Irreversible Pulpitis Clinical Trial
Official title:
Comparing the Outcome of Pulpotomy Using Biodentine and Portland Cement in Mature Cases With Irreversible Pulpitis: Randomized Clinical Trial
The aim of the study is to compare the treatment outcome of pulpotomy using Biodentine or Portland cement regarding success rate and post-operative pain.
- Patients will be screened for eligibility through obtaining medical and dental histories
together with clinical [visual, palpation, percussion, cold sensitivity testing and
probing] and radiographic evaluations for the teeth.
- After ensuring eligibilty, profound local anesthesia of the tooth will be achieved using
4% Articaine with 1: 100000 epinephrine (Septodont. Saint-Maur-des-Fosses. France).
- Caries will be removed using a round, high-speed bur with adequate water cooling.
- Cases will be randomly divided into two groups according to pulpotomy material either:
Biodentine or Portland cement. Biodentine is mixed according to manufacturer's
instructions and placed in a 2-3 mm layer above the pulp tissue using an amalgam carrier
and gently packed using a condenser. Initial setting is achieved after 12 minutes.
Preparation of Portland cement: Industrial Portland cement is mixed with Bisthmus oxide
or Barium sulphate radio-opacifier in a 3:1 ratio. The mix is sieved through silk sieve
then sterilized in hot air oven at 135 ֯C for 2 hours. Portland cement is mixed in a 3:1
powder: distilled water ratio and placed in the pulp chamber and condensed against a
moist cotton pellet. A small cotton pellet moistened with saline is placed in the pulp
chamber against PC for 5 seconds to ensure water uptake then removed.
- Appropriate interim restoration will be done and checked throughout follow up period.
Patients will be referred for final restoration after endpoint of research. A
post-operative periapical radiograph is taken after interim restoration placement.
- Patients will be contacted by telephone by the same operator to record pain intensity
(at 6, 12, 24, 48 and after 7 days).
- Clinical and radiographic evaluation is scheduled at 3 months postoperatively, and the
outcome will be determined according to clinical and radiographic criteria. Clinical
criteria include: absence of tenderness to palpation or percussion and the tooth is
functional, normal mobility and probing pocket depth. Soft tissues around the tooth are
normal with no swelling or sinus tract. Radiographic criteria include: absence of
periapical pathosis evident on the radiograph such as root resorption, root canal
calcification, furcal pathosis or new periapical rarefaction. In case of failure, the
tooth will be treated endodontically and referred for final restoration.
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