Dental Pulp Necrosis Clinical Trial
Official title:
Effect Of Different Lining Materials on Clinical Symptoms of Stepwise Excavation Without Re-enter: Double Blind Randomizd Clinical Trial
Deep carious lesions will encounter the dentist with the challenge of selecting a treatment
method that could avoid the pulpal exposure and maintain the pulp vitality.Conventional
restorative treatments suggest complete removal of the caries in one visit which could cause
pulpal exposure in 53% of the cases which in next step needs pulpotomy, pulpectomy or Root
Canal Therapy (RCT).
Stepwise Excavation(SE)is an old concept but has been researched recently to reduce the
possibility pulpal exposure during the removal of the lesion. Contrary to Indirect Pulp
Capping (IPC), in this technique only the central infected part of the caries is removed in
first visit and the rest of the caries will be lined by a suitable material to suppress the
remained cariogenic biomass and seal the cavity. This will help the pulp to defend and
survive. After a period, the cavity is re-opened and the rest of the caries which is darker,
harder and with less bacteria will be removed and the tooth is restored permanently.The aim
of this study was to compare the effect of different lining materials in clinical and
radiographical symptoms in stepwise excavation without re-enter after one year.
In this randomized clinical trial of 4 lining materials have been applied in deep caries
teeth in stepwise excavation. The common material which is applied as a liner over the
remained caries in SE is Calcium Hydroxide(CH). There are several reports of the solubility
of this liner over time which could interact with sealing of the cavity in long term. It
seems that a material with antibacterial activity, good sealing ability and suitable
mechanical properties could cause SE be done efficiently with good prognosis.
MTA is a biomaterial that has been introduced since 1993 with antibacterial property and
good sealing ability. A New Endodontic Cement, Calcium Enriched Mixture (CEM) cement with
good antibacterial effect like CH with sealing ability that is proposed to be similar to MTA
according to its double sealing property. CEM cement has been suggested as a suitable
material in pulp capping of permanent molars with irreversible pulpitis.
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Outcomes Assessor), Primary Purpose: Treatment
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