3Mixtatin versus MTA in pulp therapy of primary teeth: a systematic review and meta-analysis of current randomized controlled trials

Mobina Sadat Zarabadi; Parsa Firoozi; Samira Basir Shabestari; Azam Maleki; Bahareh Nazemi Salman

doi:10.1038/s41432-024-00987-8

3Mixtatin versus MTA in pulp therapy of primary teeth: a systematic review and meta-analysis of current randomized controlled trials

Evid Based Dent. 2024 Mar 6. doi: 10.1038/s41432-024-00987-8. Online ahead of print.

Authors

Mobina Sadat Zarabadi¹, Parsa Firoozi², Samira Basir Shabestari³, Azam Maleki⁴, Bahareh Nazemi Salman⁵

Affiliations

¹ Department of Pediatric Dentistry, School of Dentistry, Zanjan University of Medical Sciences, Zanjan, Iran.
² Private Practice, Zanjan, Iran.
³ Department of Oral Medicine, School of Dentistry, Firoozgar Clinical Research Development Center, Iran University of Medical Sciences, Tehran, Iran.
⁴ Social Determinants of Health Research Center, Health and Metabolic Diseases Research Institute, Zanjan University of Medical Sciences, Zanjan, Iran.
⁵ Department of Pediatric Dentistry, School of Dentistry, Zanjan University of Medical Sciences, Zanjan, Iran. drnazemi@zums.ac.ir.

PMID: 38448571
DOI: 10.1038/s41432-024-00987-8

Abstract

Aim: 3Mixtatin (a combination of Metronidazole, Minocycline, and Ciprofloxacin along with statins) is a novel biomaterial in pulp therapy, while Mineral Trioxide Aggregate (MTA) is considered the gold standard in endodontics. This study aimed to compare the clinical and radiographic success rates of MTA and 3Mixtatin in pulp therapy of primary teeth.

Methods and materials: MEDLINE (PubMed), CENTRAL, Web of Science, Scopus, ProQuest databases, and Google Scholar were searched to identify randomized controlled trials (RCTs) on pulp therapy with 3Mixtatin and MTA in primary teeth, published up to February 2023. It should be noted that the protocol was previously registered in the International Prospective Register of Systematic Reviews (PROSPERO; CRD42021243626). RCTs were assessed independently by two researchers in terms of eligibility and quality. Data extracted and tabulated. The Cochrane Risk of Bias (RoB-2) tool was used to assess the risk of bias. The effect sizes were evaluated utilizing risk ratios (RRs). The heterogeneity investigation was conducted utilizing I² measurement at α = 0.10.

Results: Out of 86 retrieval records, four articles met the inclusion criteria. Based on clinical and radiographic outcomes, the application of 3Mixtatin in the pulp therapy of primary teeth was as successful as MTA in 12 months (Clinical RR = 1.087 | Radiographic RR = 2.132). The RoB-2 tool showed a low risk of bias in all included RCTs.

Conclusion: The limited evidence showed the clinical and radiographic efficacy of 3Mixtatin as a potential alternative to MTA. Further empirical research with larger sample sizes and strict methodology will be essential to substantiate this assertion.