World Journal of Dentistry

Register      Login

VOLUME 13 , ISSUE S2 ( Supplementary Issue 2, 2022 ) > List of Articles

ORIGINAL RESEARCH

Comparative Assessment of Complete Pulpotomy in Mature Permanent Teeth with Carious Exposure Using Calcium Silicate Cement: A Randomized Clinical Trial

Akshata Jagadish Airsang, Adarsha Mandya Shankaregowda, Naganath Meena, Upasana Lingaiah, Vijayalakshmi Lakshminarasimhaiah, Shreya Harti

Keywords : Calcium silicate cements, Complete pulpotomy, Mature permanent teeth, Symptomatic irreversible pulpitis

Citation Information : Airsang AJ, Shankaregowda AM, Meena N, Lingaiah U, Lakshminarasimhaiah V, Harti S. Comparative Assessment of Complete Pulpotomy in Mature Permanent Teeth with Carious Exposure Using Calcium Silicate Cement: A Randomized Clinical Trial. World J Dent 2022; 13 (S2):S135-S143.

DOI: 10.5005/jp-journals-10015-2145

License: CC BY-NC 4.0

Published Online: 31-12-2022

Copyright Statement:  Copyright © 2022; The Author(s).


Abstract

Aim: To assess the clinical and radiographic outcome of complete pulpotomy procedure with NeoMTA and Biodentine in mature permanent vital teeth with carious exposure after 6 months and 1 year. Materials and methods: A total of 60 mature permanent mandibular molar teeth with a clinical diagnosis of irreversible pulpitis (IP) were included in the study. After the teeth were anesthetized, a complete pulpotomy procedure was performed under an aseptic environment. The cases were randomly divided into two groups [group I = NeoMTA (n = 30) and group II = Biodentine (n = 30)]. The teeth were temporized using type VII pink glass ionomer cement (GIC) for 2 weeks, following which a resin-modified GI (RMGI) was placed as a liner over the pulpotomy agent, and direct composite resin restorations were done. The cases were reevaluated postoperatively, clinically, and radiographically after 6 months and 1 year. Results: Following pulpotomy, complete pain relief was reported in 92.45% of the cases. External root resorptions were observed at the end of 6 months in two cases (group I: n = 1 and group II: n = 1). Radiographic evidence of periapical pathosis was present in three cases in group II at 6 months intervals. Radiographic evidence of periapical pathosis was present in three new cases at the end of a 1-year interval (group I: n = 2 and group II: n = 1). The success rate at 1 year for group I was 85.71%, and for group II was 84%. Conclusion: NeoMTA and Biodentine have favorable and comparable clinical and radiographic outcomes as therapeutic materials for complete pulpotomy procedures in mature permanent teeth with carious exposure. NeoMTA is a promising therapeutic agent for complete pulpotomy procedures in mature permanent teeth with carious exposure. Clinical significance: Considering the outcome of the study, complete pulpotomy procedures with calcium silicate-based cement can be considered a valid treatment alternative to non-surgical endodontic therapy (NSET) for mature permanent vital teeth with carious exposure.


PDF Share
  1. Ng YL, Mann V, Rahbaran S, et al. Outcome of primary root canal treatment: systematic review of the literature – part 2. Influence of clinical factors. Int Endod J 2008;41(1):6–31. DOI: 10.1111/j.1365-2591.2007.01323.x
  2. Aguilar P, Linsuwanont P. Vital pulp therapy in vital permanent teeth with cariously exposed pulp: a systematic review. J Endod 2011;37(5):581–587. DOI: 10.1016/j.joen.2010.12.004
  3. Seltzer S, Bender IB, Murray Z. The dynamics of pulp inflammation: correlations between diagnostic data and actual histologic findings in the pulp. Oral Surg Oral Med Oral Pathol 1963;16(7):846–871. DOI: 10.1016/0030-4220(63)90323-2
  4. Dummer PM, Hicks R, Huws D. Clinical signs and symptoms in pulp disease. Int Endod J 1980;13(1):27–35. DOI: 10.1111/j.1365-2591.1980.tb00834.x
  5. Ricucci D, Loghin S, Siqueira JF Jr. Correlation between clinical and histologic pulp diagnoses. J Endod 2014;40(12):1932–1939. DOI:10.1016/j.joen.2014.08.010
  6. Awawdeh L, Al-Qudah A, Hamouri H, et al. Outcomes of vital pulp therapy using mineral trioxide aggregate or biodentine: a prospective randomized clinical trial. J Endod 2018;44(11):1603–1609. DOI: 10.1016/j.joen.2018.08.004
  7. Asgary S, Fazlyab M, Sabbagh S, et al. Outcomes of different vital pulp therapy techniques on symptomatic permanent teeth: a case series. Iran Endod J 2014;9(4):295–300.PMID: 25386213.
  8. Taha NA, About I, Sedgley CM, et al. Conservative management of mature permanent teeth with carious pulp exposure. J Endod 2020;46(9S):S33–S41. DOI: 10.1016/j.joen.2020.06.025
  9. Nair PN, Duncan HF, Pitt Ford TR, et al. Histological, ultrastructural and quantitative investigations on the response of healthy human pulps to experimental capping with mineral trioxide aggregate: a randomized controlled trial. Int Endod J 2008;41(2):128–150. DOI: 10.1111/j.1365-2591.2007.01329.x
  10. Torabinejad M, Parirokh M, Dummer PMH. Mineral trioxide aggregate and other bioactive endodontic cements: an updated overview - part II: other clinical applications and complications. Int Endod J 2018;51(3):284–317. DOI: 10.1111/iej.12843
  11. Camilleri J. Staining potential of Neo MTA plus, MTA plus, and biodentine used for pulpotomy procedures. J Endod 2015;41(7):1139–1145. DOI: 10.1016/j.joen.2015.02.032
  12. Laurent P, Camps J, About I. Biodentine(TM) induces TGFβ1 release from human pulp cells and early dental pulp mineralization-. Int Endod J 2012;45(5):439–448. DOI: 10.1111/j.1365-2591.2011.01995.x
  13. Linu S, Lekshmi MS, Varunkumar VS, et al. Treatment outcome following direct pulp capping using bioceramic materials in mature permanent teeth with carious exposure: a pilot retrospective study. J Endod 2017;43(10):1635–1639. DOI: 10.1016/j.joen.2017.06.017
  14. Taha NA, Abdelkhader SZ. Outcome of full pulpotomy using biodentine in adult patients with symptoms indicative of irreversible pulpitis. Int Endod J 2018;51(8):819–828. DOI: 10.1111/iej.12903
  15. Kunert GG, Kunert IR, da Costa Filho LC, et al. Permanent teeth pulpotomy survival analysis: retrospective follow-up. J Dent 2015;43(9):1125–1131. DOI: 10.1016/j.jdent.2015.06.010
  16. Asgary S, Eghbal MJ. Treatment outcomes of pulpotomy in permanent molars with irreversible pulpitis using biomaterials: a multi-center randomized controlled trial. Acta Odontol Scand 2013;71(1):130–136. DOI: 10.3109/00016357.2011.654251
  17. Galani M, Tewari S, Sangwan P, et al. Comparative evaluation of postoperative pain and success rate after pulpotomy and root canal treatment in cariously exposed mature permanent molars: a randomized controlled trial. J Endod 2017;43(12):1953–1962. DOI: 10.1016/j.joen.2017.08.007
  18. Taha NA, Al-Rawash MH, Imran ZA. Outcome of full pulpotomy in mature permanent molars using 3 calcium silicatebased materials: a parallel, double blind, randomized controlled trial-. Int Endod J 2022;55(5):416–429. DOI: 10.1111/iej.13707
  19. Duncan HF, Galler KM, Tomson PL, et al. European society of endodontology position statement: management of deep caries and the exposed pulp. Int Endod J 2019;52(7):923–934. DOI: 10.1111/iej.13080
  20. Taha NA, Al-Khatib H. 4-year follow-up of full pulpotomy in symptomatic mature permanent teeth with carious pulp exposure using a stainproof calcium silicate-based material. J Endod 2022;48(1):87–95. DOI: 10.1016/j.joen.2021.09.008
  21. Beauquis J, Setbon HM, Dassargues C, et al. Short-term pain evolution and treatment success of pulpotomy as irreversible pulpitis permanent treatment: a non-randomized clinical study. J Clin Med 2022;11(3):787. DOI: 10.3390/jcm11030787
  22. Alqaderi H, Lee CT, Borzangy S, et al. Coronal pulpotomy for cariously exposed permanent posterior teeth with closed apices: a systematic review and meta-analysis. J Dent 2016;44:1–7. DOI: 10.1016/j.jdent.2015.12.005
  23. Alqaderi HE, Al-Mutawa SA, Qudeimat MA. MTA pulpotomy as an alternative to root canal treatment in children's permanent teeth in a dental public health setting. J Dent 2014;42(11):1390–1395. DOI: 10.1016/j.jdent.2014.06.007
  24. Matsuo T, Nakanishi T, Shimizu H, et al. A clinical study of direct pulp capping applied to carious-exposed pulps. J Endod 1996;22(10):551–556. DOI: 10.1016/S0099-2399(96)80017-3
  25. Hafez AA, Cox CF, Tarim B, et al. An in vivo evaluation of hemorrhage control using sodium hypochlorite and direct capping with a one- or two-component adhesive system in exposed nonhuman primate pulps. Quintessence Int 2002;33(4):261–272.PMID: 11989375.
  26. Bjørndal L, Simon S, Tomson PL, et al. Management of deep caries and the exposed pulp. Int Endod J 2019;52(7):949–973. DOI: 10.1111/iej.13128
  27. Rajasekharan S, Martens LC, Cauwels RGEC, et al. Biodentine™ material characteristics and clinical applications: a 3 year literature review and update. Eur Arch Paediatr Dent 2018;19(1):1–22. DOI: 10.1007/s40368-018-0328-x
  28. Taha NA, Ahmad MB, Ghanim A. Assessment of mineral trioxide aggregate pulpotomy in mature permanent teeth with carious exposures. Int Endod J 2017;50(2):117–125. DOI: 10.1111/iej.12605
  29. Anta S, Diouma N, Ousmane NS, et al. Evaluation of complete pulpotomy with biodentine on mature permanent molars with signs and symptoms of symptomatic irreversible pulpitis: 12-months follow-up. J Endod 2022;48(3):312–319. DOI: 10.1016/j.joen.2021.12.008
  30. Hashem DF, Foxton R, Manoharan A, et al. The physical characteristics of resin composite-calcium silicate interface as part of a layered/laminate adhesive restoration. Dent Mater 2014;30(3):343–349. DOI: 10.1016/j.dental.2013.12.010
  31. McDougal RA, Delano EO, Caplan D, et al. Success of an alternative for interim management of irreversible pulpitis. J Am Dent Assoc 2004;135(12):1707–1712. DOI: 10.14219/jada.archive.2004.0123
  32. Shallal-Ayzin M. A Prospective Analysis of Perioperative Pain Following VPT on Permanent Teeth with Mature Apices (Doctoral dissertation, The University of North Carolina at Chapel Hill).
  33. Khoroushi M, Karvandi TM, Kamali B, et al. Marginal microleakage of resin-modified glass-ionomer and composite resin restorations: effect of using etch-and-rinse and self-etch adhesives. Indian J Dent Res 2012;23(3):378–383. DOI: 10.4103/0970-9290.102234
  34. Tan SY, Yu VSH, Lim KC, et al. Long-term pulpal and restorative outcomes of pulpotomy in mature permanent teeth. J Endod 2020;46(3):383–390. DOI: 10.1016/j.joen.2019.11.009
  35. Zanini M, Hennequin M, Cousson PY. A review of criteria for the evaluation of pulpotomy outcomes in mature permanent teeth. J Endod 2016;42(8):1167–1174. DOI: 10.1016/j.joen.2016.05.008
  36. Aravind A, Rechithra R, Sharma R, et al. Response to pulp sensibility tests after full pulpotomy in permanent mandibular teeth with symptomatic irreversible pulpitis: a retrospective data analysis. J Endod 2022;48(1):80–86. DOI: 10.1016/j.joen.2021.10.005
  37. Suzuki T, Kyoizumi H, Finger WJ, et al. Resistance of nanofill and nanohybrid resin composites to toothbrush abrasion with calcium carbonate slurry. Dent Mater J 2009;28(6):708–716. DOI: 10.4012/dmj.28.708
  38. Simon S, Perard M, Zanini M, et al. Should pulp chamber pulpotomy be seen as a permanent treatment? Some preliminary thoughts. Int Endod J 2013;46(1):79–87. DOI: 10.1111/j.1365-2591.2012.02113.x
  39. Akhlaghi N, Khademi A. Outcomes of vital pulp therapy in permanent teeth with different medicaments based on review of the literature. Dent Res J (Isfahan) 2015;12(5):406–417. DOI: 10.4103/1735-3327.166187
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.