Abstract
Background: The greatest threats to developing teeth are dental caries and traumatic injury. If pulpal exposure occurs, then a pulpotomy procedure aims to preserve pulp vitality to allow for normal root development. Historically, calcium hydroxide has been the material of choice for pulpotomy procedures. Recently, an alternative material called mineral trioxide aggregate (MTA) has demonstrated the ability to induce hard-tissue formation in pulpal tissue. Objectives: This prospective study was conducted to observe the clinical and radiological findings of pulpotomies done with Mineral Trioxide Aggregate (MTA) &Calcium Hydroxide{Ca(OH)2} and to evaluate success rate of MTA in maintaining pulpal health in teeth with carious lesion. Materials and Methods: In this clinical trial study, 40 primary molars were treated by a conventional pulpotomy technique. They all fulfill the inclusion criteria and gave consent regarding this study. All selected teeth were evenly divided into 2 test groups. In group 1, the MTA pulpotomy (experimental) was performed, whereas in group 2, the conventional Ca(OH)2 pulpotomy (control) was done. The teeth of both groups were finally restored by Glass Ionomer Cement (GIC). The children were recalled for clinical and radiographic evaluations after 3, 6, and 12 months. Result: The follow-up evaluations revealed failure due to pain and swelling detected at 6 and 12 months postoperative evaluations in only 3 teeth treated with Ca(OH)2 and one treated with MTA. The remaining 36 teeth appeared to be clinically and radiographically successful 12 months postoperatively. Calcific metamorphosis was a radiographic finding in 4 teeth treated with MTA and 2 teeth treated with Ca(OH)2. Conclusion: Based on this clinical and radiographical evaluation study of 3, 6, and 12 months follow-up, MTA could be used as a safe material for pulpotomy in cariously and mechanically exposed primary molars and seems to be a suitable alternative to calcium hydroxide. Further research, however, is required to clarify this conclusion. DOI: http://dx.doi.org/10.3329/updcj.v3i1.17981 Update Dent. Coll. j: 2013; 3 (1): 24-31
Highlights
Preservation of primary teeth before the eruption of permanent teeth is desirable since they help to determine the shape of dental arches, maintain the space between teeth, prevent detrimental tongue and speech habits, preserve aesthetics, and maintain chewing function
Calcium hydroxide has been a popular pulpotomy agent for vital pulp therapy and is widely used clinically. It was introduced by Herman as a biologic dressing.5Despite its apparent success in vital pulp therapy, considerable confusion and condemnation of this material have long persisted because Ca(OH)2 —in its pure state and in the original formulations— kills a certain amount of tissue when placed in direct contact with the pulp rather than merely functioning as a biologic dressing
Mineral Trioxide Aggregate (MTA) was developed with the purpose of serving as an apical root end filling material, but it has proven to be successful in vital pulp therapy procedures both in animals 12, 13 and humans.4Many clinical studies have recommended that, MTA is a biocompatible material and its sealing ability is better than that of amalgam or zinc oxide eugenol.[4, 15]
Summary
Preservation of primary teeth before the eruption of permanent teeth is desirable since they help to determine the shape of dental arches, maintain the space between teeth, prevent detrimental tongue and speech habits, preserve aesthetics, and maintain chewing function. Several vital pulp treatments such as direct pulp capping and pulpotomy have been suggested by many of the previous studies.2,3Although, in young permanent teeth, indirect and direct pulp capping techniques are an accepted procedure, but in primary teeth it is contraindicated because of possibility of undetected avascular microscopic pulp exposure.[2,4] Calcium hydroxide has been a popular pulpotomy agent for vital pulp therapy and is widely used clinically It was introduced by Herman as a biologic dressing.5Despite its apparent success in vital pulp therapy, considerable confusion and condemnation of this material have long persisted because Ca(OH)2 —in its pure state and in the original formulations— kills a certain amount of tissue when placed in direct contact with the pulp rather than merely functioning as a biologic dressing. In the present study, the clinical outcome of MTA in pulpotomy of primary teeth was compared with that of Calcium hydroxide at
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