Comparison of mineral trioxide aggregate and calcium hydroxide for apexification of immature permanent teeth: A systematic review and meta-analysis

Calcium hydroxide and mineral trioxide aggregate (MTA) are used for inducing a calcific barrier at an open tooth root (apexification). The purpose of this study was to compare the efficacy of calcium hydroxide and MTA for apexification of immature permanent teeth. Methods: Medline, Cochrane, EMBASE, and Google Scholar were searched until November 24, 2015, using the keywords apexification, permanent teeth, MTA, and calcium hydroxide. Results: Of 216 studies identified, four studies were included. There were no differences in the clinical success rate [pooled odds ratio (OR) = 3.03, 95% confidence interval (CI): 0.42–21.72, p = 0.271], radiographic success rate (pooled OR = 4.30, 95% CI: 0.45–41.36, p = 0.206), or apical barrier formation rate (pooled OR = 1.71, 95% CI: 0.59–4.96, p = 0.322) between calcium hydroxide and MTA groups. The time required for apical barrier formation was significantly less in the MTA group (pooled difference in means = −3.58, 95% CI: from −4.91 to −2.25, p < 0.001). Conclusion: While both materials provide similar success rates, the shorter treatment time with MTA may translate into higher overall success rates because of better patient compliance