Mineral Trioxide Aggregate Pulpotomy Research Articles

Assessing the efficacy of Laser pulpotomy versus conventional pulpotomy in primary teeth: A systematic review and meta-analysis of clinical trials.

This study systematically reviewed the clinical and radiographic outcomes of laser versus conventional pulpotomy in primary teeth. It also compared the success and effectiveness of different lasers to enhance the understanding and use of laser pulpotomy as an alternative treatment. An electronic search was carried out in PubMed and Cochrane from 1st January 1999 to 31st December 2023. The published articles in the English language were searched using MeSH terms and text words. Only randomized controlled trials with a sample size of more than 10 and follow-ups over 6 months were included. Meta-analysis and forest plots were evaluated by utilizing Review Manager 5.4 software. Two reviewers assessed the risk of bias using the RoB 2 tool and discrepancies were resolved by the third reviewer. The success rates were combined using a random effects model to determine clinical and radiographic outcomes. We used risk ratios with 95% confidence intervals (CI) as the primary effect measures and set the significance level at 0.05. Only 18 studies met the inclusion criteria after an electronic search. Among them, 13 studies evaluated the clinical and radiographic outcomes of laser with formocresol pulpotomy, 2 studies compared with ferric sulfate pulpotomy, and the remaining studies with Mineral trioxide aggregate (MTA) pulpotomy. The various studies showed different levels of bias. There was no significant difference in the clinical success rate (p = 0.47; RR: 1.01; 95% CI 0.98-1.04; I2 = 0%; p = 0.70) and radiographic success rate (p = 0.94; RR: 1.00; 95% CI 0.91-1.09; I2 = 64%; p = 0.001) between laser pulpotomy and formocresol. Similarly, there was no significant difference between laser pulpotomy and ferric sulfate or MTA pulpotomy. Diode laser and LLLT can be considered as alternative pulpotomy agents to formocresol in primary teeth. However, high-quality trials are needed to confirm the accuracy and reliability of these findings.

Optimal outcomes of pulpotomy in young patients: Long-term prospects for permanent molars with signs and symptoms indicative of irreversible pulpitis

ObjectivesLimited literature addresses the long-term success of complete pulpotomy in permanent molars with signs of irreversible pulpitis in young patients. The aim of this observational study was to prospectively evaluate the long-term outcomes of complete pulpotomy using mineral trioxide aggregate (MTA) over an average period exceeding 11 years. MethodsOut of 27 molars displaying signs suggestive of irreversible pulpitis which underwent MTA pulpotomy, 24 molars were followed-up for a mean duration of 11.0 ± 2.2 years (range 8.2 to 14.8 years). Clinical and radiographic assessments were periodically conducted, tailored to each patient's specific circumstances. Treatment failure criteria included clinical signs and symptoms and radiographic evidence suggesting a lack of pulpal or periapical healing. Results83 % of molars had signs and symptoms of symptomatic irreversible pulpitis, with 83 % displaying apical periodontitis. Clinically and radiographically, all pulpotomies (100 %) were considered successful. A hard tissue barrier was observed in 71 % of teeth, and continued root maturation was evident in all molars with open apices. Complete pulp canal obliteration (PCO) was present in 21 % of the molars. All radiographic apical radiolucencies completely resolved. ConclusionsThis study demonstrates a 100 % success rate over an average 11-year follow-up for complete pulpotomy in managing permanent molars with signs and symptoms of irreversible pulpitis in young patients. It offers evidence for its long-term efficacy in promoting healing of pulp and periapical tissues. Clinical significanceThis study showed high long-term success for complete pulpotomy in young permanent molars with irreversible pulpitis, with clinical and radiographic success over 11 years. Despite initial symptoms of pulpitis and apical periodontitis, the treatment resulted in tissue healing, root maturation, and resolution of periapical radiolucencies, suggesting it as an alternative to root canal therapy.

Application of mineral trioxide aggregate pulpotomy in the treatment of early pulpitis of primary molars

Application of mineral trioxide aggregate pulpotomy in the treatment of early pulpitis of primary molars

Clinical and Radiographic Outcomes of Mineral Trioxide Aggregate Pulpotomies in Vital Permanent Teeth with Carious Pulp Exposure: A Pioneering Retrospective Study.

Vital partial pulpotomy (PP) or cervical pulpotomy (CP) in carious pulp-exposed permanent teeth preserves tooth vitality, promotes pulp healing, decreases treatment costs, and shortens treatment duration, which is a significant factor in treating noncooperative children. The aim of this retrospective study was to compare clinical and radiographic outcomes of partial and CP in vital carious-exposed permanent teeth. All vital permanent teeth with carious pulp exposure, treated by pulpotomy using mineral trioxide aggregate (MTA) during 2017-2019, by two operators in one dental center, were included in the study. Around 118 permanent teeth in 97 children and adolescents (mean age 10.9 years) were evaluated 6-57 months postoperatively. The total success rates of CP and PP were 82.5 and 80.8%, respectively (p = nonsignificant). The only factor that significantly affected the success rate was the presence of preoperative periapical pathology. Teeth without such pathology showed an 87.3% success rate compared to 74.1 and 58.3% in teeth with preoperative enlarged periodontal ligament (PDL) or with periapical radiolucency, respectively (p = 0.0301). Demographic variables, maturation state of the tooth, type of tooth (incisor, premolar, molar), postoperative variables, such as the presence of radiographic dentinal bridge, partial or full obliteration of the pulp during the follow-up period, and the integrity of the final restoration during the recall examinations did not affect the success rate of the treatment. Partial and CP in vital permanent teeth with carious pulp exposure in children and adolescents might be a reliable alternative to full root canal treatment (RCT). Yoshpe M, Kaufman AY, Lin S, et al. Clinical and Radiographic Outcomes of Mineral Trioxide Aggregate Pulpotomies in Vital Permanent Teeth with Carious Pulp Exposure: A Pioneering Retrospective Study. Int J Clin Pediatr Dent 2023;16(4):555-559.

Comparative assessment of the outcome of complete pulpotomy using mineral trioxide aggregate and Biodentine in mature permanent mandibular molars with symptomatic irreversible pulpitis: A randomized clinical trial with 18 months of follow-up.

Mature permanent teeth with irreversible pulpitis have traditionally been managed with pulpectomy. With advancements in pulp biology and dental materials, many clinicians are using vital pulp therapies like pulpotomy to manage such teeth. The current study was conducted to help clinicians in making decisions about case selection and choice of material for such cases. This randomized clinical trial evaluated the outcome of complete pulpotomy, using mineral trioxide aggregate (MTA) and Biodentine, in permanent mandibular molars with symptomatic irreversible pulpitis (SIP). Fifty patients with moderate-to-severe pain in mandibular molars with SIP were included in this prospective, parallel, single-blind clinical trial. Coronal pulp was completely removed and hemostasis was achieved with a cotton pellet moistened with 2.5% sodium hypochlorite. Subsequently, the radicular orifices were randomly covered with MTA or Biodentine. All teeth were permanently restored with composite restoration at the same appointment. Clinical evaluation was performed at 1 week, 3 months, 6 months, 12 months, and 18 months and radiographic evaluation was done after 6 months, 12 months, and 18 months. Mann-Whitney U and Chi-square tests were utilized for statistical analysis. Success rates of MTA and Biodentine pulpotomy were 63.6% and 69.6%, respectively, with no significant difference between the two groups at any follow-up period (P > 0.05). There were no significant differences in complete pulpotomy success rates between MTA and Biodentine over 18 months in mandibular molars with SIP.

Efficacy and safety of mineral trioxide aggregate (MTA) pulpotomy for caries-exposed permanent teeth in children: a systematic review and meta-analysis.

This study aimed to evaluate the effect of mineral trioxide aggregate (MTA) pulp capping for caries-exposed permanent teeth. However, the efficacy of MTA in the treatment of children's gums is still controversial, and different studies have shown different efficacy. Therefore, it is necessary to systematically review the efficacy and safety of MTA pulp incision in the treatment of pediatric caries using meta methods. We used meta-analysis to compare differences in the efficacy of MTA and calcium hydroxide (CH) for treating caries in permanent teeth. The mean treatment success rate of MTA for reversible and irreversible pulpitis groups was calculated, and the effect of apical opening condition and surgical type on success rate were investigated. A total of 15 studies were included, and meta-analysis showed that there was a significant statistical difference between the MTA group and CH group in efficacy [odds ratio (OR) =1.87, 95% confidence interval (CI): 1.28, 2.73, P=0.001, I2=63%, Z=3.25], success rate (OR =3.20, 95% CI: 1.93, 5.30, P<0.00001, I2=0%, Z=4.52), influence of apical foramen condition on success rate (OR =1.77, 95% CI: 1.14, 2.73, P=0.01, I2=15%, Z=2.56), and surgical procedure on success rate (OR =2.64, 95% CI: 1.65, 4.23, P<0.0001, I2=45%, Z=4.05). Our results showed that MTA pulpotomy was superior to CH. Nonclosure of apical openings and complete coronal pulpotomy may be more beneficial than partial pulpotomy.

Outcome of full pulpotomy in mature permanent molars using 3 calcium silicate-based materials: A parallel, double blind, randomized controlled trial.

The aim of the study was to compare the outcome of full pulpotomy using 2calcium silicate-based materials compared with mineral trioxide aggregate (MTA) in symptomatic mature permanent teeth with carious pulp exposure. This study was designed as a parallel, double blind, randomized controlled trial where symptomatic mature permanent teeth with carious pulp exposure meeting the inclusion criteria were randomly treated with full pulpotomy using one of 3calcium silicate-based materials (ProRoot MTA, Biodentine and TotalFill). Full pulpotomy was performed, and haemostasis was achieved via a cotton pellet moistened with 2.5% NaOCl. A 3-mm layer of the calcium silicate-based material was randomly placed as the pulpotomy agent through a block randomization process followed by a resin-based composite restoration. Postoperative periapical radiograph was taken. Clinical and radiographic evaluation were completed after 6months and 1year. The patient and evaluator were blinded to the type of materials used. Pain levels were scored preoperatively and 7days after treatment. Effect of potential prognosis factors including gender, age, diagnosis, bleeding time and type of caries were also analysed. One hundred and sixty-four teeth in 146 patients received full pulpotomy and were randomly assigned to either the tested or control material through block randomization technique (50MTA, 50 Biodentine and 64TotalFill). The age ranged from 10 to 70years. The diagnosis was irreversible pulpitis in 112 teeth (72%) and reversible pulpitis in 28 teeth (28%). The majority of patients presented with severe pain, during the first week 96.9% reported complete relief of pain or mild pain. Four cases had immediate failure. At 6months the overall success rate was 92.2%, over 1year 156/164 teeth attended follow-up with 12 failures (2 restorative failures and 10 endodontic failures), the overall success of pulpotomy at 1year was 92.3% (144/156); 91.8% in MTA, 93.3% in Biodentine and 91.9% in TotalFill with no significant difference amongst the groups and no side effects observed. No significant association was evident between outcome and the investigated variables. The 1-year success rate of full pulpotomy did not differ significantly between Biodentine pulpotomy, TotalFill pulpotomy, and MTA pulpotomy. The study was registered with clinical trials; registration number (NCT04345263).

The comparison of calcium hydroxide + biostimulation, calcium hydroxide, formocresol, and MTA pulpotomies without biostimulation in primary teeth: 12-months clinical and radiographic follow-up.

This study has aimed to evaluate the clinical and radiographic success rates of calcium hydroxide pulpotomy (CH) with biostimulation (PBMT) and compare them to that of CH, formocresol (FC), mineral trioxide aggregate (MTA) pulpotomies without PBMT in primary molars. A total of 172 pulpotomies were performed on primary first or second mandibular molars in 94 children who were 5-8years old. The pulpotomy procedure was performed with four different techniques. In the PBMT group, before the CH placement, 820-nm diode laser radiation was applied to each pulp-stump for 12s (10 mW, 2.5J/cm2). The clinical (lack of spontaneous pain, abscess or fistula, and pathological mobility) and radiographic success (lack of periapical/furcal lesions and internal/external resorption) were recorded at 6 and 12months. The data was statistically evaluated. p value < 0.05 was considered as significant. After 12months, the clinical and radiographic success rate (a tooth with at least one of the findings was considered unsuccessful) was 97%/92% for FC and 97%/95%, 87%/73%, and 71%/45% for MTA, CH + PBMT, and CH, respectively. There was no significant difference between the CH + PBMT and the other groups in clinical success, while a significant difference was found between CH and FC, MTA groups. In radiographic success, there was a significant difference between the CH and the other groups. No significant difference was found between the 6th- and 12th-month results in clinical success for all the groups. A decrease in success over time was seen only in the CH group for radiographic results. CH without PBMT showed the worst clinical and radiographic results among the groups. CH + PBMT showed similar clinical success compared to the MTA and FC groups. In radiographic success, CH + PBMT showed higher success compared to CH, but this success was not high as compared to MTA and FC.

Comparison of two vital pulp therapies in β-Thalassemic children

Aim: Beta-thalassemia (β-thalassemia) major is one of the most common inherited genetic blood disorders and is characterized by many systemic manifestations and skeletal problems. Children with β-thalassemia have a high caries index and must receive proper dental treatment to achieve better oral health. The aim of study is to compare two types of vital pulp therapies in children with β-thalassemia major. Methods: Sixty-five children with β-thalassemia major having carious primary molars were selected from Ain Shams University and the Hereditary Blood Disorders Clinic at the National Research Centre to be treated at Pediatric Dentistry, Department, Faculty of Dentisrtry, Ain Shams University . Patients received one of both types of vital pulp therapies: mineral trioxide aggregate (MTA) pulpotomy and indirect pulp capping. The children were divided into two groups as follow: Group I (n=30) received MTA pulpotomy and Group II (n=35) received indirect pulp capping using high viscosity glass ionomer cement. Clinical and radiographic follow-ups were done at the baseline, six months, and after one year. Patient preferences for types of vital pulp therapies were evaluated at the end of treatment. Comparison of the groups with qualitative data was done using Chi-square test. Comparison of the groups with quantitative data and a parametric distribution was done using an independent t-test at significance level 0.05. Results: The findings revealed success rates of 90% in Group I and 100% in Group II. There was 10% clinical and radiographic failure in Group I and 0% in Group II but the difference between the two groups when compared to each other was statistically not significant (p= 0.055). Conclusions: Both types of vital pulp therapies showed high success rates in children with β-thalassemia major and thus can be used safely in these patients. However, minimally invasive types of dental treatment may be preferred in children with β-thalassemia major as indirect pulp capping for being less invasive and requires less effort, fatigue and time.

Association between concentration of active MMP-9 in pulpal blood and pulpotomy outcome in permanent mature teeth with irreversible pulpitis - a preliminary study.

To investigate the correlation between the concentration of active-matrix metalloproteinases-9 (aMMP-9) in pulpal blood and the outcome of pulpotomy in mature permanent teeth with symptomatic irreversible pulpitis (SIP). Forty permanent molar teeth with a clinical diagnosis of SIP and normal apical tissues with periapical index (PAI) score≤2 and ten permanent teeth (8 molars and two premolars) with a diagnosis of normal pulp that required root canal treatment for prosthetic reasons from patients between the ages of 15-35years were recruited. All clinical procedures were performed under local anaesthesia and rubber dam isolation. After access opening, the coronal pulp tissue was amputated up to the canal orifice. A 100μL volume of the pulpal blood was collected using a micropipette and transported to the laboratory. Sodium hypochlorite (2.5 %) was used as a haemostatic agent, and mineral trioxide aggregate (MTA) was used as the pulp capping material. The tooth was restored with composite at the same visit. Teeth with normal pulps were treated with single-visit root canal treatment. Patients with pulpotomy were recalled at 6 and 12months. Outcome assessment of teeth with pulpotomy was carried out at 12months and was categorized as success (asymptomatic patients with PAI score≤2) or failure (symptomatic patients or PAI score≥3). Quantification of aMMP-9 in pulpal blood was achieved using a fluorometric assay. The following statistical analyses were performed to assess the data: t-test, Fisher's exact test, kappa coefficient, non-parametric test, Wilcoxon rank-sum test, Spearman rank correlation test and receiver operating characteristic curve (ROC). The success rate of pulpotomy was 88 % at 12-months. There was a significant difference between the median concentrations of aMMP-9 in pulpal blood of teeth with normal pulps (52 (12-96)ngmL-1 :) and SIP (193.3 (25.8-607.7)ngmL-1 :) (P=0.0003) and successful (132.3 (25.8-548.3)ngmL-1 :) and failed cases (512.4 (334.8-607.7ngmL-1 :) (P=0.0015) of MTA pulpotomy. A significant association was established between aMMP-9 concentration and outcome of pulpotomy. The area under the receiver operating characteristics curve (0.9484, 95%CI) suggested excellent discriminatory power of aMMP-9 concentration in pulpal blood to predict the pulpotomy outcome. The pulpal blood concentration of aMMP-9 was significantly associated with the outcome of pulpotomy in teeth with symptomatic irreversible pulpitis, where it may be used as a potential prognostic biomarker.

Prognostic factors for the survival of primary molars following pulpotomy with mineral trioxide aggregate: a retrospective cohort study.

The aim of the present study was to evaluate potential factors influencing the success rates of mineral trioxide aggregate (MTA) pulpotomy performed in primary molars. A total of 347 teeth treated between March 2012 and December 2016 in 258 patients, with a mean age of 5.3 ± 1.7years, were included in the analysis. Kaplan-Meier analyses were used to analyze were used time to failure. Multivariate Cox regression analysis with shared frailty was used to evaluate the clinical factors associated with failures. The mean (standard deviation) follow-up period was 35.8 (19.6) months. Within 84months, the survival rate was 87.1%. In multivariate Cox regression, treatment performed in lower primary molars had a lower survival rate than upper primary molars (hazard ratio [HR] = 3.38, P = 0.012). Caries extension below the cemento-enamel junction had more risk of failure (HR = 10.9, P < 0.001). Final restoration using resin-modified glass ionomer or amalgam (direct filling) had a lower survival rate than stainless steel crown (HR = 5.62, P = 0.002). Clinical variables such as arch type, degree of caries extension, and type of final restoration may affect the survival of primary molars following MTA pulpotomy. The results of this study indicate that specific clinical variables can be used to predict the prognosis of MTA pulpotomy in primary teeth, and estimate the risk of treatment failure. Assessments of these variables should be performed in the context of evidence-based clinical decision making.

Biodentine Pulpotomies on Permanent Traumatized Teeth with Complicated Crown Fractures

IntroductionThe aim of this multicentric prospective study was to evaluate the clinical and radiographic outcomes of Biodentine (BD) pulpotomies on permanent teeth with complicated crown fractures. MethodsThis study was carried out in 2 hospital-based dental departments in Quebec, Canada. Children seeking emergency care after trauma to anterior permanent teeth were invited to participate in this study. The treatment outcome was assessed clinically and radiographically at 1 week and 1, 3, 6, 12, 18, and 24 months after treatment. ResultsForty-five patients between the ages of 8 and 16 years (mean, 10.8 ± 2.4) were included in this study. Fifty-one teeth were treated with a BD pulpotomy. The study showed a survival rate of 100% and a success rate of 91%. Four failures were noted at 1-, 6-, and 15-month follow-up, and the teeth were subsequently treated with either conventional root canal therapy or regenerative endodontic procedure. Dental sensitivity to cold reported by patients reduced over time, and more teeth responded normally to pulp vitality tests during the course of this study. Slight discoloration was noted on 8 teeth (17%). Radiographic outcomes showed dentinal bridge formation in 91% of cases, and all immature teeth showed continued root formation. ConclusionsBD is a suitable material for pulpotomies on anterior permanent teeth with complicated crown fractures. It may be a good alternative to mineral trioxide aggregate pulpotomies because it does not cause significant discoloration, and it allows root maturation.

Success rates of mineral trioxide aggregate, ferric sulfate, and sodium hypochlorite pulpotomies: A prospective 24-month study

Several medicaments have been used as alternatives to formocresol (FC) for pulpotomy in primary molars with deep carious lesions. However, no prospective study has observed and compared the outcomes of different medicaments. The aim of this prospective study was to compare 12- and 24-month success rates among sodium hypochlorite (NaOCl), ferric sulfate (FS), and mineral trioxide aggregate (MTA) pulpotomies performed in primary molars. A total of 108 primary molars in 27 children (18 boys and nine girls) were selected. All subjects exhibited one primary molar indicated for indirect pulp therapy (IPT; control group) and three carious primary molars indicated for pulpotomy with 5% NaOCl, 15.5% FS, and MTA. Clinical and radiographic assessments for determining success rates were performed using established criteria before and at 12 and 24 months after treatment. All data were analyzed using the chi-square test. Clinical treatment success was observed for all teeth during the first 12 months. At 24 months, the clinical and radiographic success rates were both 100% in the control and MTA groups, both 92.6% in the NaOCl group, and 92.6% and 88.9%, respectively, in the FS group. There were no significant differences in the clinical (p=0.328) and radiographic (p=0.164) success rates among the four groups. NaOCl is easily available and less expensive than MTA, and our results suggest that the outcomes of NaOCl pulpotomy and MTA pulpotomy are similar. Therefore, NaOCl may be a practical alternative to FC for pulpotomy in primary molars.

Mineral trioxide aggregate pulpotomy: patient selection and perspectives.

This narrative aims at reviewing the available literature for mineral trioxide aggregate (MTA) pulpotomy to understand the procedure better and eventually improve the clinical and radiographic outcomes. An electronic search was conducted in PubMed, Cochrane, ScienceDirect and ClinicalKey databases with the following keywords: MTA pulpotomy, clinical outcomes, radiographic outcomes, primary teeth. No specific inclusion or exclusion criteria were applied as to what articles would be included in this review. The time period for the search began from 2001 with respect to MTA pulpotomy. However, this was not restrictive during the search. MTA pulpotomy has been a successful treatment modality in primary molars with proven success over the years. There is limited literature to support its success in primary incisors.

Postoperative assessment of diode laser zinc oxide eugenol and mineral trioxide aggregate pulpotomy procedures in children: A comparative clinical study.

The present study is an attempt to compare and evaluate postoperative assessment of diode laser zinc oxide eugenol (ZOE) pulpotomy and diode laser mineral trioxide aggregate (MTA) pulpotomy procedures in children. Forty carious primary molars indicated for pulpotomy within the age group of 4-9 years were selected and divided into two groups of 20 each using simple randomization, Group 1: Diode laser MTA and Group 2: Diode laser ZOE pulpotomy. The teeth were evaluated clinically for 1 year at 3, 6, and 12 months interval and radiologically for 6 and 12 months. Clinically and radiographically, 100% teeth treated with diode laser MTA and 94% treated with diode laser ZOE were considered successful after 12-month follow-up interval. No significant difference was seen between two groups. Despite the success rate, the cost factor of diode laser and MTA could be the limiting factor in its judicious use in pulpotomy procedure.

Mineral Trioxide Aggregate VS Calcium Enriched Mixture molar pulpotomy: A systematic review and meta-analysis

Objectives: The aim of the current systematic review /meta-analysis was to perform a comparison of the outcomes of Calcium Enriched Mixture (CEM) and Mineral Trioxide Aggregate (MTA) as agents for pulpotomy in primary and permanent molars.The proposed PICO question was “Whenever there is vital pulp exposure in primary and permanent molars, what are the treatment outcomes of CEM compared to MTA pulpotomy regarding clinical and radiographic success?” Methods: We looked for published randomized clinical trials (RCTs) of the at least 12-month period; the search covered papers published up to July 2017 in PubMed (Medline) and SpringerLink databases. Meta-analysis was performed using R program 3.3.3 with specialized meta-analysis packages, namely rmeta, metaphor, and RGtk2. Data was reformulated dichotomously (success or other [healing, failure, or missing]) for the selected studies. The fixed effect model was tested, OR (Odds ratio), RR (Risk ratio), and 95% CI (Confidence interval) were calculated using the formulated raw dichotomous data of the selected studies. The heterogeneity among studies was assessed using standard chi- square test and Woolf’s test. Mantel-Haenszel fixed-effect method was used to compute OR for the fixed model. The level of significance was at 0.05. Results: Four hundred forty-nine articles were gathered. Two reviewers screened the articles, and three RCTs were included in the study. After the assessment, three RCTs were suitable for meta-analysis tested by Mantel Haenszel method. Statistically, the insignificant difference was found between the success rate of CEM compared to MTA, with OR=0.92(95% CI, 0.57-1.49). RR= 0.94 (95% CI, 0.66-1.35). Test for heterogeneity showed p-values (0.4241, 0.4455) Conclusions: Systematic review /meta-analysis of the chosen RCTs showed that CEM pulpotomy in human teeth presented insignificant but superior clinical and radiographic success compared to those treated with MTA. Good quality and homogeneity of the included RCTs were yielded.

Comparative Evaluation of Postoperative Pain and Success Rate after Pulpotomy and Root Canal Treatment in Cariously Exposed Mature Permanent Molars: A Randomized Controlled Trial

IntroductionThe aim of this study was to compare postoperative pain and success rate following pulpotomy and root canal treatment. MethodologyFifty-four permanent teeth with carious exposures were randomly divided equally into 2 groups. Mineral trioxide aggregate pulpotomy was performed in the experimental group and root canal treatment was performed in the control group, using standardized protocols. The treated teeth were restored with base of glass-ionomer cement followed by composite restoration. Pain was recorded every 24 hours for 7 days after intervention. Clinical and radiographic evaluations were done every 3 months for 18 months. The data collected were statistically analyzed. ResultsAt the end of follow-up, overall success rate was 85% in the pulpotomy group and 87.5% in the root canal treatment group (P > .05). Significant difference in pain incidence and pain reduction was found between the 2 groups (P < .05), with lower scores reported in the pulpotomy group. ConclusionPulpotomy can be an alternative treatment for management of symptomatic permanent teeth with deep caries lesions.

One-year outcomes of MTA and modified Portland cement pulpotomy in primary teeth: a randomized clinical trial

Purpose: To compare the efficacy of Mineral Trioxide Aggregate (MTA) and Modified Portland Cement (MPC) as pulpotomy medicaments in primary molars. Methods: A sample of 54 children 4 to 6 years old of age, who had at least one primary mandibular second molar that needed pulpotomy were randomly placed in MTA (n = 28) or MPC (n = 26) groups. After completing the pulpotomy procedures, the teeth received a stainless-steel crown. Clinical and radiographic successes/failures were blindly evaluated at 6 and 12 months, and Fisher's exact test was used to analyze the differences. Results: At 6- and 12-month follow-ups, MTA and MPC had 100% clinical success rate. Radiographic success rates of MTA were 92.9% at 6 months and 89.3% at 12 months. While the rate for MPC group was 88.5% at both intervals. There was no statistically significant difference between the two groups. Conclusion: The results of this investigation showed that treatment success rate with MPC was comparable to MTA pulpotomy. However, additional clinical research that considers long-term follow-ups is required to test the usefulness of MPC in the pulpotomy treatment of primary teeth.

Management of permanent incisors with complicated crown fracture by MTA pulpotoy

Introduction: Complicated crown fractures involve enamel, dentin, and pulp and occur in 0.9 to l3 of all dental injuries. If left untreated, will always result in pulp necrosis but, if it handled correctly, prognosis of the pulp following a traumatic crown fracture can be favorable. Correspondence: Saeedeh Sadr, DMS, MS. School of Dentistry, Hormozgan University of Medical Sciences. Bandar Abbas, Iran Tel:+98 9390815095 Email: sadrsaeede@yahoo.com Case Report: The present case report describes an apexogenesis report of a 9-year old boy referred to department of Endodontics 4 days after an impact trauma to the maxillary right central and lateral incisor that caused a complicated crown fracture and pulpal exposure. In the radiographic examination, the tooth was observed to be immature. After access cavity preparation, cervical pulpotomy was performed, and the remaining pulp was capped with mineral trioxide aggregate (MTA) cement. The crown was restored by composite on the next day. The radiographic and clinical examinations on the 18-month follow ups showed that the tooth remained functional, root development was completed, and the apex was formed. No further endodontic intervention was necessary. Conclusion: MTA pulpotomy is an effective treatment in maintaining pulpal vitality and allowing physiological root development.

Comparative Evaluation of Fresh Aloe barbadensis Plant Extract and Mineral Trioxide Aggregate as Pulpotomy Agents in Primary Molars: A 12-month Follow-up Study.

Background:The purpose of this study was to compare the clinical and radiographic outcomes of fresh Aloe vera barbadensis plant extract and mineral trioxide aggregate (MTA) as pulpotomy agents in primary molar teeth.Materials and Methods:Pulpotomy procedure was performed in sixty primary molar teeth which were randomly allocated to two groups, i.e., Aloe vera pulpotomy (Group A) and MTA pulpotomy (Group B). All the pulpotomized teeth were evaluated clinically and radiographically at 1, 3, 6, 9, and 12 months of time interval using predetermined criteria.Results:The success rates between Groups A and B at the end of the 1st month were 24.1% and 96.4%, at the end of 3rd month were 57.1% and 100%, at the end of 6th month were 75% and 100%, at the end of 9th month were 66.6% and 100%, and at the end of 12 months were 100% and 100% respectively. The overall success rates at the end of 12-month follow-up period were 6.9% and 71.4%, respectively, after taking dropout patients into consideration, and the difference was statistically significant (P < 0.001).Conclusions:MTA pulpotomy was found to be superior when compared to fresh A. barbadensis plant extract pulpotomy in primary molars.