Int Endod J. 2022 Nov 20. doi: 10.1111/iej.13872. Online ahead of print.
ABSTRACT
AIM: To assess and compare the clinical and radiographic outcome of partial pulpotomy and full pulpotomy using Biodentine in cariously exposed mature molar teeth with symptoms indicative of irreversible pulpitis METHODOLOGY: This study is a an unicentric, double-arm, randomised superiority clinical trial with parallel experimental groups, registered under CTRI (CTRI/2019/12/022559). Fifty mature permanent molar teeth with carious exposures with symptoms indicative of irreversible pulpitis were randomly allocated equally into two groups. Partial Pulpotomy (PP) and Full Pulpotomy (FP) was performed in the first and second group respectively following standardised protocols. Exposed pulp tissue was removed up to a depth of 2-3 mm for partial pulpotomy whereas complete coronal pulp tissue was removed up to the level of root orifices for full pulpotomy. Haemostasis was achieved with placement of 2.5% sodium hypochlorite-moistened cotton pellets placed on amputated pulp tissue for a maximum of 10 minutes. Biodentine was used as the pulp capping material. Pain scores were evaluated using 11-point visual analogue scale (VAS) pre-operatively, at 24 hours, 48 hours and 7th day after the intervention(s). Clinical and radiographic evaluation was done at 3 months, 6 months and 1 year. The data was statistically analysed using chi-square test, Mann-Whitney U test, Friedman’s test and Wilcoxon signed-rank test. The significance level was predetermined at p<0.05. Cumulative survival probabilities were assessed at 12 months using Kaplan Meier analysis.
RESULTS: Intra-group analysis of pain scores revealed significant reduction in pain scores pre-operatively and at 24 hours, 48 hours and 7th day in both the groups. However, the difference in the pain score(s) reduction between both the groups was not statistically significant at any time interval (p > 0.05). At 1 year follow up, the success rate was 88% (22/25) and 91.6% (22/24) for PP and FP respectively (p>0.05).
CONCLUSION AND CLINICAL SIGNIFICANCE: Partial pulpotomy showed comparable results to full pulpotomy in terms of clinical/radiographic treatment outcome. If the long-term results remain the same, partial pulpotomy can be proposed as an alternative treatment modality for mature teeth with cariously exposed pulp tissue presenting with signs of symptomatic irreversible pulpitis.
PMID:36403208 | DOI:10.1111/iej.13872
