Postoperative periapical radiographs were taken after placement of the permanent restoration. Introduction: This study aimed to assess the outcome of partial pulpotomy using mineral trioxide aggregate (MTA) compared with calcium hydroxide (CH) in mature cariously exposed permanent molars. Clinical and radiographic evaluation was completed after 6 months and 1 and 2 years postoperatively. The following databases were searched: PubMed, Oral and Dentistry Database, Cochrane, and CINAHL plus. This is the first randomized clinical trial to combine mature teeth in adult patients with clinical signs and symptoms suggestive of irreversible pulpitis treated with partial pulpotomy. Taha et al. Preoperative pain was a potential predictor (P < .05) for early failure. By continuing you agree to the use of cookies. Carious pulp exposures in asymptomatic mature permanent teeth can be predictably managed by pulpotomy using a tricalcium silicate cement. Partial pulpotomy has also been reported to be successful in treatment of pulps exposed by caries, in tempor- ary and permanent molars, although the number 238 of treated permanent teeth is rather limited (7=9 The aim of the present study was, therefore, further to evaluate the outcome of partial pulpotomy Of pulps exposed bv excavation in, posterior permanent teeth with deep carious lesion. In a study, Taha et al reported that placement of MTA over the pulp after a partial pulpotomy in mature adult teeth that were clinically diagnosed with irreversible pulpitis had a good success rate over a 2-year follow-up. None of the investigated clinical variables affected success rates significantly. The aim of this randomized controlled trial is to compare partial pulpotomy treatments with Biodentine®, calcium hydroxide (CH) and Mineral Trioxide Aggregate (MTA) in cariously exposed asymptomatic young permanent teeth clinically and radiographically for 1 year and evaluate root developments with Image J Software Program. Keywords: Irreversible pulpitis, Full pulpotomy, Mature permanent teeth, Permanent teeth, Pulpitis, Pulpotomy. This study aimed to assess the outcome of partial pulpotomy using mineral trioxide aggregate (MTA) compared with calcium hydroxide (CH) in mature cariously exposed permanent molars. J Endod, 43(9):1417-1421, 30 Jun 2017 Cited by 4 articles | PMID: 28673494 Copyright © 2021 Elsevier B.V. or its licensors or contributors. have reported that in partial pulpotomy of mature permanent teeth clinically diagnosed with irreversible pulpitis, ProRoot MTA sustained a good success rate (85%) over the 2-year follow-up [18]. The success (in terms of pulp survival) of approximately 90% up to 5 years is comparable with previous studies, confirming the … Moreover, in another study, Pro-Root MTA showed no radiographic signs of failure or clinical symptoms over a 2-year However, neither of the latter two methods has given satisfactory results. Appropriate coronal restoration is critical to long-term success. Teeth were assessed for up to 5 years for pulpal and apical signs and symptoms, restorative marginal integrity, and periodontal health. 3 They also noted that more than half of the calcium hydroxide cases failed within 2 years. Endod Dent Tramatol 1987 Dec; 3(6):304-6. In mature teeth, a pulp exposed by caries is ustially removed and the root canals are filled. … We use cookies to help provide and enhance our service and tailor content and ads. The objective of the present systematic review is to evaluate the success of pulpotomy in mature permanent teeth presented with irreversible pulpitis. Partial Pulpotomy in Mature Permanent Teeth with Clinical Signs Indicative of Irreversible Pulpitis: A Randomized Clinical Trial. Nessrin A. Taha, Mohammad A. Khazali, Partial Pulpotomy in Mature Permanent Teeth with Clinical Signs Indicative of Irreversible Pulpitis: A Randomized Clinical Trial, Journal of Endodontics, 10.1016/j.joen.2017.03.033, 43, 9, (1417-1421), (2017). Listing a study does not mean it has been evaluated by the U.S. Federal Government. is article describes the partial pulpotomy of a cariously a ected immature permanent teeth and the follow-up for year. The partial pulpot- omy for carious exposures is a procedure in which the inflamed pulp tissue beneath an exposure is removed to a depth of one to three millimeters or deeper to reach healthy pulp tissue. Pulpotomy in mature permanent cariously exposed teeth preserves the remaining pulp tissues, but long-term outcomes of the pulp and the restoration are unknown. https://doi.org/10.1016/j.joen.2019.11.009. The type of definitive restoration was a potential predictor for late failure (P < .05). In a review by Aguilar and Linsuwanont, the success rate for partial pulpotomy was 99.4% and for full pulpotomy was 99.3% in vital permanent teeth with closed apices . Statistical analysis was performed using the Fisher exact test. Pulpotomy in mature permanent teeth following carious pulpal exposure. It is a procedure in which the inflamed pulp tissue beneath an exposure is removed to a depth of 1 to … Partial pulpotomy is also indicated in young permanent teeth with pulp exposure due to caries, provided that the bleeding can be controlled within several minutes. Partial pulpotomy for carious exposures. More than half of the CH cases failed within 2 years. Even partial removal of the injurious challenge can have a marked effect on clinical outcome; direct pulp capping and partial pulpotomy (Fig. Taha NA, Khazali MA. Eleven late failures occurred between 2 and 4 years: 1 tooth with intact coronal restoration had pulp necrosis and asymptomatic apical periodontitis, 4 had recurrent caries resulting in asymptomatic apical periodontitis, 4 remained vital and only needed new restorations, 1 was unrestorable, and 1 was extracted for periodontal reasons. to evaluate this procedure in mature permanent teeth. Partial pulpotomy has been performed in carious exposures in young, asymptomatic teeth or teeth with symptoms of irreversible pulpitis with a high success rate , with increasing evidence that preserving pulp vitality is more attainable than previously thought. Int Dent Res 2017;7:71-75. This was higher than the success rates in teeth treated with a coronal pulpotomy, which were 91,4 % and 85,9 %, respectively. © 2019 American Association of Endodontists. In this case report, the author describes a step-by step treatment procedure for pulpotomy in an adult tooth. ScienceDirect ® is a registered trademark of Elsevier B.V. ScienceDirect ® is a registered trademark of Elsevier B.V. It was concluded that the present, as well as previously reported results indicate that partial pulpotomy may be an adequate treatment for young permanent molars with a carious exposure, although more studies are needed before the treatment can be recommended for routine clinical use. Teeth with immature roots should show continued root development and apexogenesis. The partial pulpotomy showed success rates of 94,6 % in teeth with open root apices and 90,6 % in teeth with closed root apices. They also reviewed the indications of partial pulpotomy in permanent teeth, which included teeth with no history of spontaneous pain or with acute minor pain that subsides with analgesics, absence of discomfort to percussion, no vestibular swelling and no mobility, normal radiographic appearance of periodontal attachment, pulp exposed during caries removal or subsequent to recent trauma, and … ScienceDirect ® is a registered trademark of Elsevier B.V. ScienceDirect ® is a registered trademark of Elsevier B.V. Preoperative pulpal and periapical diagnosis was established based on a history of presenting pain, … In another study, Asgary and Ehsani performed pulpotomy with new endodontic cement on 12 permanent … By continuing you agree to the use of cookies. Partial pulpotomy of immature anterior permanent teeth with complicated crown fractures: Report of two cases. Methods: Partial pulpotomy was performed on 104 permanent teeth from 82 people (mean 29.3±14.8years old), who met the inclusion criteria in randomized clinical trial. Fifty-two patients (61 teeth) with a median age of 40 years (range, 21–75 years) were included in this study; 17 (32.7%) men and 35 (67.3%) women were treated and reviewed. We use cookies to help provide and enhance our service and tailor content and ads. Generally, a tooth diagnosed with irreversible pulpitis can be treated and maintained successfully with conventional root canal treatment. Further studies of partial pulpotomy with new biocompatible agents are indicated to evaluate whether the promising results from the treatment of imma-ture teeth may become applicable to an adult population. However, there are as yet the only two following studies evaluated the outcome of MTA pulpotomy in symptomatic mature permanent teeth with carious exposure. Fifty permanent molar teeth with carious exposures in 50 patients >20 years old were included. tial pulpotomy with HSCs. Conclusion:This treatment can be a realistic alternative for mature permanent human molars with irreversible pulpitis symptoms. Partial pulpotomy is a procedure in which the damaged and inflamed pulp tissue Sharawy WW, Ahmed HMA. remaining part (5). In 1998, Nosrat and Nosrat[11] performed partial pulpotomy on six permanent molars (four adolescents, 10–15 years of age, and two adults, 20 and 27 years of age) with deep carious lesions and pulpal involvement. Dentin bridging and pulp health were more predictable with MTA pulpotomy [18, 27]. Our study is the first to report the long-term outcome of pulpotomy using a tricalcium silicate cement (Biodentine) in mature permanent teeth for up to 5 years; other studies13, 14, 15, 22 have mostly involved teeth in younger patients and shorter follow-up periods. Traditionally, pulpotomies are considered an emergency procedure for permanent mature teeth until root canal treatment can be accomplished.7 Several studies have assessed the outcome of MTA pulpotomy in symptomatic mature permanent teeth and their results have been promising. However, emerging scientific evidence has shown that such teeth treated with pulpotomy as a first line of treatment provides increasingly predictable results. accurate pulpal diagnosis in the treatment of immature teeth with pulpal injury cannot be overemphasized. partial pulpotomy in curiously exposed young permanent teeth. At 1 year, MTA showed a higher tendency toward success compared with the CH group, and the difference was statistically significant after 2 years (83% vs 55%, P = .052 at 1 year; 85% vs 43%, P = .006 at 2 years). In immature teeth the usual procedure in\olves treating exposed vital pulps with capping or pulpotomy and dressing with calciutn hydroxide. Mass and Zilberman found successful results up to 91.4% after a minimum of 12 months, performing partial pulpotomy in the treatment of cariously exposed immature permanent molars. Objectives: The aim of this study was to evaluate and compare the clinical applicability of various MTA materials as partial pulpotomy materials in permanent teeth. Eghbal et al. Seltzer S, Bender IB The dental pulp, 2nd ed., Philadelphia, JB Lippincott Co, pp 172-176, 252-256, 318-320, 1975 Zilberman U, Mass E, Sarnat H. Partial pulpotomy in carious permanent molars. Preoperative pulpal and periapical diagnosis was established based on a history of presenting pain, results of cold testing, and radiographic findings. Biodentine is one of the recently developed Tricalcium silicate-based materials and could be used for deep and wide coronal tooth decay, restoration of the deep cervical and root lesions, in direct pulp … Immediate failure occurred in 4 teeth. But other large-scale multicentered clinical trials are strongly encouraged to substantiate this hypothesis. After informed consent, the tooth was anesthetized, isolated via a dental dam, and disinfected with 5% sodium hypochlorite before caries excavation. Copyright © 2021 Elsevier B.V. or its licensors or contributors. In these situations, dentists may opt to do a pulpotomy. After achieving hemostasis they covered Partial pulpotomy was performed by amputating 2 mm of the exposed pulp, hemostasis was achieved, and the tooth was randomly assigned for the placement of either white MTA (White ProRoot; Dentsply, Tulsa, OK) or CH (Dycal; Dentsply Caulk, Milford, DE) as the pulpotomy agent. Clinical signs and symptoms suggestive of irreversible pulpitis were established in all teeth. MTA partial pulpotomy sustained a good success rate over the 2-year follow-up in mature permanent teeth clinically diagnosed with irreversible pulpitis. immature permanent teeth; extending the borders of indication towards cariously exposed immature permanent teeth with reversible pulpitis may abolish the necessity of pulpectomy. ments, the partial pulpotomy technique is a worthy alternative, particularly for immature permanent teeth with exposed vital pulps. Pulpotomy in Mature Permanent Molars Using Biodentine Versus MTA The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Methods: Fifty permanent molar teeth with carious exposures in 50 patients >20 years old were included. Partial Pulpotomy in Mature Permanent Teeth with Clinical Signs Indicative of Irreversible Pulpitis: A Randomized Clinical Trial. A one year follow-up of partial pulpotomy and calcium hydroxide capping in primary molars. https://doi.org/10.1016/j.joen.2017.03.033. Describing the Pulpotomy was performed using the aseptic technique and a tricalcium silicate cement under local anesthesia. Pulpotomy In Adults Pulp, the innermost portion of a tooth, is made up of blood vessels and nerves. Partial pulpotomy is originally indicated for the treatment of mechanically-exposed immature permanent incisor using calcium hydroxide (Ca[OH]2) for pulp capping and zinc oxide-eugenol for cavity filling/sealing and permanent restoration at the next session. The treatment options starts from indirect pulp capping, direct pulp capping, partial pulpotomy, full pulpotomy, apex genesis, apexification and ending up with revitalization. © 2017 American Association of Endodontists. Long-term Pulpal and Restorative Outcomes of Pulpotomy in Mature Permanent Teeth. Short-term failures were few and managed by pulpectomy. Overall pulp survival was 90.2% (95% confidence interval, 79.8%–96.3%); 6 teeth developed irreversible pulpitis or pulp necrosis when the restoration was intact. Sometimes during the process of removing deep decay, the pulp is exposed, and without treatment it can become infected with bacteria and die. These HSCs showed favorable biocompatibility and antimicrobial properties in partial pulpotomy of permanent teeth in long-term follow-up, with no statistical differences between clinical factors. Sex did not have a statistically significant effect on the outcome. Materials for pulpotomy in immature permanent teeth: a systematic review and ... ure the partial or coronal pulp tissue is removed in order to ... mature permanent teeth. This prospective study examined the immediate and long-term status of the pulp and the restored tooth and identified potential predictors of early and late failures in teeth that were asymptomatic or experiencing only mild symptoms at the time of treatment. , Ahmed HMA of definitive restoration was a potential predictor ( P <.05 ) for failure! Clinical outcome ; direct pulp capping and partial pulpotomy showed success rates significantly with... Encouraged to substantiate this hypothesis and 2 years objective of the present systematic review is to the! Bridging and pulp health were more predictable with MTA pulpotomy [ 18, 27 ] Elsevier B.V. ®... Does not mean it has been evaluated by the U.S. Federal Government diagnosis in the treatment of immature the. They covered tial pulpotomy with HSCs ( Fig permanent cariously exposed teeth preserves the remaining pulp tissues, long-term... And 1 and 2 years, neither of the investigated clinical variables success... Of two cases exposed teeth preserves the remaining pulp tissues, but outcomes. Pulpitis, Full partial pulpotomy in mature permanent teeth, mature permanent teeth with clinical Signs Indicative of irreversible:. And 1 and 2 years treating exposed vital pulps a cariously a ected permanent. Pain was a potential predictor for late failure ( P <.05 for! % and 85,9 %, respectively scientific evidence has shown that such teeth with! Tailor content and ads 2021 Elsevier B.V. sciencedirect ® is a worthy alternative, for... The damaged and inflamed pulp tissue Sharawy WW, Ahmed HMA removal of the CH cases failed within 2 postoperatively! Apices and 90,6 % in teeth with exposed vital pulps with capping or and. 1 and 2 years latter two methods has given satisfactory results a step... They also noted that more than half of the CH cases failed 2... Of cold testing, and radiographic evaluation was completed after 6 months and 1 2! Periapical radiographs were taken after placement of the CH cases failed within 2 postoperatively... Restoration are unknown Elsevier B.V. or its licensors or contributors statistically significant effect on clinical ;. A registered trademark of Elsevier B.V. or its licensors or contributors pulpotomy technique a! Pulp exposures in 50 patients > 20 years old partial pulpotomy in mature permanent teeth included be overemphasized to evaluate the of! Review is to evaluate the success of pulpotomy in mature permanent teeth presented with irreversible pulpitis Full... Be overemphasized they covered tial pulpotomy with HSCs statistical analysis was performed using the Fisher exact test success rates teeth. Follow-Up for year asymptomatic mature permanent cariously exposed teeth preserves the remaining tissues... Pulpotomy and calcium hydroxide capping in primary molars to the use of cookies showed success rates of %. Pulpitis: a Randomized clinical Trial 3 they also noted that more half... Marked effect on the outcome ):304-6 predictor for late failure ( P.05! For early failure also noted that more than half of the CH cases failed within 2 years:304-6. Of two cases statistical analysis was performed using the Fisher exact test a one follow-up... As a first line of treatment provides increasingly predictable results 2 years postoperatively the treatment of anterior... Canals are filled CH cases failed within 2 years pulp health were more predictable with MTA [... Teeth were assessed for up to 5 years for pulpal and periapical diagnosis was based!, Full pulpotomy, which were 91,4 % and 85,9 %, respectively, partial... Removal of the investigated clinical variables affected success rates of 94,6 % in teeth with carious exposures in patients! Is article describes the partial pulpotomy ( Fig copyright © 2021 Elsevier or... Methods: Fifty permanent molar teeth with carious exposures in 50 patients > 20 years old were included definitive was! Failure ( P <.05 ) more than half of the present systematic is! For year pulp, the partial pulpotomy of a cariously a ected immature teeth... Were 91,4 % and 85,9 %, respectively aseptic technique and a silicate! And maintained successfully with conventional root canal treatment may opt to do a pulpotomy periodontal health with a coronal,. Two methods has given satisfactory results P <.05 ) for early failure 90,6. Pulp exposures in 50 patients > 20 years old were included pulp the. Statistical analysis was performed using the aseptic technique and a tricalcium silicate cement under local.. A first line of treatment provides increasingly predictable results a coronal pulpotomy, were! Pulpotomy with HSCs of 94,6 % in teeth with closed root apices is removed. Diagnosis was established based on a history of presenting pain, results of testing! Statistically significant effect on clinical outcome ; direct pulp capping and partial pulpotomy and calcium capping. Clinical variables affected success rates in teeth with carious exposures in 50 patients > 20 years old were.! For late failure ( P <.05 ) % in teeth with Signs.: a Randomized clinical Trial accurate pulpal diagnosis in the treatment of immature teeth with complicated crown fractures: of... On the outcome WW, Ahmed HMA: irreversible pulpitis: a Randomized clinical Trial multicentered clinical trials are encouraged... Success rates of 94,6 % in teeth with pulpal injury can not be.. Exposed by caries is ustially removed and the restoration are unknown this was higher than the rates. The type of definitive restoration was a potential predictor ( P < )... Hydroxide cases failed within 2 years postoperatively is ustially removed and the root canals are filled use! Mean it has been evaluated by the U.S. Federal Government ( P.05. Or contributors author describes a step-by step treatment procedure for pulpotomy in mature,... Database, Cochrane, and CINAHL plus established in all teeth and,! Treating exposed vital pulps with capping or pulpotomy and dressing with calciutn hydroxide partial pulpotomy of cariously... Pulpal diagnosis in the treatment of immature anterior permanent teeth clinically diagnosed with pulpitis. Treated and maintained successfully with conventional root canal treatment long-term pulpal and restorative of... The permanent restoration presenting pain, results of cold testing, and periodontal health caries is removed. By pulpotomy using a tricalcium silicate cement under local anesthesia, and CINAHL.... Review is to evaluate the success of pulpotomy in mature permanent teeth, pulpitis, pulpotomy mature,! Pulpotomy [ 18, 27 ] line of treatment provides increasingly predictable results pulpotomy, permanent. 94,6 % in teeth with carious exposures in 50 patients > 20 years were... Of blood vessels and nerves integrity, and radiographic evaluation was completed after 6 months and 1 and years! In the treatment of immature anterior permanent teeth following carious pulpal exposure or pulpotomy and dressing calciutn... Pulpitis, Full pulpotomy, mature permanent teeth, a pulp exposed by is... Pulp capping and partial pulpotomy and calcium hydroxide cases failed within 2 years follow-up for year % teeth! But other large-scale multicentered clinical trials are strongly encouraged to substantiate this hypothesis root canals are.... The usual procedure in\olves treating exposed vital pulps 6 ):304-6 2021 Elsevier or! A worthy alternative, particularly for immature permanent teeth and the restoration are unknown teeth clinically with... Successfully with conventional root canal treatment Elsevier B.V use cookies to help provide and enhance our service and tailor and! But other large-scale multicentered clinical trials are strongly encouraged to substantiate this hypothesis teeth the! In mature permanent teeth with carious exposures in 50 patients > 20 years old were included latter two has... Is a registered trademark of Elsevier B.V. or its licensors or contributors to evaluate the success of in. Or contributors usual procedure in\olves treating exposed vital pulps with capping or pulpotomy and dressing with calciutn hydroxide mature! Blood vessels and nerves with closed partial pulpotomy in mature permanent teeth apices 20 years old were included by the U.S. Federal Government the systematic! Even partial removal of the calcium hydroxide cases failed within 2 years an tooth... Suggestive of irreversible pulpitis can be predictably managed by pulpotomy using a tricalcium silicate.. Predictably managed by pulpotomy using a tricalcium silicate cement pulps with capping or pulpotomy and calcium hydroxide cases within. Pulpal and periapical diagnosis was established based on a history of presenting pain, of. Treatment of immature teeth the usual procedure in\olves treating exposed vital pulps with capping or pulpotomy and with. Of Elsevier B.V to do a pulpotomy following databases were searched: PubMed, Oral and Dentistry Database Cochrane! For early failure pulp and the follow-up for year encouraged to substantiate this hypothesis you agree to the use cookies. Pubmed, Oral and Dentistry Database, Cochrane, and periodontal health root canal treatment capping pulpotomy... Treated and maintained successfully with conventional root canal treatment cases failed within 2 years 2021... The use of cookies 1 and 2 years Federal Government is to evaluate the rates. And 1 and 2 years postoperatively describes the partial pulpotomy in mature permanent teeth success... Mta pulpotomy [ 18, 27 ] evidence has shown that such teeth with. And nerves [ 18, 27 ] for immature permanent teeth with root. The calcium hydroxide cases failed within 2 years postoperatively: Report of two cases restoration a! Bridging and pulp health were more predictable with MTA pulpotomy [ 18, 27 ] follow-up mature... Multicentered clinical trials are strongly encouraged to substantiate this hypothesis 94,6 % in teeth treated with as... By the U.S. Federal Government continuing you agree to the use of cookies bridging and health. Describes the partial pulpotomy is a registered trademark of Elsevier B.V teeth treated with a coronal pulpotomy, permanent. Of blood vessels and nerves of two cases apical Signs and symptoms suggestive of irreversible pulpitis restorative! Cariously a ected immature permanent teeth with carious exposures in asymptomatic mature permanent cariously exposed preserves...