Comparative success of platelet-rich fibrin and mineral trioxide aggregate in direct pulp capping and pulpotomy: a systematic review and meta-analysis.

Abstract

<h4>Purpose</h4>This systematic review and meta-analysis aimed to compare the clinical success rates of Platelet-Rich Fibrin (PRF) and Mineral Trioxide Aggregate (MTA) when used in pulp-capping and pulpotomy.<h4>Materials and methods</h4>A systematic search of PubMed, Scopus, Embase, and Web of Science was performed. Randomized and non-randomized clinical trials with a minimum 6-month follow-up were included. The risk of bias was assessed using RoB-2 and ROBINS-I tools, and the certainty of evidence was evaluated using GRADE.<h4>Results</h4>Nine studies were included in the qualitative and quantitative synthesis. The meta-analysis at 6 months (7 studies, 436 treated teeth) showed no significant difference between PRF and MTA (odds ratio [OR] 0.72, 95% confidence interval [CI]: 0.29-1.78; P= 0.4799). At 12 months (7 studies, 352 treated teeth), the results also indicated no statistically significant difference (OR 1.50, 95% CI: 0.93-2.43; P= 0.0962), though the point estimate favored PRF.<h4>Conclusion</h4>Within the limitations of this study, PRF and MTA demonstrate broadly similar clinical success rates in pulp-capping and pulpotomy over 6 and 12 months. The low certainty of evidence underscores the need for well-designed, larger randomized controlled trials with extended follow-up to more definitively establish their comparative long-term efficacy.