Natural versus Conventional Medicaments for Pulpotomy in Primary Teeth: A Systematic Review

Introduction: Natural medicaments are used in the treatment of infectious diseases due to their antibacterial and antiinflammatory properties. Pulpotomy is an effective vital pulp therapy for carious primary teeth, aimed at preserving radicular pulp vitality. While natural medicaments can serve as pulpotomy agents, their efficacy in comparison to conventional medicaments remains questionable. Aim: To analyse the scientific evidence comparing the efficacy of natural and conventional pulpotomy medicaments in primary teeth. Materials and Methods: This systematic review included human studies, Randomised Controlled Trials (RCTs), in-vivo studies, studies comparing natural and conventional pulpotomy agents, and studies conducted using primary molars. An electronic database search was performed using MeSH terms, limited to English-language publications in MEDLINE (PubMed), the Cochrane Library, and Ovid, with no restrictions on publication date. A hand search of scholarly articles was also conducted to uncover supplementary data. Relevant publications were selected based on established criteria, and quality analysis was carried out using the Cochrane risk of bias assessment tool. Results: Out of 483 articles, 11 randomised clinical trials were included in this systematic review. Ten of these evaluated clinical and radiographic efficacy, one assessed only histological efficacy, and one article examined all three outcomes of natural medicaments such as Allium sativum, Curcuma longa, Elaeagnus angustifolia, Copaifera langsdorffii, and Rosmarinus officinalis, comparing them with conventional medicaments in primary teeth. Quality analysis of the included studies indicated that four had good quality, three had fair quality, and four had poor quality. Conclusion: Based on the available evidence, it is difficult to determine the efficacy of natural pulpotomy medicaments definitively. There is a paucity of literature regarding the histological efficacy of these natural agents. More high-quality studies are recommended to seek an appropriate alternative to conventional pulpotomy medicaments in primary teeth.