Abstract
ObjectivesThis study aimed to retrospectively evaluate clinical and radiographic outcomes of partial pulpotomy performed in permanent teeth with carious pulp exposure.Materials and methodsRecords of patients undergoing treatment at an undergraduate dental clinic between 2010 and 2019 were screened for partial pulpotomies in teeth with a presumptive diagnosis of normal pulp or reversible pulpitis. The follow-up had to be ≥ 1 year. Patient data were retrieved and analyzed using Mantel-Cox chi square tests and Kaplan–Meier statistics. The level of significance was set at α = 0.05.ResultsPartial pulpotomy was performed in 111 cases, of which 64 (58%) fulfilled the eligibility criteria. At the time of partial pulpotomy, the mean age was 37.3 (± 13.5) years (age range 18–85). The mean observation period was 3.1 (± 2.0) years. Two early failures (3.1%) and five late failures (7.7%) were recorded. The overall success rate of maintaining pulp vitality was 89.1%, with 98.4% tooth survival. The cumulative pulp survival rates of partial pulpotomy in patients aged < 30 years, between 30 and 40 years, and > 40 years were 100%, 75.5%, and 90.5%, respectively, with no significant difference between the age groups (p = 0.225). At follow-up, narrowing of the pulp canal space and tooth discoloration were observed in 10.9% and 3.1% of cases, respectively.ConclusionsAcross age groups, partial pulpotomy achieved favorable short and medium-term outcomes in teeth with carious pulp exposure.Clinical relevanceAdequate case selection provided, partial pulpotomy is a viable operative approach to treat permanent teeth with deep carious lesions irrespective of patients’ age.
Highlights
Different operative treatment approaches are available to manage deep carious lesions, which are defined by a radiographic involvement of ≥ 75% of the total dentin thickness [1]
Vital pulp therapy treatment modalities may offer a viable alternative to root canal treatment [8]
Partial pulpotomy was performed in 111 cases
Summary
Different operative treatment approaches are available to manage deep carious lesions, which are defined by a radiographic involvement of ≥ 75% of the total dentin thickness [1]. In the absence of signs and symptoms of irreversible pulpitis, indicative of either partial or total necrosis of the coronal pulp, a primary goal of these treatment approaches is to maintain the vitality and health of pulp tissue [2, 3]. Stepwise and selective caries removal aim to avoid pulp exposure and to alter the microbial ecology of the. Pulp exposure is inevitable in some cases, in particular when nonselective carious tissue removal to firm dentin is performed [7]. In such cases, vital pulp therapy treatment modalities may offer a viable alternative to root canal treatment [8]. Vital pulp therapy includes direct pulp capping, partial pulpotomy, and complete pulpotomy [9]
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