Aim: This study aims to evaluate, over 12 months of clinical and radiographic follow-ups, the performance and outcomes of Biodentine™ pulpotomy in stage I primary molars.
Materials and methods: A total number of 20 stage I primary molars requiring pulpotomy were selected from eight healthy patients aged between 34 and 45 months. Patients presenting a negative attitude toward dental treatment on the dental chair were scheduled for dental treatments under general anesthesia.
Pulpotomy with Biodentine™ as a pulp-dressing material was performed on all selected molars. The patients were called back at 1 and 3 months for clinical follow-ups, then at 6 and 12 months for clinical and radiographic follow-ups. Data were tabulated according to follow-up intervals and occurrence of any changes in root maturation, pulp canal obliteration (PCO), periodontal ligament space (PLS), and bone or root lesion.
Results: No statistically significant differences were recorded at 1, 3, 6, and 12 months. There was a statistically significant increase in number of roots with closed apices from six roots at 6 months to 50 roots at 12 months (p < 0.0005) and the PCO was present in all 50 roots at 12 months, after it was present in 36 roots only at 6 months (p = 0.0001).
Conclusion: This is the first randomized clinical trial that evaluates the performance of Biodentine™ as a pulp-dressing agent in stage I primary molar pulpotomy over 12 months of follow-up. Contrary to previous studies, the present work highlights the continued root formation and apical closure (AC) in pulpotomized immature primary molars.
Girish MS, Chandra P, Anandakrishna L. Clinical and radiographic evaluation of mineral trioxide aggregate and electrosurgical pulpotomies in primary molars: an in-vivo study. J Int Oral Health 2016;8(5):601–606.
Praveen P, Anantharaj A, Venkataraghavan K, et al. A review of obturating materials for primary tooth. SRM Univ J Dent Sci 2011;2: 42–44.
Cohn C. Pulpotomy for primary teeth with tricalcium silicate material. Inside Dent 2013;9(9):100–102.
Godhi B, Sood PB, Sharma A. Effects of mineral trioxide aggregate and formocresol on vital pulp after pulpotomy of primary molars: an in vivo study. Contemp Clin Dent 2011;2(4):296–301. DOI: 10.4103/0976-237X.91792
Kusum B, Rakesh K, Richa K. Clinical and radiographical evaluation of mineral trioxide aggregate, biodentine and propolis as pulpotomy medicaments in primary teeth. Restor Dent Endod 2015;40(4): 276–285. DOI: 10.5395/rde.2015.40.4.276
Havale R, Anegundi RT, Indushekar K, et al. Clinical and radiographic evaluation of pulpotomies in primary molars with formocresol, glutaraldehyde and ferric sulphate. Oral Health Dent Manag 2013;12(1):24–31.
Pilipili CM, Vanden Abbeele A, van den Abbeele K. La pulpotomie de la dent temporaire [Pulpotomy of deciduous teeth]. Rev Belge Med Dent (1984) 2004;59(3):156–162.
Demars C, Fortier JP. Propos sur l'endodontie des dents temporaires [Endodontics of temporary teeth]. Actual Odontostomatol (Paris) 1981;35(134):213–224.
Chen Y, Chen X, Zhang Y, et al. Materials for pulpotomy in immature permanent teeth: a systematic review and meta-analysis. BMC Oral Health 2019;19(1):227. DOI: 10.1186/s12903-019-0917-z
Parisay I, Ghoddusi J, Forghani M. A review on vital pulp therapy in primary teeth. Iran Endod J 2015;10(1):6–15.
Rodd HD, Waterhouse PJ, Fuks AB, et al. Pulp therapy for primary molars. Int J Paediatr Dent 2006;16 (Suppl 1):15–23. DOI: 10.1111/j.1365-263X.2006.00774.x
Rajasekharan S, Martens LC, Vandenbulcke J, et al. Efficacy of three different pulpotomy agents in primary molars: a randomized control trial. Int Endod J 2017;50(3):215–228. DOI: 10.1111/iej.12619
Caruso S, Dinoi T, Marzo G, et al. Clinical and radiographic evaluation of biodentine versus calcium hydroxide in primary teeth pulpotomies: a retrospective study. BMC Oral Health 2018;18(1):54. DOI: 10.1186/s12903-018-0522-6
Rajasekharan S, Martens LC, Cauwels RG, et al. Biodentine™ material characteristics and clinical applications: a review of the literature. Eur Arch Paediatr Dent 2014;15(3):147–158. DOI: 10.1007/s40368-014-0114-3
Cuadros-Fernández C, Lorente Rodríguez AI, Sáez-Martínez S, et al. Short-term treatment outcome of pulpotomies in primary molars using mineral trioxide aggregate and Biodentine: a randomized clinical trial. Clin Oral Investig 2016;20(7):1639–1645. DOI: 10.1007/s00784-015-1656-4
Shayegan A, Jurysta C, Atash R, et al. Biodentine used as a pulp-capping agent in primary pig teeth. Pediatr Dent 2012;34(7): e202–e208.
Grewal N, Salhan R, Kaur N, et al. Comparative evaluation of calcium silicate-based dentin substitute (Biodentine®) and calcium hydroxide (pulpdent) in the formation of reactive dentin bridge in regenerative pulpotomy of vital primary teeth: triple blind, randomized clinical trial. Contemp Clin Dent 2016;7(4):457–463. DOI: 10.4103/0976-237X.194116
N Nasseh H, El Noueiri B, Pilipili C, et al. Evaluation of Biodentine pulpotomies in deciduous molars with physiological root resorption (stage 3). Int J Clin Pediatr Dent 2018;11(5):393–394. DOI: 10.5005/jp-journals-10005-1546
Nasrallah H, El Noueiri B, Pilipili C, et al. Clinical and radiographic evaluations of Biodentine™ pulpotomies in mature primary molars (stage 2). Int J Clin Pediatr Dent 2018;11(6):496–504. DOI: 10.5005/jp-journals-10005-1564
Kazeminia M, Abdi A, Shohaimi S, et al. Dental caries in primary and permanent teeth in children's worldwide, 1995 to 2019: a systematic review and meta-analysis. Head Face Med 2020;16(1):22. DOI: 10.1186/s13005-020-00237-z
Togoo RA. Early childhood caries—cause, diagnosis & management. Int J Health Sci Res 2012;1(2):148–160.
Collado-González M, García-Bernal D, Oñate-Sánchez RE, et al. Cytotoxicity and bioactivity of various pulpotomy materials on stem cells from human exfoliated primary teeth. Int Endod J 2017;50 (Suppl 2): e19–e30. DOI: 10.1111/iej.12751
Smaïl-Faugeron V, Courson F, Durieux P, et al. Pulp treatment for extensive decay in primary teeth. Cochrane Database Syst Rev 2014;6(8):CD003220. DOI: 10.1002/14651858.cd003220
Sultana A, Karim FA, Sheikh MAH, et al. Better outcome in pulpotomy on primary molar with Biodentine. Update Dent Coll J 2016;5(2):57–62. DOI: 10.3329/updcj.v5i2.27277
Laurent P, Camps J, De Méo M, et al. Induction of specific cell responses to a Ca(3)SiO(5)—based posterior restorative material. Dent Mater 2008;24(11):1486–1494. DOI: 10.1016/j.dental.2008.02.020
Luo Z, Li D, Kohli MR, et al. Effect of Biodentine™ on the proliferation, migration and adhesion of human dental pulp stem cells. J Dent 2014;42(4):490–497. DOI: 10.1016/j.jdent.2013.12.011
Çelik BN, Mutluay MS, Arıkan V, et al. The evaluation of MTA and Biodentine as a pulpotomy materials for carious exposures in primary teeth. Clin Oral Investig 2019;23(2):661–666.
Guelmann M, Shapira J, Silva DR, et al. Esthetic restorative options for pulpotomized primary molars: a review of literature. J Clin Pediatr Dent 2011;36(2):123–126. DOI: 10.17796/jcpd.36.2.34h304265110137r
Kuo HY, Lin JR, Huang WH, et al. Clinical outcomes for primary molars treated by different types of pulpotomy: a retrospective cohort study. J Formos Med Assoc 2018;117(1):24–33. DOI: 10.1016/j.jfma.2017.02.010
El Meligy OAES, Alamoudi NM, Allazzam SM, et al. Biodentine versus formocresol pulpotomy technique in primary molars: a 12-month randomized controlled clinical trial. BMC Oral Health 2019;19(1):3.
Niranjani K, Prasad MG, Vasa AA, et al. Clinical evaluation of success of primary teeth pulpotomy using Mineral Trioxide Aggregate(®), laser and Biodentine(TM)—an in vivo study. J Clin Diagn Res 2015;9(4):ZC35–ZC37.
Guagnano R, Romano F, Defabianis P. Evaluation of Biodentine in pulpotomies of primary teeth with different stages of root resorption using a novel composite outcome score. Materials (Basel) 2021;14(9):2179. DOI: 10.3390/ma14092179
Ramanandvignesh P, Gyanendra K, Mridula DJKG. Clinical and radiographic evaluation of pulpotomy using MTA, Biodentine and Er,Cr:YSGG laser in primary teeth—a clinical study. Laser Ther 2020;29(1):29–34. DOI: 10.5978/islsm.20-OR-03
Abuelniel GM, Duggal MS, Kabel N. A comparison of MTA and Biodentine as medicaments for pulpotomy in traumatized anterior immature permanent teeth: a randomized clinical trial. Dent Traumatol 2020;36(4):400–410. DOI: 10.1111/edt.12553
Akhlaghi N, Khademi A. Outcomes of vital pulp therapy in permanent teeth with different medicaments based on review of the literature. Dent Res J (Isfahan) 2015;12(5):406–417. DOI: 10.4103/1735-3327.166187
Waterhouse PJ, Nunn JH, Whitworth JM. An investigation of the relative efficacy of Buckley's Formocresol and calcium hydroxide in primary molar vital pulp therapy. Br Dent J 2000;188(1):32–36. DOI: 10.1038/sj.bdj.4800380
Camp JH. Diagnosis dilemmas in vital pulp therapy: treatment for the toothache is changing, especially in young, immature teeth. Pediatr Dent 2008;30(3):197–205.
Borum MK, Andreasen JO. Sequelae of trauma to primary maxillary incisors. I. Complications in the primary dentition. Endod Dent Traumatol 1998;14(1):31–44. DOI: 10.1111/j.1600-9657.1998.tb00806.x