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

Moretti 2008.

Methods RCT, parallel‐arm
Teeth randomly assigned
Setting not mentioned. Conducted in Brazil. Operators were 3 authors of the article
Participants 23 children, 45 teeth, mean age 6 years, standard deviation age 0.4 years, age range 5 to 9 years
Interventions Group 1:Pulpotomy (formocresol); n = 15 (1 visit)
  • Rubber dam

  • Caries removal prior to pulpal access

  • Pulp access with slow‐speed bur

  • Pulpotomy amputation with excavator

  • For haemostasis, saline solution

  • Irrigation with saline

  • Cotton wool pellet soaked with FC placed on pulp stumps for 5 minutes after pulpotomy, followed by ZOE and IRM before being restored with glass‐ionomer cement


Group 2:Pulpotomy (MTA); n = 15 (1 visit)
  • Rubber dam

  • Caries removal prior to pulpal access

  • Pulp access with slow‐speed bur

  • Pulpotomy amputation with excavator

  • For haemostasis, saline solution

  • Irrigation with saline

  • MTA (1:1 ratio powder/saline) applied after pulpotomy, followed by IRM before being restored with glass‐ionomer cement


Group 3:Pulpotomy (calcium hydroxide); n = 15 (1 visit)
  • Rubber dam

  • Caries removal prior to pulpal access

  • Pulp access with slow‐speed bur

  • Pulpotomy amputation with excavator

  • For haemostasis, saline solution

  • Irrigation with saline

  • CH applied after pulpotomy, followed by IRM before being restored with glass‐ionomer cement

Outcomes Clinical success (no spontaneous pain, no mobility, no swelling, no fistula and no smell), radiographic success (no internal root resorption, no inter‐radicular bone destruction, no furcation radiolucency or dentine bridge formation), fistula, pathological mobility, inter‐radicular bone destruction, internal root resorption, dentine bridge formation: evaluation at 3, 6, 12, 18 and 24 months (at tooth level)
Notes Dropouts: "Two children… were lost to follow‐up because they moved to another city"
Group 1: 6, 12, 18, 24 months: 1 exfoliation per month
Group 2: 18 months: 1 exfoliation
Group 3: 12 and 18 months: 1 exfoliation per month; 24 months: 3 exfoliations
Exfoliations and extractions were excluded from analysis? No information
Source of funding: not reported
Risk of bias
Bias Authors' judgement Support for judgement
Random sequence generation (selection bias) Low risk Random number‐producing system
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 Low risk Quote: "...each checkup involved a clinical examination of the pulpotomized teeth, which was performed by two blinded and previously calibrated investigators"
Blinding of radiological outcomes assessment Low risk Quote: "...each checkup involved a periapical radiographic examination of the pulpotomized teeth, which was performed by two blinded and previously calibrated investigators"
Incomplete outcome data (attrition bias) 
 All outcomes Low risk Proportion of missing outcomes < 10% of children randomly assigned
Selective reporting (reporting bias) Unclear risk Insufficient information to make a clear judgement