Citation Information :
Yoshpe M, Kaufman AY, Lin S, Malul M, Ashkenazi M. Clinical and Radiographic Outcomes of Mineral Trioxide Aggregate Pulpotomies in Vital Permanent Teeth with Carious Pulp Exposure: A Pioneering Retrospective Study. Int J Clin Pediatr Dent 2023; 16 (4):555-559.
Purpose: Vital partial pulpotomy (PP) or cervical pulpotomy (CP) in carious pulp-exposed permanent teeth preserves tooth vitality, promotes pulp healing, decreases treatment costs, and shortens treatment duration, which is a significant factor in treating noncooperative children. The aim of this retrospective study was to compare clinical and radiographic outcomes of partial and CP in vital carious-exposed permanent teeth.
Materials and methods: All vital permanent teeth with carious pulp exposure, treated by pulpotomy using mineral trioxide aggregate (MTA) during 2017–2019, by two operators in one dental center, were included in the study. Around 118 permanent teeth in 97 children and adolescents (mean age 10.9 years) were evaluated 6–57 months postoperatively.
Results: The total success rates of CP and PP were 82.5 and 80.8%, respectively (p = nonsignificant). The only factor that significantly affected the success rate was the presence of preoperative periapical pathology. Teeth without such pathology showed an 87.3% success rate compared to 74.1 and 58.3% in teeth with preoperative enlarged periodontal ligament (PDL) or with periapical radiolucency, respectively (p = 0.0301). Demographic variables, maturation state of the tooth, type of tooth (incisor, premolar, molar), postoperative variables, such as the presence of radiographic dentinal bridge, partial or full obliteration of the pulp during the follow-up period, and the integrity of the final restoration during the recall examinations did not affect the success rate of the treatment.
Conclusion: Partial and CP in vital permanent teeth with carious pulp exposure in children and adolescents might be a reliable alternative to full root canal treatment (RCT).
Jälevik B, Klingberg GA. Dental treatment, dental fear and behaviour management problems in children with severe enamel hypomineralization of their permanent first molars. Int J Paediatr Dent 2002;12(1):24–32. DOI: 10.1046/j.0960-7439.2001.00318.x
Bjørndal L, Simon S, Tomson PL, et al. Management of deep caries and the exposed pulp. Int Endod J 2019;52(7): 949–973. DOI: 10.1111/iej.13128
Sadaf D. Success of coronal pulpotomy in permanent teeth with irreversible pulpitis: an evidence-based review. Cureus 2020;12(1):e6747. DOI: 10.7759/cureus.6747
Zanini M, Hennequin M, Cousson PY. A review of criteria for the evaluation of pulpotomy outcomes in mature permanent teeth. J Endod 2016;42(8):1167–1174. DOI: 10.1016/j.joen.2016.05.008
AAE position statement on vital pulp therapy. J Endod 2021;47(9):1340–1344. DOI: 10.1016/j.joen.2021.07.015
Mass E, Zilberman U. Clinical and radiographic evaluation of partial pulpotomy in carious exposure of permanent molars. Pediatr Dent 1993;15(4):257–259.
Mass E, Zilberman U, Fuks AB. Partial pulpotomy: another treatment option for cariously exposed permanent molars. ASDC J Dent Child 1995;62(5):342–345.
Barrieshi-Nusair KM, Qudeimat MA. A prospective clinical study of mineral trioxide aggregate for partial pulpotomy in cariously exposed permanent teeth. J Endod 2006;32(8):731–735. DOI: 10.1016/j.joen.2005.12.008
Alqaderi HE, Al-Mutawa SA, Qudeimat MA. MTA pulpotomy as an alternative to root canal treatment in children's permanent teeth in a dental public health setting. J Dent 2014;42(11):1390–1395. DOI: 10.1016/j.jdent.2014.06.007
Taneja S, Singh A. Evaluation of effectiveness of calcium hydroxide and MTA as pulpotomy agents in permanent teeth: a meta-analysis. Pediatr Dent J 2019;29(2):90–96. DOI: 10.1016/j.pdj.2019.04.001
Jiang S, Wu H, Zhang CF. Partial pulpotomy of immature teeth with apical periodontitis using bioceramics and mineral trioxide aggregate: a report of three cases. Chin J Dental Res 2016;19(2):115–120. DOI: 10.3290/j.cjdr.a36182
Tran XV, Ngo LTQ, Boukpessi T. BiodentineTM full pulpotomy in mature permanent teeth with irreversible pulpitis and apical periodontitis. Healthcare (Basel) 2021;9(6):720. DOI: 10.3390/healthcare9060720
Simon S, Perard M, Zanini M, et al. Should pulp chamber pulpotomy be seen as a permanent treatment? Some preliminary thoughts. Int Endod J 2013;46(1):79–87. DOI: 10.1111/j.1365-2591.2012.02113.x
Linsuwanont P, Wimonsutthikul K, Pothimoke U, et al. Treatment outcomes of mineral trioxide aggregate pulpotomy in vital permanent teeth with carious pulp exposure: the retrospective study. J Endod 2017;43(2):225–230. DOI: 10.1016/j.joen.2016.10.027
Tawil PZ, Duggan DJ, Galicia JC. Mineral trioxide aggregate (MTA): its history, composition, and clinical applications. Compend Contin Educ Dent 2015;36(4):247–252.
Qudeimat MA, Barrieshi-Nusair KM, Owais AI. Calcium hydroxide vs mineral trioxide aggregates for partial pulpotomy of permanent molars with deep caries. Eur Arch Paediatr Dent 2007;8(2):99–104. DOI: 10.1007/BF03262577
R Core Team ’R: A language and environment for statistical computing’. Vienna, Austria: R Foundation for Statistical Computing. 2018. Available at: https://www.r-project.org.
Mejàre I, Cvek M. Partial pulpotomy in young permanent teeth with deep carious lesions. Endod Dent Traumatol 1993;9(6):238–242. DOI: 10.1111/j.1600-9657.1993.tb00279.x
Taha NA, Ahmad MB, Ghanim A. Assessment of mineral trioxide aggregate pulpotomy in mature permanent teeth with carious exposures. Int Endod J 2017;50(2):117–125. DOI: 10.1111/iej.12605
Ray HA, Trope M. Periapical status of endodontically treated teeth in relation to the technical quality of the root filling and the coronal restoration. Int Endod J 1995;28(1):12–18. DOI: 10.1111/j.1365-2591.1995.tb00150.x