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



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.


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.


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.

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Fig. 5: Pulp therapy with 3Mixtatin in a glance.

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Data availability

Data can be made available upon reasonable request to the corresponding author and with permission from the Zanjan University of Medical Sciences.


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Authors and Affiliations



Authors contributed to data acquisition and searching, data analysis, and quality assessment and critically revised the final manuscript. In the process of data collection and risk of bias assessment, any contradictory ideas were resolved by the discussion between authors. Therefore, All authors participating in this research declare no conflict of interest.

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Correspondence to Bahareh Nazemi Salman.

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The authors declare no competing interests.

Ethics approval

Ethics approval was admitted by the ethics committee of Zanjan University of Medical Sciences with the ethics ID IR.ZUMS.REC.1400.230. This systematic review was prepared based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines13. The protocol was previously registered in the International Prospective Register of Systematic Reviews (PROSPERO; CRD42021243626).

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Zarabadi, M.S., Firoozi, P., Basir Shabestari, S. et al. 3Mixtatin versus MTA in pulp therapy of primary teeth: a systematic review and meta-analysis of current randomized controlled trials. Evid Based Dent 25, 111–112 (2024).

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