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. 2018 May 31;2018(5):CD003220. doi: 10.1002/14651858.CD003220.pub3

Doyle 2010.

Methods RCT, parallel‐arm
Teeth randomly assigned
Conducted in the Hospital for Sick Children, Toronto, Canada. Operators were 3 paediatric dentists
Participants 112 children, 266 teeth, mean age 4.0 years, standard deviation age 1.1 years
Interventions Group 1:Pulpotomy (FS + eugenol); n = 58 (1 visit)
  • Rubber dam

  • Caries removal prior to pulpal access

  • Pulp access with high speed followed by slow speed

  • Pulpotomy amputation with slow speed

  • For haemostasis saline ‐ water flush

  • No irrigation

  • 15.5% aqueous FS solution was gently burnished with the syringe applicator for 15 seconds after pulpotomy, followed by IRM dressings before being restored with stainless‐steel crown


Group 2:Pulpotomy (FS); n = 78 (1 visit)
  • Rubber dam

  • Caries removal prior to pulpal access

  • Pulp access with high speed followed by slow speed

  • Pulpotomy amputation with slow speed

  • For haemostasis saline ‐ water flush

  • No irrigation

  • Eugenol‐free FS. 15.5% aqueous FS solution was gently burnished with the syringe applicator for 15 seconds after pulpotomy, followed by Cimpact S dressings before being restored with stainless‐steel crown


Group 3:Pulpotomy (MTA); n = 53 (1 visit)
  • Rubber dam

  • Caries removal prior to pulpal access

  • Pulp access with high speed followed by slow speed

  • Pulpotomy amputation with slow speed

  • For haemostasis, saline ‐ water flush

  • No irrigation

  • MTA (3:1 powder:water ratio) placed on pulp stumps after pulpotomy, followed by IRM dressings before being restored with stainless‐steel crown


Group 4:Pulpotomy (MTA + FS + eugenol); n = 77 (1 visit)
  • Rubber dam

  • Caries removal prior to pulpal access

  • Pulp access with high speed followed by slow speed

  • Pulpotomy amputation with slow speed

  • For haemostasis saline ‐ water flush

  • No irrigation

  • FS: MTA. 15.5% aqueous FS solution was gently burnished with the syringe applicator then MTA 3:1 for 15 seconds after pulpotomy, followed by IRM dressings before being restored with stainless‐steel crown

Outcomes Tenderness to percussion, pathological mobility, erythema, parulis, pathological radiolucency, internal root resorption, external root resorption, periodontal ligament widening, pulp canal obliteration, N (score 5‐rx), Po (score 5‐rx), Px (score 5‐rx): mean evaluation at 22 (range 6 to 38) months (at tooth level)
Quote: "Subjects were invited to return for clinical and radiographic assessments at 12, 24, and 36 months after treatment"
Notes Source of funding: not reported
Risk of bias
Bias Authors' judgement Support for judgement
Random sequence generation (selection bias) Low risk Computer‐generated random numbers table
Allocation concealment (selection bias) Unclear risk Insufficient information to make a clear judgement
Blinding of participants and personnel (performance bias) 
 All outcomes Unclear risk Insufficient information to make a clear judgement
Blinding of clinical outcomes assessment Unclear risk Insufficient information to make a clear judgement
Blinding of radiological outcomes assessment Low risk Quote: "2 blinded, disinterested raters classified each molar into 1 of 3 radiographic outcomes"
Incomplete outcome data (attrition bias) 
 All outcomes High risk Proportion of missing outcomes > 10% of children randomly assigned
Selective reporting (reporting bias) Unclear risk Insufficient information to make a clear judgement