# Parental Acceptance of Passive Protective Stabilization During Pulp Therapy in Primary and Young Permanent Dentition: A Systematic Review and Meta-Analysis

## TL;DR

This study reviews how parents feel about a dental technique called PPS during treatments for children's teeth, finding mixed acceptance influenced by urgency and child health needs.

## Contribution

The study provides the first systematic review and meta-analysis on parental acceptance of PPS in pediatric pulp therapy.

## Key findings

- Pooled parental acceptance of PPS was 48.9% with high heterogeneity.
- Acceptance was higher in emergency situations and for children with special health care needs.
- Certainty of evidence was rated as very low due to inconsistency and imprecision.

## Abstract

Background: Passive protective stabilization (PPS) remains controversial in pediatric dentistry, particularly in invasive procedures such as pulp therapy. This systematic review and meta-analysis aimed to evaluate current parental acceptance of PPS. Methods: A systematic search of PubMed/MEDLINE, Cochrane Library, Scopus, and Embase was conducted up to 25 November 2025. Cross-sectional studies assessing parental acceptance of PPS in children aged 2–10 years were included. Studies published in English within the last 10 years and including at least 100 participants were eligible. Case reports, reviews, editorials, and studies not aligned with the objectives were excluded. Risk of bias was assessed using the Joanna Briggs Institute checklist. A random-effects meta-analysis with logit transformation was performed. Heterogeneity was quantified using I2 statistics. Certainty of evidence was evaluated using GRADE. Results: Five cross-sectional studies, including 1005 parents, were included. The pooled parental acceptance of PPS was 48.9% (95% CI: 29.0–69.2%), with substantial heterogeneity (I2 = 97%). Acceptance was consistently higher in emergency situations and among parents of children with special health care needs. Three studies showed low risk of bias and two moderate risk. The overall certainty of evidence was rated as very low due to inconsistency and imprecision. Conclusions: Parental acceptance of PPS is context-dependent and influenced by treatment urgency and patient characteristics. Given the high heterogeneity and low certainty of evidence, results should be interpreted cautiously. Further high-quality research is required.