Pulp Exposure, Dental Clinical Trial
Official title:
Clinical and Radiographic Evaluation of Pulpotomy Technique for Preserving Vitality of Traumatized Anterior Permanent Immature Teeth: A Randomized Clinical Trial
Aim of the study: To compare the clinical and radiographic outcomes of mineral trioxide
aggregate (MTA) and Biodentine as vital pulp therapy materials (pulpotomy) preserving the
vitality of traumatized immature anterior permanent teeth.
Materials and Methods: fifty vital traumatized immature anterior permanent teeth exposed with
symptomatic /asymptomatic pulpitis were included in the study according to inclusion criteria
and were equally divided in two groups. Included teeth were randomly assigned to either a
control group (MTA 25 teeth) or a test group (Biodentine 25 teeth). After conducting
pulpotomy and covering pulp stumps with the MTA and Biodentine, treated teeth received
permanent restorations. Blinded clinical and radiographic evaluations were performed at
different time intervals (base line immediate postoperative, 6, 12 and 18 months) according
to clinical and radiographic criteria of success. Data were recorded and analyzed.
Informed consent was obtained from all patients prior to treatment, and patients were offered
Root canal treatment in case of treatment failure.
Thirty-three patients who were referred to the postgraduate pediatric dentistry department
clinic for the management of their traumatized permanent incisors teeth were assessed. Only
Patients who had a traumatic incisor tooth with a vital pulp (detected by clinical
signs/symptoms) were included.
Incisors were assigned randomly in the two groups. The MTA group was considered the control
group while the biodentine was the test group.
All patients who were clinically eligible for enrollment in the study went through screening
pre-operative digital periapical radiographic examination to assess the degree of root
development/ formation and any dental infections or anomalies that could interfere with the
planned treatment.
The main investigator performed all pulpotomies. Local anesthesia was administrated followed
by rubber dam isolation, the coronal pulp tissue was excised to the level of the orifice
using a diamond bur with water cooling. Hemostasis was achieved by gentle placement of a
saline-moistened cotton pellet over amputated pulps for 5-10 min. Pulp stumps were covered
with:
In the first group (control group) white mineral trioxide aggregate (MTA) ProRoot® MTA
(Dentsply/ Johnson City,TN,USA) was used as the reference material for comparison and was
prepared according to the manufacturer's instructions. A 3-mm-thick layer of MTA was placed
over the amputated pulps and was gently adapted to the dentinal walls using a wet cotton
pellet deep onto the radicular pulp. A self-cure glass ionomer (GC; GC Corporation, Tokyo,
Japan) was placed over the pulpotomy agent before final restoration of composite resin
(ClearfilTM, Kuraray, New York, USA) was done.
In the second group Calcium silicate-based BiodentineTM (Septodont Ltd., Saint Maur des
Fausse´s, France) was mixed according to the manufacturer's instructions, pulpotomy was
performed, radicular pulp was covered, and teeth received self-cure glass ionomer prior to
final restoration with the same technique as in the first group.
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