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It followed PRISMA principles and applied PICOS to include permanent teeth with deep carious lesions, comparing calcium hydroxide with RMGIC, GIC/RMGIC variants, MTA, Biodentine, or Theracal with 1-year follow-up. Meta-analysis of included studies found no statistically significant differences in pulp vitality outcomes across the liner types, and sensitivity analysis confirmed similar findings.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":40,"@type":76,"position":81},"https://docshare.wps.com/document/research-report/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/a-systematic-review-and-meta-analysis-evaluating-the-success-of-different-protective-liners-after-performing-selective-caries-removal/437495/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/a-systematic-review-and-meta-analysis-evaluating-the-success-of-different-protective-liners-after-performing-selective-caries-removal/437495.png","ImageObject",300,407,{"name":92,"@type":93},"Mimi","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-09-30","2026-09-29",true,{"@type":102,"interactionType":103,"userInteractionCount":8},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"What clinical question did the review address?","Question",{"text":112,"@type":113},"The review assessed whether different protective liners, used after selective caries removal, differ in their ability to preserve pulp vitality.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"Which liner materials were compared against calcium hydroxide?",{"text":117,"@type":113},"Comparisons included RMGIC (and related glass ionomer approaches), Biodentine, Theracal, and MTA versus calcium hydroxide after selective caries removal.",{"name":119,"@type":110,"acceptedAnswer":120},"What did the meta-analysis show about treatment success?",{"text":121,"@type":113},"No statistically significant differences were found between RMGIC and calcium hydroxide, Biodentine and calcium hydroxide, Theracal and calcium hydroxide, or MTA and calcium hydroxide for clinical outcomes at follow-up.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},437495,1790795579,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":39,"category_name":40,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":8,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":139,"language":140,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":67,"update_tm":144,"read_time":145},2336477974920,"https://ap-avatar.wpscdn.com/davatar_155a257f0dc6eb9ab79c44ca47cae57d","SYSTEMATIC REVIEW  \nA systematic review and meta-analysis evaluating the success of different protective liners after performing selective caries removal  \nVaishnavi Ratnakar Patankara , Ashish K. Jaina , Rahul D. Raoa , Laresh N. Mistryb  and Deepakkumar Langadec   \naM.D.S Conservative Dentistry and Endodontics, Bharati Vidyapeeth Dental College, Navi Mumbai, Maharashtra, India; bM.D.S Pedodonticsand Preventive Dentistry, Bharati Vidyapeeth Dental College, Navi Mumbai, Maharashtra, India; c Pharmacology, DY Patil University School of Medicine, Navi Mumbai, Maharashtra, India  \nABSTRACT  \nAim: This systematic review appraised clinical trials that evaluated the efficacy of various protective linerson preserving pulp vitality after selective caries removal.  \nMethods: This systematic review adhered to the Preferred Reporting Items for Systematic Review and Meta-analysis principles. The Population, Intervention, Comparison, Outcome and Study Design (PICOS)strategy was intended to encompass individuals with deep carious lesions in permanent teeth. Studies comparing the efficacy of calcium hydroxide with glass ionomer cement (GIC) or resin-modified glass ionomer (RMGIC) or mineral trioxide aggregate (MTA) or Biodentine or Theracal on pulp vitality after selective caries removal having 1 year of follow-up were included.  \nResults: After full-text analysis, eight studies (n = 8 trials, 678 teeth) were included. The results of meta-analysis of seven studies indicated that there was no statistically significant difference between RMGIC and calcium hydroxide (risk ratio [RR] = 0.98; 95% Confidence limits (CL) = 0.92 to 1.06; P = 0.68), Biodentine and calcium hydroxide (RR = 1.05; 95% CL = 0.94 to 1.18; P = 0.40), Theracal and calcium hydroxide (RR = 1.02 ; 95% CL = 0.97 to 1.07; P = 0.48) and MTA and calcium hydroxide (RR = 1.13; 95% CL = 0.95 to 1.34; P = 0.17). Sensitivity analysis also showed no significant difference between Theracal and calcium hydroxide. Heterogeneity was moderate for comparison between MTA and calcium hydroxide (I² = 54%) . Two studies were with low risk of bias, and six studies were classified as having some concerns. Evidence ranged from very low to moderate.  \nConclusion: There were no differences in clinical outcomes between RMGIC and calcium hydroxide, Biodentine and calcium hydroxide, Theracal and calcium hydroxide and MTA and calcium hydroxide. Thus, the findings suggest that treatment success is not significantly influenced by the type of protective liner employed.  \nARTICLE HISTORY  \nReceived 24 July 2025 Accepted 26 November 2025  \nKEYWORDS  \nCalcium hydroxide; dental caries; dental pulp; silicates; vital pulp therapy  \nIntroduction  \nThe field of dentistry has seen substantial changes since its professional inception, with more invasive treatments being replaced by minimally invasive dentistry [1]. One such domain is the management of deep dentinal caries [2]. The early practice of complete caries removal is now slowly being replaced by selective caries removal [3] . Selective caries removal can be defined as a procedure in which carious dentin is removed completely from the periphery while leaving behind a layer of soft carious tissue adjacent to the pulp [4] . Clinically, teeth treated with selective caries removal have excellent chances of retaining pulp vitality and increased long-term survival [5–7] . Also, this procedure can be done in a single visit unlike stepwise excavation, which requires multiple sessions and the need tore-enter the lesion [8] .  \nThe use of protective liners has been an important step in the restoration of carious lesions in close proximity to the pulp. Calcium hydroxide is the most frequently utilized protective  \nliner in deep cavities. Its alkaline pH, capacity to stimulate the growth of reparative dentin, antimicrobial qualities, and biocompatibility signal remineralization at the interface between the pulp and dentine [9, 10] . However, it has a poor seal and is extrem","cbCaisrSBDwb8LJn","https://ap.wps.com/l/cbCaisrSBDwb8LJn","pdf",2760861,13,"English","# Abstract\n# Introduction\n## Selective caries removal and outcomes\n## Protective liners in deep cavities\n# Methods\n# Results\n# Conclusion\n# Article history\n# Keywords","[{\"question\":\"What clinical question did the review address?\",\"answer\":\"The review assessed whether different protective liners, used after selective caries removal, differ in their ability to preserve pulp vitality.\"},{\"question\":\"Which liner materials were compared against calcium hydroxide?\",\"answer\":\"Comparisons included RMGIC (and related glass ionomer approaches), Biodentine, Theracal, and MTA versus calcium hydroxide after selective caries removal.\"},{\"question\":\"What did the meta-analysis show about treatment success?\",\"answer\":\"No statistically significant differences were found between RMGIC and calcium hydroxide, Biodentine and calcium hydroxide, Theracal and calcium hydroxide, or MTA and calcium hydroxide for clinical outcomes at follow-up.\"}]","A systematic review and meta-analysis evaluating the success of different protective liners after performing selective caries removal | PDF",1790682143,33]