Endodontic Treatment Research Articles

Diagnosis and endodontic treatment of odontogenic cutaneous sinus tracts: A report of two cases

Introduction: The odontogenic cutaneous sinus tract (OCST), caused by pulp necrosis, creates connections between pathological spaces and anatomical structures. Extraoral manifestations pose diagnostic challenges leading to inappropriate treatments such as multiple surgery and antibiotic therapies. Effective management requires the treatment of dental pathology through endodontic therapy or extraction. This paper presents two cases of OCST and emphasizes the importance of accurate diagnosis and successful non-surgical endodontic treatment. Observations: Case report 1: A 23-year-old male patient referred by his dermatologist with a cutaneous sinus tract on his chin that had appeared five years ago. During this period, he reported spontaneous pain and pus discharge from the chin area. The examination revealed a periapical lesion associated with tooth number 31. Cone beam computed tomography (CBCT) revealed the existence of a localized perforation on the buccal alveolar table and a second root canal of the tooth. After six months of follow-up, the cutaneous sinus tract was significantly improved by the appropriate endodontic treatment. Case report 2: A 36-year-old female patient was referred by her dentist to examine a chin lesion that had appeared a month ago. In clinical examination and radiographic assessment, periapical lesion associated with two mandibular central incisor teeth #41 and #31 was observed. After identifying the source of infection, endodontic treatment was carried out, and a good improvement in fistula was observed after one month. Conclusions: The correct diagnosis and treatment of OCST are important for healing. CBCT aids to identify odontogenic origin of the sinus tract through the detection of apical periodontitis and bone lesion. Root canal therapy is the treatment of choice for these cases and should always be attempted first. Monitoring the patients is necessary until complete healing of the disease.

The immune landscape in apical periodontitis: From mechanism to therapy.

Apical periodontitis (AP) is featured by a persistent inflammatory response and alveolar bone resorption initiated by microorganisms, posing risks to both dental and systemic health. Nonsurgical endodontic treatment is the recommended treatment plan for AP with a high success rate, but in some cases, periapical lesions may persist despite standard endodontic treatment. Better comprehension of the AP inflammatory microenvironment can help develop adjunct therapies to improve the outcome of endodontic treatment. This review presents an overview of the immune landscape in AP, elucidating how microbial invasion triggers host immune activation and shapes the inflammatory microenvironment, ultimately impacting bone homeostasis. The destructive effect of excessive immune activation on periapical tissues is emphasized. This review aimed to systematically discuss the immunological basis of AP, the inflammatory bone resorption and the immune cell network in AP, thereby providing insights into potential immunotherapeutic strategies such as targeted therapy, antioxidant therapy, adoptive cell therapy and cytokine therapy to mitigate AP-associated tissue destruction.

Clinical management of mandibular permanent premolars with periapical lesion and bilateral supernumerary teeth: A 7-years follow-up case report

Objectifs: This 7-years follow-up case report describes two diversified strategies for the management of bilateral mandibular permanent premolars associated with periapical lesion and unerupted supernumerary teeth. Case Report: A non-syndromic 9 years-old Asian female patient presented pain and swelling of the 35 in anatomical contiguity with an immature and unerupted supernumerary tooth. Clinical examination revealed an intraoral vestibular sinus tract related to the necrotic 35. Periapical radiography and CBCT showed that the 35 had an immature apex associated with a periapical lesion, and a supernumerary tooth in a lingual direction. Endodontic treatment of the 35 was performed by creating an apical plug with ProRoot MTA, while the supernumerary tooth was monitored radiographically with no intervention. Four years later, the 45 developed the same clinical condition of the left arch. Radiographic examination revealed a periapical lesion with massive periapical bone resorption, and a supernumerary tooth in normal alignment. The second premolar was herein extracted to allow for eruption of the supernumerary tooth. Outcomes: 3-years follow-up revealed continued root maturation and its spontaneous eruption in the dental arch. Proper healing of both mandibular lesions was monitored after 10 months, 3-years and 7-years revealing no recurrence on both sides.

A EFICÁCIA DA TERAPIA FOTODINÂMICA NO TRATAMENTO ENDODÔNTICO EM DENTES IMATUROS COM DIAGNÓSTICO DE NECROSE PULPAR: RELATO DE CASO CLÍNICO

Photodynamic Therapy (PDT) has been very effective in endodontics due to its benefits in eliminating resistant microorganisms in root canals. Being combined with a photosensitizing agent such as Methylene Blue, enhancing the effect of PDT, complementing conventional disinfection treatments, improving the effectiveness of endodontic treatment. The objective of this study was to report a clinical case on the use of photodynamic therapy in immature teeth with pulp necrosis, emphasizing the procedures performed, clinical and radiographic results obtained, as well as the effectiveness of different methods for disinfecting root canals. Research was carried out in electronic databases: Pubmed and Virtual Health Library from 2018 to 2024. The present work concluded that having knowledge about diagnosis and management in cases of immature teeth with pulp necrosis is extremely important to the dentist so that a good prognosis can be obtained in the treatment and so that the patient has the functionality of their oral environment reestablished.

Dental Emergency Rates at an Expeditionary Medical Facility Supporting Operation Inherent Resolve.

A core objective of U.S. medical services is to ensure the medical and dental readiness of military personnel. Oral diseases, resulting in pain, infection, or functional impairment, greatly affect the operational effectiveness of military personnel. This study aimed to compare the current causes of dental emergencies and the rates of dental disease nonbattle injuries in a deployed setting with those documented in previous research. Additionally, the study sought to determine if these rates have decreased because of preventive measures or potential improvements in overall oral health. Each soldier reporting to the health facility for dental care was screened by a dentist to determine the presence of a dental emergency. The reason for seeking care was classified into 1 of 7 categories and the rate of dental emergencies per 1,000 military members per calendar year was calculated. The majority of emergencies (38.60%) were due to tooth fractures and/or caries. The second most common reason for visiting the dental clinic was pain from a tooth requiring endodontic therapy (16.81%). This was followed by musculoskeletal or nonendodontic tooth pain (16.10%), most often associated with stress. Periodontal issues accounted for 14.33% of emergencies. Teeth requiring extraction made up 7.16% of all emergencies, prosthodontic bonding complications accounted for 5.16%, and orthodontic bonding complications affected 1.84% of individuals. The dental disease nonbattle injuries rates determined from the current study were 154 emergencies per 1,000 personnel per year for Air Force members and 264 emergencies per 1,000 personnel per year for Army members, which align with previous research findings. The results of this study confirm that dental emergencies continue to be a threat to overall readiness in deployed environments. The primary etiologic factor in the current study was as a result of tooth fracture and/or caries.

RESTAURAÇÃO BIOMIMÉTICA EM DENTE TRATADO ENDODONTICAMENTE: RELATO DE CASO CLÍNICO

Biomimetic dentistry is constantly evolving evolution, seeking inspiration from nature to develop technologies and biocompatible materials that mimic the structure and function of natural dental tissues. tissues. This innovative approach aims to improve the effectiveness of dental treatments by preserving tooth structure, improving the adhesion of restorative restorative materials, restoring structural integrity and replicating natural biomechanics. With a focus on regenerating and replacing lost dental tissues, biomimetic dentistry promises to revolutionise clinical practice, offering practice, offering more effective and safer solutions to patients through biomimetic products with improved properties. This study aims to aim of this study is to report a clinical case of restoration of a tooth treated tooth, using the principles of biomimetic dentistry to preserve tooth structure the tooth structure. Research was carried out in the following electronic databases databases: National Library of Medicine (PUBMED), Virtual Health Library (BVS), Brazil (BVS), Brazil Scientific Electronic Library Online (SciELO) from 2019 to 2024. Following the Biomimetic Dentistry approach, the use of intracanal pins was avoided in the restoration was avoided, prioritising methods that improve adhesion and reduce resin shrinkage and reduce the shrinkage of the composite resin. These techniques were considered sufficient to carry out the restoration, even in cases of extensive tooth loss after root canal treatment after root canal treatment.

Evaluation of root canal filling length on periapical radiograph using artificial intelligence.

This work proposes a novel method to evaluate root canal filling (RCF) success using artificial intelligence (AI) and image analysis techniques. 1121 teeth with root canal treatment in 597 periapical radiographs (PARs) were anonymized and manually labeled. First, RCFs were segmented using 5 different state-of-the-art deep learning models based on convolutional neural networks. Their performances were compared based on the intersection over union (IoU), dice score and accuracy. Additionally, fivefold cross validation was applied for the best-performing model and their outputs were later used for further analysis. Secondly, images were processed via a graphical user interface (GUI) that allows dental clinicians to mark the apex of the tooth, which was used to find the distance between the apex of the tooth and the nearest RCF prediction of the deep learning model towards it. The distance can show whether the RCF is normal, short or long. Model performances were evaluated by well-known evaluation metrics for segmentation such as IoU, Dice score and accuracy. CNN-based models can achieve an accuracy of 88%, an IoU of 79% and Dice score of 88% in segmenting root canal fillings. Our study demonstrates that AI-based solutions present accurate and reliable performance for root canal filling evaluation.

Analysis of modern methods of endodontic treatment of complicated caries according to the literature

The result of endodontic treatment depends on many factors: on the level of professional training of a dentist, the material and technical equipment of the workplace, competent diagnosis and chosen treatment tactics, which is largely impossible without the use of modern scientific achievements. The article provides an overview of the current literature on the treatment of complicated caries. The methods of treatment of pulpitis and periodontitis using modern methods and tools are described, which significantly improves the effectiveness of treatment.

Retratamento endodôntico de dente portador de lesão periapical extensa com presença de núcleo metálico

This study aims to present a clinical case of retreatment of a tooth with an extensive periapical lesion with the presence of a metal core. A 59-year-old patient was referred for dental treatment due to the need for retreatment of tooth 22. During clinical examination, the presence of a fistula was observed and the patient reported pain on vertical and horizontal percussion, absence of a periodontal pocket, and radiographic examination showed extensive periapical bone radiolucency, presence of filling material, as well as a fused metal core. After removal of the metal core with the aid of ultrasound, retreatment was performed with rotary instrumentation (Prodesign Logic RT). Sodium hypochlorite at 2.5% was used as the irrigating solution. The root canal system was obturated using the single cone technique associated with BIO-C Sealer cement. It is concluded that endodontic retreatment after removal of a fused metal core can be performed in a single session and determine the success of endodontic therapy.

Patient’s Perceptions and Experiences about the Root Canal Treatment: A Survey among Patients Visiting Nobel Medical College

Introduction: One major drawback of root canal therapy (RCT) is that most people don't know enough about it. To effectively address the issue, it is imperative to comprehend and identify the elements that impede or discourage patients from undergoing Root Canal Treatment. A survey of the literature reveals a dearth of information regarding patients' understanding and acceptability of root canal treatment (RCT) in the Nepali community. Objective: The objective of the study was to determine how well-informed patients were about root canal treatment at Nobel Medical College and Teaching Hospital in Biratnagar. A wide-ranging patient viewpoint on the matter was sought by means of a patient survey. Methods: This survey was conducted with the help of prestructured questionnaire consisting of 15 questions, distributed to random 250 patients coming to the outpatient department of Conservative dentistry and Endodontics at Nobel Medical College and Teaching Hospital. The completed questionnaires were then analyzed to assess patients’ experiences, concerns, and perceptions about RCT. Results: There is a lack of awareness among patients regarding RCT. Conclusion: The people need to be made more aware of the importance of maintaining a healthy dentition and the consequences that follow if this isn't done. If patients were fully informed about endodontic procedures, more might consider having them.

Reasons for Patients Preferring Extraction over Root Canal Treatment in a Tertiary Care Hospital

Introduction: Dental caries is a major global oral health issue, potentially progressing to irreversible pulpitis and causing substantial discomfort. Although advancements in materials, instruments and knowledge have improved the success rates of root canal procedures, some patients opt for tooth extraction instead of root canal treatment. This choice can result in tooth loss, necessitating costly prosthetic replacements. Objective: The objective of this study was to determine the reasons for patients choosing extraction over root canal treatment. Methods: A descriptive cross-sectional study was conducted among 205 patients visiting the Department of Conservative Dentistry and Endodontics at Kathmandu Medical College for the treatment of irreversible pulpitis, who ultimately opted for extraction. A structured questionnaire was utilized, and responses were recorded and analyzed using the Statistical Package for the Social Sciences. Mean, standard deviation, frequency and percentage were calculated depending upon the nature of data. Results: The study found that the primary reason for patients not undergoing root canal treatment (RCT) was the high cost of RCT and crown, accounting for 42.9% (88 patients), followed by the need for more appointments with pain, at 31.2% (64 patients). Conclusions: This study revealed the cost of RCT and crown to be the major factor for patients opting out from RCT. The study provides valuable insights into the psychology of patients regarding RCT, highlighting reasons for its rejection. Such understanding assists dentists and specialists in tailoring treatment plans that align with patient preferences and needs.

Transient Apical Breakdown: Incidence, Pathogenesis, and Healing.

Transient apical breakdown (TAB) is a phenomenon that indicates temporary apical periodontal destruction and root resorption after tooth luxation injuries, followed by the healing process of the dental pulp. Andreasen in 1986, reported that TAB was seen in approximately 4.2% of all luxation injuries. However, there have been no reports thereafter on the types and frequency of the luxation traumatic injuries in which TAB occurs. Therefore, this retrospective study was aimed to assess the incidence and pathogenesis of dental trauma-induced TAB and to suggest a possible mechanism of subsequent healing based on a series of cases. Data analysis included mature teeth (n = 56) of 49 patients aged 9-30 years who presented in a private dental office over a period of 10 years (2012-2022) to investigate the incidence and healing sequala of TAB. TAB was observed in 43.8% of subluxation, 62.5% of extrusive luxation, and 75% of lateral luxation injuries. The average age of patients who developed TAB was 14.5 years, ranging from 9 to 28 years old. TAB can be expected in many cases of luxation injuries with minimal dislocation. Therefore, mild injuries (subluxation, extrusion, and lateral luxation), may exhibit spontaneous healing, recovery of dark discoloration of the crown, disappearance of a periapical radiolucent lesion and return to normal response to EPT as long as 12 months after the traumatic injury. Thus, a decision to perform endodontic treatment in these cases might be postponed until clear evidence for an infection exists.

Tratamento endodôntico em sessão única em dentes com lesão apical: relato de caso

Endodontics is a branch of dentistry responsible for treating the inside of the teeth through endodontic treatment. One of the main objectives of endodontic treatment is to guide the root canal system to a clean place, consequently eliminating microorganisms, providing the cure of the infection and later restoring the function of the tooth. Endodontic treatment performed correctly is successful in the long term regardless of the number of sessions, therefore, endodontic treatment in a single session is a great alternative due to the saving of operative time, lower risk of infiltrations, shorter time to resume function of the tooth in the stomatognathic system, reduced risk of cross-infection and reduced drug administration to patients who need antibiotic prophylaxis. The success of the root canal treatment will depend on the infection control through the correct cleaning and modeling of the canals, the filling of the same through the obturation and all the care to be executed and not the medication used between sessions. Thus, the objective of this work is to report the effectiveness of endodontic treatment in a single session through a clinical case report of a patient with a large periapical lesion in elements 21 and 22.

Outcomes and prognostic factors of endodontically treated teeth filled with calcium silicate- or epoxy resin-based root canal sealers: A retrospective cohort study.

The objectives of this study were to compare the clinical outcomes of root canal treatment between calcium silicate-based sealer using the cold hydraulic condensation technique and epoxy resin-based sealer using warm vertical compaction and to identify the prognostic factors affecting the outcomes of both obturation techniques. Dental records and radiographs of the teeth that received root canal treatment with calcium silicate-based sealer using the cold hydraulic condensation technique or epoxy resin-based sealer using warm vertical compaction during 2015-2021 were selected using inclusion and exclusion criteria. The cases were matched between the two groups based on four factors: primary root canal treatment or retreatment, tooth type, periapical lesion and its size and extension of root canal filling. The success rates of root canal treatment between two sealers/obturation techniques were analysed. The incidence and resorption of extruded sealer were evaluated using the McNemar's test. Generalized estimated equations were used to evaluate any prognostic factors. The median recall period of this study was 15 months. A total of 234 teeth, comprising 117 cases in each sealer/obturation group, were included. No significant difference was found in the success rates between the calcium silicate-based sealer using the cold hydraulic condensation technique group (91.5%) and the epoxy resin-based sealer using the warm vertical compaction group (94.9%). The incidence of sealer extrusion for the calcium silicate-based sealer (27.6%) did not significantly differ from that of the epoxy resin-based sealer (36.2%), with both sealers typically demonstrating no resorption at recalls. No prognostic factors related to the success rate of either technique were detected. The study findings suggest no difference in the success rate between calcium silicate-based sealer and epoxy resin-based sealer. The study did not identify any prognostic factors that significantly influenced the outcomes of the endodontic treatments.

Influence of sonic activation of epoxy-resin and calcium silicate sealer on postoperative pain: a patient-blinded, parallel group, randomized clinical trial

BackgroundThis clinical study aims to compare postoperative pain after single-visit root canal treatment of teeth with asymptomatic apical periodontitis using epoxy-resin-based AH Plus and calcium silicate-based Endosequence BC sealers with or without sonic activation.MethodsThis study included 72 individuals with one first or second mandibular premolar tooth with asymptomatic apical periodontitis. They were randomly divided into four groups according to the root canal sealer (AH Plus or Endosequence BC) and activation protocol (sonic activation or non-activation) (n = 18). The participants were ask to rate their postoperative pain intensity on a NRS scale as none, minimal, moderate, or severe after 24 h, 48 h, 72 h, and 7 days following treatment. Patients were also asked to record the number of prescribed analgesic medication tablets (400 mg of ibuprofen) taken. Statistical analysis were performed using the Mann-Whitney U test, the Friedman test, the Spearman’s correlation test, the Chi-square test. Significance level was established at 0.05.ResultsThere was no statistically significant difference in postoperative pain scores or analgesic intake between AH Plus and Endosequence BC sealers regardless of the activation protocol (p > 0.05). There was no statistically significant difference in postoperative pain scores between the sonic activation and non-activation groups (p > 0.05). A weak positive correlation was detected between Endoactivator sonic activation and sealer extrusion (r = 0.36).ConclusionsAH Plus and EndoSequence BC root canal sealers showed similar results in terms of prevalance and intensity of postoperative pain. Sonic activation and non-activation groups had similar postoperative pain scores.Clinical trial registrationThe study was retrospectively registered with ClinicalTrials.gov (NCT06403293). Date of Registration: 07/05/24.

Time-Dependent Morphological Changes in Traumatic Immature Teeth With Necrotic Pulps Following Regenerative Endodontic Treatment: A Retrospective Study.

Regenerative endodontic treatment is a promising approach for healing periapical lesions and continuous root maturation. Although previous studies have reported its outcomes, the dynamics of morphological changes over time remain unclear. Therefore, this study aimed to evaluate changes in the periapical status and root dimensions over a 60-month follow-up period. The follow-up duration, periapical status changes, calcific barrier formation, degree of apical closure and radiographic root area changes were compared with those of the last follow-up in this retrospective study. Radiographic root area changes were calculated as the difference between the total root and total canal areas. Fifty-eight patients (81 teeth) underwent regenerative endodontic treatment during the study period, of whom 32 patients (36 teeth, 62%) were included. The survival and success rates of the treated teeth were 100% and 94.4%, respectively. All teeth developed a calcific bridge in the cervical third of the root canal, indicating the presence of vital tissue. Apical narrowing (partial or total) was observed in 75% of the cases. The root maturation stage affected the percentage increase in the radiographic root area. Teeth in Cvek stages II-III showed a higher radiographic root area increase than more mature teeth. All tooth radiographic root areas increased significantly in the initial 20 months of the treatment and moderately thereafter. Regenerative endodontic treatment is a safe approach for traumatised immature teeth. The presence of a radiographic calcified bridge may be an early indication of treatment success. The main complete tooth morphological changes occur after approximately 20 months posttreatment. These findings may help clinicians better understand the time-dependent changes in the root morphology after treatment, improve the follow-up schedule and predict the progress of healing during follow-up visits.

Tratamento endodôntico associado a terapia fotodinâmica em dente anterior: relato de caso

Photodynamic therapy acts on biostimulation at the cellular level, thus accelerating tissue repair and promoting analgesia. Often with conventional treatment it is not possible to achieve success and it is necessary to use alternative therapies, photodynamic therapy is used as one of these alternative therapies, demonstrating which types of photosensitizers and light can be used and how it is possible to help combat the infection. bacterial. Photosensitizers have the function of absorbing red light in the region and producing singlet oxygen. Therefore, the objective of this work was to perform endodontic treatment on element 21 with a periapical lesion, with the aid of photodynamic therapy associated with the photosensitizer Methylene Blue.

Investigation on structurally reinforced synthetic bone grafts via tricalcium silicate

AbstractTricalcium silicate (C3S) is one of the main components of mineral trioxide aggregates, which is used in dental endodontic treatment. C3S provides workable viscosity itself and fast hydration when water is added, and it is known to be nontoxic, noncarcinogenic, nongenotoxic, biocompatible, and insoluble in tissue fluids. In this study, C3S is added to synthetic bone‐graft materials from 30% to 60% to deliver viscosity to increase workability in the early stage of implant surgical procedure and to attain some degree of compressive strength after the hydration. Additionally, the porosity is not overly reduced to maintain the ability for bone regeneration. The porosity of the samples was confirmed to be 40%–50% with the formation of the C3S matrices. Simultaneously, the maximum compressive strength was ensured at 14.9 MPa within 24 h of curing time. The radiopacity required for post‐procedural diagnosis was evaluated. The radiopacity of the samples with 50% and 60% C3S was 1.0 mm Al and 1.1 mm Al, respectively. When ZrO2 was added, the radiopacity was enhanced to 1.6 mm Al. Overall, the experimental results showed that the bone‐graft added C3S would be suitable for alveolar bone support and rigid matrix formation in implant surgery.

Effects of radiotherapy dose and application time on the load-to-failure values of teeth filled with different sealers

BackgroundThe materials used in root canal filling and radiotherapy (RT) application can affect the load-to-failure of the teeth. This study aimed to compare the load-to-failure of the teeth filled with AH Plus (AHP) or AH Plus bioceramic (AHPB) before or after 60 Gy- and 70 Gy-dose radiotherapy.Materials and methodsOne hundred and ten maxillary incisors were endodontically prepared up to ProTaper Next X4 instruments. The teeth were randomly divided into 5 main groups as: non-irradiated, root canal treatment (RCT) before 60 Gy radiotherapy, RCT before 70 Gy radiotherapy, RCT after 60 Gy radiotherapy, RCT after 70 Gy radiotherapy. These groups were divided into 2 subgroups for filling material: AHP ve AHPB. After filling and radiotherapy procedures, the teeth were fixed on the thermoplastic mask plane. The plane were placed in the middle of a rectangular prism shaped glass phantom, and irradiated via a linear accelerator device. The teeth were then embedded in cylindrical acrylic blocks and the force (N) that caused the fracture was recorded under the Universal testing device. Student t-test was used for statistical comparisons. Statistical significance level was determined as p < 0.05.ResultsAfter 70 Gy dose radiotherapy, the group filled with AHPB showed statistically significantly lower fracture strength than the group filled with AHP (p < 0.05). In the control group, before 60 Gy RT group, after 60 Gy RT group, and before 70 Gy RT group, the sealers had statistically significantly similar load-to-failure. (p > 0.05).ConclusionThe group filled with AHPB caused a lower fracture strength than the group filled with AHP following a 70 Gy dose of RT. The sealers in the control group, before 60 Gy RT group, after 60 Gy RT group, and before 70 Gy RT group exhibited comparable load-to-failure values.

Efficacy of vital pulp therapy for carious pulp injury in permanent teeth: a study protocol for an open-label randomized controlled noninferiority trial.

Vital pulp therapy (VPT) has recently been reported as an effective approach for preventing and treating carious pulp injury in permanent teeth. Compared with root canal treatment (RCT), which involves complete removal of the pulp tissue, VPT effectively maintains pulp vitality and retains the physiological functions of the pulp. In the research pool, large-scale randomized controlled trials evaluating the treatment outcome of VPT using calcium silicate cements and RCT in cariously exposed permanent teeth are lacking. Here, we present a monocentric clinical protocol to compare the effects of VPT using iRoot BP Plus (Innovative Bioceramix, Vancouver, BC, Canada) as a pulp-capping material with RCT. The proposed trial is an open-label, single-centre, randomized, controlled, noninferiority trial. In total, 462 patients will be included in this trial according to the following criteria: adult patients (18-50years old), pulp exposure during the treatment of deep caries in mature permanent teeth, a diagnosis of reversible or partially irreversible pulpitis without apical translucency on X-ray, without periodontitis or systemic disease. Patients with signed informed consent forms will be enrolled and randomly divided into two groups (VPT and RCT) with a balanced treatment allocation (1:1). Clinical evaluations will be conducted at baseline and at 3, 6, 12, and 24months after treatment, with the potential for extension. The primary outcome measure will be the duration of success. The secondary outcomes will include the success rate at the 1-year follow-up and any adverse reactions. The Kaplan‒Meier method and log-rank test will be used to compare the duration of success of both treatments. For other outcomes, the χ2 test or Fisher's exact test will be used for categorical variables, and the t test or Mann‒Whitney U test will be used for continuous variables to assess the differences between groups. The results of this trial will provide a clinical reference for selecting treatments for carious pulp injuries in permanent teeth. ClinicalTrials.gov ChiCTR2100051369. The study has been registered in the Chinese Clinical Trial Registry (ChiCTR) ( www.chictr.org.cn ). Registered on 21 September 2021.