) due to the high heterogeneity of the included studies. Results: From 2864 articles, six RCTs qualified under the inclusion criteria. The meta-analysis of six studies shows no significant overall effect Tau² = 0.1679, a substantial level of heterogeneity (I² = 73.35%). Although the average outcome is estimated to be negative, in some studies the true outcome may be positive Discussion: The review highlights advancements in resin-based pulp capping materials, such as Theracal LC and RMGIC. While these materials offer improved handling and setting properties, their long-term efficacy remains uncertain compared to traditional materials like MTA and calcium hydroxide. Notable heterogeneity among studies and limited long-term data limit definitive conclusions. Conclusion: Traditional materials like MTA and Biodentine remain effective for VPT. New resin-based materials show promise but require further research to establish their long-term clinical efficacy. Future studies should aim to reduce heterogeneity and include longer follow-up periods to validate these findings.