MTA Pulpotomy Research Articles

Long-term Follow-up of MTA Pulpotomy in Young Permanent Teeth

Long-term Follow-up of MTA Pulpotomy in Young Permanent Teeth

Efficacy of two different pulpotomy agents in primary molars in a tertiary care hospital, Multan: A randomized control trial.

Objective: Multifactorial chronic dental infection and degenerative condition, the dental caries is a major health issue. Initially formocresol was the gold standard treatment for the primary teeth pulpotomy but now multiple sealing agents are used. Study Design: Prospective Interventional study. Setting: Multan Medical and Dental College/Ibn-e-Sina Hospital. Period: 15th February to 15th August 2022 and follow up 15th August to 15th November 2022. Material & Methods: After informed consent, cavities in two primary teeth of equal size after clinical and radiological examination requiring pulpotomies were selected and a total of 40 pulpotomies were done. Results: Among 15 pairs of contralateral teeth, 9 pairs were clinically as well as radiographically successful for both MTA and CH pulpotomy during the follow up appointments at 0, 1 and 3 months appointment. One pair showed failure for both MTA and CH pulpotomy. Five pairs showed success with MTA pulpotomy but failure in CH pulpotomy cases. Conclusion: It can be concluded from the study that MTA is superior and more effective than CH in primary teeth pulpotomies.

Alternative Management of Acute Irreversible Pulpitis of an Adult HIV-Positive Patient: A Case Report

Background: Root canal treatment is the usual management of acute irreversible pulpitis of mature permanent teeth. MTA Pulpotomy can be used to treat acute irreversible pulpitis of an adult HIV-Positive patient alternative to root canal treatment as it is less invasive and one-step endodontic therapy. Objective: The aim was to evaluate the outcome of MTA Pulpotomy alternative to root canal treatment to manage acute irreversible pulpitis of an adult HIV-positive patient. Methods: Based on history, clinical and radiological examination the case was diagnosed as acute irreversible pulpitis on the mandibular left 2nd molar tooth in a patient who was HIV-positive and under treatment for 16 years. After anaesthetising and isolation with rubber dam coronal pulp was completely removed and MTA (Angelus, Brazil) was placed over the pulp chamber floor covering the canal orifices, and the rest of the cavity was sealed with glass-ionomer filling over the set MTA. The severity of postoperative pain was assessed by a visual analog scale after 24 hours, 48 hours, 72 hours, and 7 days. The incidence of any clinical symptoms or periapical pathology was determined using clinical and radiographic evaluation after 3-month, 6 months, and 1-year intervals. Results: Throughout the follow-up period, the patient was asymptomatic and there was no periapical pathology at the radiograph even at the end of one year. Conclusion: As a less invasive and single sitting short procedure, MTA pulpotomy can be done to treat acute irreversible pulpitis in the HIV-positive patient as an alternative to root canal treatment. Bangladesh Med Res Counc Bull 2021; 47(2): 230-234

Success of pulpotomy with MTA in primary and permanent teeth

MTA has long been used as a Pulpotomy agent to preserve the pulp vitality, but there is a need to have an evidence-based approach when selecting the most appropriate pulpotomy agent which will be suitable for both dentitions, as the pulp of primary and permanent teeth have many histological and morphological differences. This systematic review aimed to evaluate the success of pulpotomy with MTA in primary and permanent teeth. A computerized literature search was performed through five databases: PubMed, Google Scholar, Microsoft Academics, EBSCO, and Science.gov to identify articles up to December 2020. Randomized controlled trial studies were selected in accordance with the inclusion and exclusion criteria. Out of the 5070 publications initially identified, only 18 studies that fulfilled the inclusion criteria were included in the review. Out of those 18 studies, 9 were studies performed on primary teeth, and the other 9 were performed on permanent teeth. After thorough review and evaluation, it was found that overall treatment success in primary teeth was 88.89-100% and it was 85-100% in permanent teeth. Overall clinical and radiographic success rates after follow-up showed that MTA pulpotomy showed slightly better results in primary teeth as compared to permanent teeth.

Comparison of Three Treatment Techniques for Deep Carious Lesions in Primary Teeth: An In Vivo Study.

AimsTo evaluate and compare three different treatment modalities in the management of deep carious lesions in primary molars.Material and methodsA total of 60 primary molars from patients aged 4-9 years were randomly divided into three groups with 20 samples each. Sample in Group I received indirect pulp therapy with Mineral Trioxide Aggregate [MTA] as lining material, Group II received the modified Hall technique, and Group III MTA pulpotomy. The patients were evaluated at 1, 3, 6, and 9 months as per evaluation criteria for success or failure of the same. A Chi-square test was used for proportions and for comparison between groups.ResultsClinically, the success rate for the modified Hall technique and MTA pulpotomy was higher than indirect pulp therapy. Radiographically, the modified Hall technique had the highest success rate of 100 percent among the indirect pulp therapy and MTA pulpotomy. This success rate was however not statistically significant.ConclusionAll three techniques had promising results clinically and radiographically. Since the results were not statistically significant, conservative treatment like Modified Hall's technique can be preferred over the surgical approach [MTA Pulpotomy].Clinical significanceThis study compares newer techniques called Hall's technique with traditional techniques like indirect pulp capping and MTA pulpotomy. Hall's technique is a quick and noninvasive procedure, which involves fitting the crown and seating it over the tooth without any caries removal/ tooth preparation and no local anesthesia is being practiced. In the present study Hall's technique showed higher rates of success compared to the other two procedures.How to cite this articlePoludasu M, Kumar Mallela GM, Puppala R, et al. Comparison of Three Treatment Techniques for Deep Carious Lesions in Primary Teeth: An In Vivo Study. Int J Clin Pediatr Dent 2022;15(S-2):S201-S206.

Correlation between degree of pulp inflammation and success rate of MTA pulpotomy in primary teeth: Prospective Cohort Study.

Objective: Many studies reported that the subjective clinical and radiographic examination lack the accuracy about the biological status of the pulp tissue. cytokines produced by dental pulp cells may reflect the degree of pulpal inflammation. The purpose of this study is to Correlate the cytokine levels of (IL-1α, IL-6, and IL-8) present in coronal dental pulp of primary molars with the success rate of MTA based vital pulpotomy over 18 months follow up period. Methods: 40 primary molars were enrolled. The cases are divided into group A (caries level code 5), group B (caries level code 6). Blood and pulp tissue were collected from the pulp cavity by sterile cotton pellet. The pellet was placed in 0.5ml (500 µl) phosphate buffered saline solution (PBS) to 1/10 final volume in a heparin-coated tube. Levels of cytokines IL-1 α, IL-6 and IL-8 were measured by using ELISA. Results: We found that IL-1 α, IL-6 and IL-8 were significant higher in group (B) than in (A). IL-6 showed the most significant value of expression in comparison to IL-1 α and IL-8 (p-value: 0.011, 0.014 & 0.027 respectively) which denote the prominent role of IL-6 during the inflammatory process in the pulp tissue of primary molars. Conclusion: IL-1 α, IL-6 and IL-8 cytokine expression in primary pulp molars increase with caries progression. Although the significant difference in the cytokine level expression between group A and B, a high success rate of MTA vital pulpotomy was found during the follow up period in both groups.

Considerations for Pulp therapy in primary teeth

According to the results of the questionnaire survey and the HIRA data released in KAPD conference in 2019, the pulpotomy in primary teeth is gradually decreasing while the one-visit pulpectomy is rapidly increasing. However, these changes seem to be for a more definite prognosis rather than based on academic grounds, and a more accurate diagnosis and conservative approach are needed. In addition, many studies have suggested that MTA pulpotomy was superior to any other materials and which are currently preferred as medicaments for pulpotomy. In the long term period, MTA pulpotomy is expected to be cost effective option.

Therapeutic effects of Pulpotomy and Pulpectomy on deciduous molars with deep caries.

Objective:To evaluate the therapeutic effects of pulpotomy and pulpectomy on deciduous molars with deep caries.Methods:A total of 124 children (192 molars) with deep caries treated from February 2014 to February 2015 were selected. They each had at least one molar with deep caries. MTA pulpotomy (101 molars) and Vitapex pulpectomy (91 molars) as well as prefabricated metal crown repair were conducted. The patients were followed up for 18 months after surgery, and the therapeutic effects were evaluated through clinical and X-ray examinations.Results:The proportion of molars without lesions was 80.20% in pulpotomy group, which significantly exceeded that of pulpectomy group (72.53%). The pulpotomy group with good clinical manifestations underwent spontaneous pain in four molars during follow-up, and five molars gradually underwent pain and gingival redness and swelling. The pulpectomy group suffered from occlusion discomfort in nine molars and gingival fistula in seven molars during follow-up. The postoperative morbidity of pulpectomy group was significantly higher than that of pulpotomy group (χ2=4.50, P=0.04). The 18-month tooth survival rates of pulpotomy and pulpectomy groups were 90% and 79% respectively, which were significantly different (χ2=4.645, P=0.031).Conclusion:The postoperative outcomes of pulpotomy are superior to those of pulpectomy.

Clinical and Radiographic Evaluation of Mineral Trioxide Aggregate Pulpotomy in Permanent Teeth

Abstract Aim and objective: The aim of the present study was to evaluate clinical and radiographic outcome of MTA as a pulpotomy agent in permanent teeth as an alternative to conventional root canal treatment. Materials and Methods: Ten permanent teeth with symptoms of irreversible pulpitis with vital pulp were selected for the study. MTAPulpotomy procedure was done in all the cases using standard protocol. Teeth were evaluated for various clinical and radiographic parameters at 3, 6, 9 and 12 months of follow up. Results: None of the patients reported any kind of clinical discomfort or radiographic abnormality during the follow up period of 3, 6, 9 and 12 months. All the teeth responded positive on electric pulp test at all successive follow ups. Conclusions: MTA Pulpotomy may be used as an alternative treatment modality to root canal treatment in permanent teeth with irreversible pulpitis, if future research continues to show promising results.

Effectiveness of MTA pulpotomy in primary molars: A critical assessment of relevant studies

Medline. Studies that evaluated the efficacy of MTA as a pulpotomy medicament in primary teeth were included, abstracts, observational studies and case reports were excluded. Only English language studies were considered. Studies were assessed and graded by two reviewers using a weighted criteria based system and a qualitative summary of the evidence provided. Twenty-two studies were included, 17 studies compared MTA with formocresol, four studies compared MTA with calcium hydroxide, ferric sulphate, Portland cement, calcium-enriched mixture cement (CEM) and one study compared white MTA with grey MTA. Based on the assessment criteria employed, there was no evidence that MTA was better than present materials and techniques as a pulpotomy medicament.