Monday, February 10, 2014

Randomized control trial comparing calcium hydroxide and mineral trioxide aggregate for partial pulpotomies in cariously exposed pulps of permanent molars

Chailertvanitkul P, Paphangkorakit J, Sooksantisakoonchai N, Pumas N, Pairojamornyoot W, Leela-apiradee N, Abbott PV. Randomized control trial comparing calcium hydroxide and mineral trioxide aggregate for partial pulpotomies in cariously exposed pulps of permanent molars. International Endodontic Journal.

Abstract

Aim

To compare the treatment outcomes when calcium hydroxide and mineral trioxide aggregate are used for partial pulpotomy in cariously exposed young permanent molars in a randomized control trial.

Methodology

Eighty-four teeth in 80 volunteers (aged 7–10 years) with reversible pulpitis and carious pulp exposures were randomly divided into two groups. Exposed pulps were severed using high-speed round burs until fresh pulp was seen. Cavities were irrigated with 2.5% sodium hypochlorite, and the pulp exposures were photographed and measured. Dycal or ProRoot MTA was placed on the pulp. Vitremer was placed over the material until the remaining cavity was 2 mm deep; amalgam was then placed. Teeth were evaluated for clinical symptoms and radiographic periapical changes after 24 h, 3 months, 6 months, 1 year and 2 years. Mean survival times and incidence of extraction were calculated using exact binomial confidence intervals.

Results

The median survival time for both ProRoot MTA and Dycal groups was 24 months. Three teeth had unfavourable outcomes with the incidence rate of 0.20/100 tooth-months with ProRoot MTA (95% CI: 0.02–0.71) and 0.11/100 tooth-months with Dycal (95% CI: 0.001–0.60). The incidence of unfavourable outcomes was 0.05/100 (95% CI: 0.001–0.30) and 2.38/100 (95% CI: 0.29–8.34) tooth-months in teeth with small (<5 mm="" nbsp="" sup="">2
) and large (>5 mm2) pulp exposure areas, respectively.

Conclusions

Partial pulpotomy in teeth of young patients with reversible pulpitis, either using ProRoot MTA or Dycal, resulted in favourable treatment outcomes for up to 2 years. The incidence of unfavourable outcomes tended to be higher in teeth with pulp exposure areas larger than 5 mm2.

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