The Effect of Pulpotomy Using Resin-Modified Calcium Silicate versus MTA on Survival Rate of Cariously-Exposed Vital Young Permanent Molars: A Randomized Clinical Trial
Passant Nagi Abdel Samee;
Abstract
The Effect of Pulpotomy Using Resin-Modified Calcium Silicate versus MTA on Survival Rate of Cariously-Exposed Vital Young Permanent Molars:
A Randomized Clinical Trial
Key words: Pulpotomy, MTA, TheraCal, carious young permanent molars.
Abestract:
Objective: To assess which is the most efficient pulpotomy medicament on tooth survival in patients with a cariously-exposed vital young permanent molar regarding: absence of postoperative pain, sinus or swelling, internal/ external root resorption, periapical radiolucency), root maturation and decrease chair side time of treated patient.
Trial design Randomized Clinical Trial (RCT), double-blinded, equivalence framework.
Participants and Methods: This study was conducted in Pediatric Dentistry department-Faculty of Dentistry – Cairo University - Egypt. The mean age of participants was 7.7 years. Female to male ratio was 12: 10. The 22 analyzed pairs were 14 lower right 1st permanent molars and 8 lower left 1st permanent molars. Randomization was done by using closed white envelopes. Teeth were isolated using rubber dam, treated by pulpotomy (partial/complete) technique, direct application of capping material according to manufacturer instructions, application of Riva self-cure glass ionomer base, filling the rest of cavity with composite resin at a single visit. Immediate postoperative periapical radiographs were taken as baseline record using acrylic stent specific for each patient and attached to the cone positioner to allow standardization of the radiographs taken in the follow-up later on. The trial was ended after 12 months. Only 21 teeth finished follow-up, and one patient failed to follow up at the MTA group. Pre-calibrated blinded assessor assessed clinical successes and failures. Post-operative radiographs have been evaluated by two blinded and pre-calibrated dentists separately with the strength of their agreement was “very good” (Kappa =0.85 average for all the radiographic outcomes). Outcomes were analyzed using SPSS program.
Results: Results were calculated using risk reduction (RR). Clinically, the risk of spontaneous pain, and swelling occurrence is 7 times, and 5 times, more in TheraCal group compared to MTA group respectively. Radiographically, the risk of periapical radiolucency, and external root resorption occurrence is 9 times, and 2 times more in TheraCal group compared to MTA group respectively. The probability of root maturation is 20% less in TheraCal group compared to MTA group. Overall clinical and radiographic success rates for MTA were similar. They were 90.9% (take into consideration the case which lost follow-up and if we consider it as a failure in the worst-case scenario). Overall clinical and radiographic success rate for TheraCal were 36.36% and 18% respectively. These results were not in favor of the use of TheraCal as a pulpotomy medicament in permanent teeth.
Conclusion: MTA is excellent for pulpotomy (partial/complete) in cariously exposed young permanent molars with reversible pulpitis. TheraCal is not recommended
A Randomized Clinical Trial
Key words: Pulpotomy, MTA, TheraCal, carious young permanent molars.
Abestract:
Objective: To assess which is the most efficient pulpotomy medicament on tooth survival in patients with a cariously-exposed vital young permanent molar regarding: absence of postoperative pain, sinus or swelling, internal/ external root resorption, periapical radiolucency), root maturation and decrease chair side time of treated patient.
Trial design Randomized Clinical Trial (RCT), double-blinded, equivalence framework.
Participants and Methods: This study was conducted in Pediatric Dentistry department-Faculty of Dentistry – Cairo University - Egypt. The mean age of participants was 7.7 years. Female to male ratio was 12: 10. The 22 analyzed pairs were 14 lower right 1st permanent molars and 8 lower left 1st permanent molars. Randomization was done by using closed white envelopes. Teeth were isolated using rubber dam, treated by pulpotomy (partial/complete) technique, direct application of capping material according to manufacturer instructions, application of Riva self-cure glass ionomer base, filling the rest of cavity with composite resin at a single visit. Immediate postoperative periapical radiographs were taken as baseline record using acrylic stent specific for each patient and attached to the cone positioner to allow standardization of the radiographs taken in the follow-up later on. The trial was ended after 12 months. Only 21 teeth finished follow-up, and one patient failed to follow up at the MTA group. Pre-calibrated blinded assessor assessed clinical successes and failures. Post-operative radiographs have been evaluated by two blinded and pre-calibrated dentists separately with the strength of their agreement was “very good” (Kappa =0.85 average for all the radiographic outcomes). Outcomes were analyzed using SPSS program.
Results: Results were calculated using risk reduction (RR). Clinically, the risk of spontaneous pain, and swelling occurrence is 7 times, and 5 times, more in TheraCal group compared to MTA group respectively. Radiographically, the risk of periapical radiolucency, and external root resorption occurrence is 9 times, and 2 times more in TheraCal group compared to MTA group respectively. The probability of root maturation is 20% less in TheraCal group compared to MTA group. Overall clinical and radiographic success rates for MTA were similar. They were 90.9% (take into consideration the case which lost follow-up and if we consider it as a failure in the worst-case scenario). Overall clinical and radiographic success rate for TheraCal were 36.36% and 18% respectively. These results were not in favor of the use of TheraCal as a pulpotomy medicament in permanent teeth.
Conclusion: MTA is excellent for pulpotomy (partial/complete) in cariously exposed young permanent molars with reversible pulpitis. TheraCal is not recommended
Other data
| Title | The Effect of Pulpotomy Using Resin-Modified Calcium Silicate versus MTA on Survival Rate of Cariously-Exposed Vital Young Permanent Molars: A Randomized Clinical Trial | Other Titles | تاثير بتر لب العصب وتضميده باستخدام مادتى الثيراكال مقابل مادة ثالث اكسيد المعادن الكلى على بقاء الاضراس الدائمة الحديثة السن ذات العصب السليم المكشوف من تاثير التسوس : تجربة سريرية عشوائية | Authors | Passant Nagi Abdel Samee | Issue Date | 2017 |
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