Treatment outcomes of pulpotomy in permanent molars with irreversible pulpitis using biomaterials: a multi-center randomized controlled trial. Pulpotomy in caries-exposed immature permanent molars using calcium-enriched mixture cement or mineral trioxide aggregate: a randomized clinical trial. Clinical and Radiographic Evaluation of Four Different Pulpotomy Agents in Primary Molars: A Longitudinal Study Laser Pulpotomy–An Effective Alternative to Conventional Techniques: A 12 Months Clinicoradiographic Study Indirect pulp treatment in primary teeth: 4-year results. Clinical and radiographic comparison of primary molars after formocresol and electrosurgical pulpotomy: a randomized clinical trial. A comparative evaluation of clinical and radiographic success rate of pulpotomy in primary molars using antioxidant mix and mineral trioxide aggregate: An in vivo 1-year follow-up study Treatment outcomes of pulpotomy in primary molars using two endodontic biomaterials. A 2-year randomised clinical trial. Clinical Evaluation of Success of Primary Teeth Pulpotomy Using Mineral Trioxide Aggregate(®), Laser and Biodentine(TM)- an In Vivo Study. Effect of mineral trioxide aggregate and formocresol pulpotomy on vital primary teeth: a clinical and radiographic study. Clinical and radiographic evaluation of indirect pulp treatment in primary molars: 36 months follow-up. Pulp exposure occurrence and outcomes after 1- or 2-visit indirect pulp therapy vs complete caries removal in primary and permanent molars. One-year results of vital pulp therapy in permanent molars with irreversible pulpitis: an ongoing multicenter, randomized, non-inferiority clinical trial The effect of pulpotomy using a Calcium-Enriched Mixture cement versus one-visit root canal therapy on postoperative pain relief in irreversible pulpitis: a randomized clinical trial Pulpal therapy for primary teeth: formocresol vs electrosurgery: a clinical study. Clinical, Radiographic and Histological Evaluation of Primary Teeth Pulpotomy Using MTA And Ferric Sulfate. Long-term evaluation of pulpotomy in primary molars using mineral trioxide aggregate or formocresol.
OBJECTIVE To conduct a r and omized clinical trial to compare the post-operative pain experience as well as clinical and radiographic outcomes of pulpotomy in human permanent molars with irreversible pulpitis using calcium enriched mixture ( CEM ) cement or mineral trioxide aggregate ( MTA ) . MATERIAL S AND METHODS A total of 413 patients met the inclusion criteria and consented to participate . The patients were r and omly allocated into two study arms : MTA pulpotomy ( PMTA : n = 208 ) and CEM pulpotomy ( PCEM : n = 205 ) . Numerical rating scale question naires were utilized by the patients to record pain intensity ( PI ) over 7 days post-operatively . The patients were followed-up for 12 months to assess the clinical and radiographic outcomes of treatment . The data was analyzed using Chi-square , Cohen 's kappa and t-tests . RESULTS There was no significant difference in the mean PI recorded during the 7 post-operative days between the two study arms ( p = 0.221 ) . The clinical and radiographic success rates for PMTA at 12-month follow-up were 98 and 95 % , respectively ; and 97 and 92 % for PCEM , respectively . There was no significant differences in clinical ( p = 0.7 ) and radiographic ( p = 0.4 ) success rates between the two arms . CONCLUSIONS Excellent treatment outcomes occurred in molar teeth with irreversible pulpitis undergoing pulpotomy with MTA and CEM bio material OBJECTIVE To compare clinical and radiographic outcomes of pulpotomy treatment using calcium-enriched mixture ( CEM ) cement and mineral trioxide aggregate ( MTA ) in carious-exposed vital immature permanent first molars . DESIGN Fifty-one immature molars with clinical carious exposure with symptomatic/asymptomatic pulpitis met the inclusion criteria and r and omly assigned to one of the treatment groups ( CEM [ 26 teeth ; 59 roots ] , MTA [ 25 teeth ; 59 roots ] ) . After performing pulpotomy and covering the radicular pulps with the bio material s , all teeth were permanently restored . Blinded clinical and radiographic evaluations were performed at 6 and 12 months after operation for signs of success or failure . Radiographs were evaluated for complete/partial apical closure . The data were analysed using chi-square test and generalized estimating equation ( GEE ) model . RESULTS There was no significant difference at the baseline between the two experimental groups . All available cases ( 49 teeth ) showed pulp survival and signs of continuous root development after 12 months . Overall , complete apical closure ( apexogenesis ) occurred in 76.8 % and 73.8 % of radiographically interpreted roots in CEM cement and MTA groups , respectively . There was no statistical difference in terms of radiographic outcomes between two groups . CONCLUSIONS Calcium-enriched mixture cement and MTA showed similar performance in pulpotomy of immature caries-exposed permanent molars Background The medicament formocresol ( FC ) used for pulpotomy in primary teeth has great concerns regarding its toxicity due to one of its constituent formaldehyde which acts by tissue fixation . Therefore , new medicaments were introduced which cl aim ed preservation and regeneration of pulp . Aim The present study is aim ed to compare and evaluate the clinical and radiographic success of FC , pulpotec , mineral trioxide aggregate ( MTA ) , and emdogain ( EMD ) as pulpotomy medicaments in human primary molars . Design A sample of 21 patients with 84 teeth were selected . All the patients have at least four teeth eligible for pulpotomy according to selection criteria . In each mouth , the teeth selected were r and omly allocated into four groups with 21 each . Results After 24 months of follow-up , the clinical success rates were  FC  ( 94 % ) , pulpotec ( 94 % ) , MTA ( 100 % ) , and EMD ( 83 % ) and radiographically FC  ( 88 % ) , pulpotec ( 83 % ) , MTA ( 94 % ) , and EMD ( 72 % ) , which were statistically not significant ( p > 0.05 ) . Conclusion The outcome of this study demonstrates MTA has a high success rate compared with FC , pulpotec , and EMD as pulpotomy agent . In addition , MTA , pulpotec , and EMD can be considered as alternatives to FC as pulpotomy agent . How to cite this article Sunitha B , Puppala R , Kethineni B , Mallela MK , Peddi R , Tarasingh P. Clinical and Radiographic Evaluation of Four Different Pulpotomy Agents in Primary Molars : A Longitudinal Study . Int J Clin Pediatr Dent 2017;10(3):240 - 244 ABSTRACT Background : Vital pulpotomy is a single-stage procedure of surgical amputation of the coronal portion of exposed vital pulp , usually as a means of preserving the vitality and function of the remaining radicular portion . Aims and objectives : The aim of this study was to compare the clinical and radiographic success rates for ferric sulfate ( FS ) , electrosurgery ( ES ) and laser pulpotomy in human primary molars . Material s and methods : In a r and omized clinical trial , 30 primary molars indicated for pulpotomy in children aged 4 to 10 years were treated using either a FS ( 10 teeth ) , ES technique ( 10 teeth ) and laser ( 10 teeth ) . Following the pulpotomy , the teeth were evaluated for clinical and radiographic success at 3 , 6 , 9 and 12 months on the basis of the presence of pain , sinus , mobility , internal and external resorption , periapical radiolucency , calcification in the canal and bone loss . Statistical analysis : The data were assessed with Chi-square test . Results : After 12 months of follow-up , both clinical and radiographic success rates were 100 % in the laser group but only 80 % in both ES and FS groups . There was statistically significant difference between the success rates of three groups ( p < 0.05 ) . Conclusion : Laser pulpotomy showed better clinical as well as radiographical results than ES and FS pulpotomy . Laser pulpotomy was also found superior in terms of operating time , patient cooperation , ease of use and pain . Although results of the study showed the failure rates for electrosurgical pulpotomy to be equal to those for FS pulpotomy , electrosurgical pulpotomy being a nonpharmacological technique considered more favorable . Further studies using larger sample size and longer evaluation periods are suggested . How to cite this article : Gupta G , Rana V , Srivastava N , Ch and na P. Laser Pulpotomy – An Effective Alternative to Conventional Techniques : A 12 Months Clinicoradiographic Study . Int J Clin Pediatr Dent 2015;8(1):18 - 21 PURPOSE To evaluate clinical and radiographic outcomes of indirect pulp treatment ( IPT ) in primary molars after long-term function ( up to 60 months ) . METHODS Teeth with deep carious lesions without signs and symptoms of irreversible pulpitis were divided by r and om allocation into two groups , according to the capping material utilized over demineralized dentin : experimental group ( 1 ) : self-etching adhesive system ( Clearfil SE Bond ) ; and control group ( 2 ) : calcium hydroxide liner ( Dycal ) . Both groups were filled with resin composite ( Z250 ) and su bmi tted to a clinical and radiographic monitoring period until exfoliation . RESULTS After the follow-up period ( up to 60 months ) , no statistical difference was found between groups ( P= 0.514 ) . The overall success rate reached 78 % . The failures occurred after the first year period recall BACKGROUND Vital pulpotomy is a single-stage procedure defined as the surgical amputation of the coronal portion of exposed vital pulp , usually as a means of preserving the vitality and function of the remaining radicular portion . OBJECTIVES The aim of this study was to compare the clinical and radiographic success rates for electrosurgical vs formocresol pulpotomy in human primary molar teeth . SETTING S AND DESIGN This was a prospect i ve , r and omized clinical trial . MATERIAL S AND METHODS In this r and omized clinical trial , pulpotomies were performed on 70 primary molars in children aged 5 - 10 years . The teeth were treated using either a conventional formocresol ( 35 teeth ) or electrosurgical technique ( 35 teeth ) . Following the pulpotomy procedure , the teeth were evaluated for clinical and radiographic success for three , six and nine months . The teeth were evaluated for the presence of pain , abscess , fistula , mobility , internal and external resorption , and radiolucency . STATISTICAL ANALYSIS The data were assessed with Fishers ' Exact test . RESULTS After nine months of follow-up , the clinical and radiographic success rates were 96 and 84 % respectively in the electrosurgical group and 100 and 96.8 % respectively in the formocresol group . There was no statistically significant difference between the success rates in the two groups ( P > 0.05 ) . CONCLUSIONS Our results showed the failure rates for electrosurgical pulpotomy to be equal to those for formocresol pulpotomy . Although electrosurgical pulpotomy is a nonpharmacological technique giving favorable results , it is still a preservative technique . Further studies using larger sample s and longer evaluation periods are recommended Introduction : Pulpotomy technique is most widely accepted clinical procedure for treating primary teeth with coronal pulp inflammation caused by caries with no involvement of the radicular pulp . Aim and Objective : The aim of the study was to evaluate the success and efficacy of mineral trioxide aggregate ( MTA ) and antioxidant mix as pulpotomy agents both clinical ly and radiographically . Material s and Methods : A total of forty primary molars in children aged between 6 and 9 years , requiring for pulpotomy procedures , were selected . R and om sample s distribution was done , antioxidant mix ( n = 20 ) and MTA ( n = 20 ) both were used as pulpotomy agent . Under rubber dam isolation , pulpotomy procedure was performed in all sample s followed by restoration with stainless steel crowns . Later , the patients were recalled after 6 and 12 months for clinical and radiographic evaluation . The data were evaluated using Fisher 's exact test . Results : Statistically analysis shows no significant difference between the two groups ( P > 0.05 ) with respect to clinical and radiographic success rate , but antioxidant mix showed more efficient result than MTA . Conclusion : Antioxidant mix pulpotomy is more biocompatible and cost effective than any other commercially available medicament AIM To compare the treatment outcomes of calcium-enriched mixture ( CEM ) cement and mineral trioxide aggregate ( MTA ) as pulp dressing bio material s in vital pulpotomy of carious primary molars . STUDY DESIGN split-mouth r and omised clinical trial . MATERIAL S AND METHODS Forty children aged 4 - 8 years with 2 carious teeth requiring pulpotomy were selected and r and omly assigned to MTA ( n = 40 ) or CEM ( n = 40 ) groups . After coronal pulp removal , the remaining radicular pulp was covered with an appropriate bio material ; the teeth were then permanently restored . Clinical /radiographic success/failures were blindly evaluated at 6- , 12- and 24-month follow-ups . STATISTICS the recorded data were analyzed with McNemar test and GEE . RESULTS A total of 36 , 33 and 35 patients were available for 6- , 12- and 24-month follow-ups , respectively . At the 12-month follow-up only one and three teeth in the CEM and MTA groups had pathologic external root resorption , respectively . The resorbed teeth were then missed due to extraction /exfoliation at the 24-month follow-up ; all other treated teeth were sign/symptom-free . Overall , clinical and radiographic outcomes in both MTA/CEM groups were comparable at the three follow-ups without significant differences . Time had no significant effect on the success . CONCLUSION MTA and CEM demonstrated favourable treatment outcomes for pulpotomy of carious primary molars ; CEM may be an effective pulp dressing bio material INTRODUCTION Pulpotomy technique basically consists of removing the coronal pulp and fixing the radicular pulp with a medicament . It is the most widely accepted clinical procedure for treating primary teeth with coronal pulp inflammation caused by caries with no involvement of the radicular pulp . AIM To evaluate the success and efficacy of Mineral Trioxide Aggregate ( MTA ) , Lasers and Biodentine as pulpotomy agents both clinical ly and radiographically . MATERIAL S AND METHODS In the present study , 60 primary molars in children whose pulpal status warranted pulpotomy were selected and r and omly assigned into three groups that included MTA , Laser and Biodentine allocating 20 teeth to each group . The pulpotomy procedure was then performed on all selected teeth followed by restoration with stainless steel crowns . Later the patients were recalled for 3 months and 6 months for clinical and radiographic evaluation . RESULTS Statistical analysis was done using Fisher exact test to determine pair wise comparison of three agents with respect to clinical and radiographic criteria . Kruskal-Wallis ANOVA , Mc Nemars test was applied to evaluate the efficacy of each agent between 3 months and 6 months . The results showed that maximum success rate was found in MTA group . However , the comparison between three groups was statistically not significant ( p<0.05 ) . CONCLUSION Pulpotomies performed with either MTA , Laser or Biodentine are equally efficient with similar clinical /radiographic success and hence can be considered as alternatives to Formocresol BACKGROUND Pulpotomy is the common therapy for cariously exposed pulps in symptom-free primary molar teeth .  Formocresol ( FC ) is considered the gold st and ard dressing agent for pulpotomy , but concerns have been raised over the years about its safety . Other alternative pulpotomy agents have been investigated and suggested . OBJECTIVE The objective was to evaluate and compare the clinical and radiographic response of FC and white mineral trioxide aggregate ( MTA ) as pulpotomy material s on primary molars . MATERIAL S AND METHODS Fifty primary molars , with deep carious lesion that exposed a vital but asymptomatic pulp , in 37 children aged 4 - 7 years were treated with conventional pulpotomy procedure .  The teeth were divided r and omly into two groups . Group I ( FC ) and group II ( MTA ) . The treated teeth were evaluated clinical ly and radiographically and were followed-up for 12 months . RESULTS At the end of the 12 months follow-up , the clinical success rates for FC and MTA were 81 % and 100 % , respectively . There was a statistically significant difference ( P = 0.04 ) between the clinical success rates of FC and MTA . While the radiographic success rates for FC and MTA were 81 % and 96 % , respectively , there was no statistically significant difference between the radiographic success of MTA and FC . CONCLUSION White MTA showed a higher clinical and radiographic success rate when compared to FC as a pulpotomy agent in vital primary molars , and it has a potential to become a replacement for FC in primary molars PURPOSE To evaluate the clinical and radiographic changes in primary teeth su bmi tted to indirect pulp treatment ( IPT )  over a 36-month period . METHODS Thirty-nine primary molars with deep caries , but without preoperative signs and symptoms of irreversible pulpits , received IPT .  The teeth were r and omly divided into two groups , according to the material used for protection of the dentin-pulp complex : ( 1 ) a calcium hydroxide liner ( Hydro C ) and ( 2 ) a gutta-percha sheet . Both groups were restored with Z250 resin-based composite . RESULTS After 36 months , Group 1 showed a success rate of 73.3 % and Group 2 , 85.7 % . The overall success rate was 79.3 % , with no statistically significant difference between the groups ( P = 0.36 ) PURPOSE The purpose of this study was to examine whether 1- or 2-visit indirect pulp therapy ( IPT ) is more successful and to determine if the operator can successfully decide when to stop removing caries without exposing the pulp . METHODS A total of 154 teeth ( 94 primary second molars and 60 young permanent first molars ) were included in the study from a total of 123 4- to 15-year-old patients . The teeth had deep carious lesions but lacked the preoperative signs and symptoms of irreversible pulpitis . The teeth were r and omly selected and treated either with 1-visit IPT , 2-visit IPT , or direct complete excavation ( DCE ) . Follow-up examinations were conducted on the teeth over 1 year at 3-month intervals . RESULTS The pulp was exposed in 12 teeth ( 22 % ) treated by DCE , whereas 3 teeth ( 6 % ) were treated by 1-visit IPT and 4 teeth ( 8 % ) with 2-visit IPT . A statistically significant difference was found between IPT and DCE groups in terms of pulp exposure ( P<.05 ) . The teeth without pulp exposure showed normal clinical and radiographic conditions during the 1-year follow-up , except for 3 primary teeth . CONCLUSIONS Indirect pulp therapy in both primary and young permanent teeth can be used successfully with a 1- or 2-visit approach Objectives Root canal therapy ( RCT ) and tooth extraction have been conventional treatment options for management of human mature teeth with irreversible pulpitis . Excellent short-term treatment outcomes of vital pulp therapy with calcium-enriched mixture cement ( VPT/CEM ) , as a new treatment option , on postoperative pain relief was demonstrated ; if intermediate- and long-term treatment outcomes of the new treatment are also non-inferior compared to RCT , then VPT/CEM may become a viable treatment option for management of mature teeth with irreversible pulpitis . Material s and methods In 23 healthcare centers , 407 9- to 65-year-old patients were r and omly allocated into two study arms including one-visit RCT ( reference treatment ; n = 202 ) and VPT/CEM ( alternative treatment ; n = 205 ) . Six- and twelve-month clinical and radiographic successes were assessed . Results Mean follow-up times at 6- and 12-month follow-ups were “ 6.70 ± 0.68 and 6.72 ± 0.71 months ” and “ 12.96 ± 0.67 and 12.90 ± 0.66 months ” in the available cases of RCT and VPT/CEM arms , respectively . Favorable clinical success rates in the two study arms did not show statistical difference ; however , the radiographic success rate in the VPT/CEM was significantly greater than RCT arm at the two follow-ups ( P < 0.001 ) . The patients ’ age had no effect on the treatment outcomes ( P = 0.231 ) . Conclusions Treatment outcomes of VPT/CEM may be superior to RCT in mature molars with irreversible pulpitis . The performance of bio material s such CEM cement may assist in the shift towards more biologic treatments . Clinical relevance VPT/CEM may be a realistic alternative treatment for human mature molar teeth with symptoms of irreversible pulpitis ; the use of VPT/CEM is highly beneficial for patients as well as general dentists The purpose of this noninferiority trial was to compare postoperative pain relief after one-visit root canal therapy ( O RCT ) with a pulpotomy performed with a new endodontic calcium-enriched mixture cement ( PCEM ) in human permanent molars with irreversible pulpitis . A total of 407 selected patients were r and omly allocated into the O RCT group ( n = 202 ) or the PCEM group ( n = 205 ) . Numerical Rating Scale question naires were used to record pain intensity ( PI ) by the patients during the first 7 days after treatment . While there was no statistically significant difference in the mean PI at baseline between the two study groups ( P = 0.45 ) , changes in mean PI were significantly different between them ( P < 0.001 ) . In the O RCT group , pain relief was achieved after 36 h [ 95 % confidence interval ( CI ) , 27.00–45.00 ] , compared to 18 h in the PCEM group ( 95 % CI , 15.00–21.00 ) , a significant difference ( P < 0.01 ) . Comparison of the mean PI sum recorded over 7 days showed that patients in the O RCT group experienced significantly more pain than those in the PCEM group ( P < 0.001 ) ; a similar difference was observed for pain in response to percussion tests ( P < 0.001 ) . Treatment with PCEM thus had the better pain-reducing effects than O RCT in irreversible pulpitis cases Post-operative clinical and x-ray findings on 80 primary molars were evaluated . These molars had undergone pulpal therapy by 2 techniques : pulpotomy with formocresol and with electrosurgery .  The sample was selected from children between the ages of 4 and 7 . A criterion for inclusion was each child must have at least 2 primary molars with pulp exposed by caries . Experimental molars with 1 or more of the following clinical or radiographic signs and symptoms were excluded : mobility , sensitivity to percussion , the presence of fistulae , groove drainage , apical or internal resorption , fetid smell and compromised furcation .  Also excluded were patients previously diagnosed with diabetes , cardiopathy and renal alterations . Initially , a dinical and radiographic examination was carried out , followed by another at 1 , 3 and 6 months after application of the techniques . No significant differences were found at the end of the period . However , electrosurgery had an advantage : it was faster to apply and dispensed with the use of formocresol . Further research is suggested , using larger sample s and shorter evaluation periods The aim of this study was to evaluate the clinical , radiographic and histological outcomes of the dentin-pulp complex from primary molars after pulpotomy with mineral trioxide aggregate ( MTA ) and 15.5 % ferric sulfate ( FS ) . Thirty-one primary molars were r and omly allocated into MTA or FS groups . Clinical and radiographic evaluations were recorded at 3- , 6- , 12- and 18-month follow-up . Teeth at the regular exfoliation period were extracted and processed for histological analysis . Clinical and radiographic data were tested by statistical analysis ( p≤0.01 ) . Histological outcomes were analyzed descriptively . All of the treated teeth presented clinical success over the experimental periods . Both groups exhibited 100 % of radiographic success at 3 , 6 and 12 months . At the 18-month follow-up , one tooth from FS group presented inter-radicular radiolucency ( p>0.01 ) . Histologically , the treated teeth presented pulp vitality and absence of inflammatory infiltrate into the connective tissue . Only MTA group showed hard tissue barrier surrounded by odontoblasts over the pulp stumps . Both MTA and 15.5 % FS  are effective for pulpotomies of primary teeth . Although MTA is considered the first-choice material , FS may be a suitable alternative when treatment cost is an issue PURPOSE The objective of this study was to assess the effect of mineral trioxide aggregate ( MTA ) as pulp dressing material following pulpotomy in primary molars with carious pulp exposure and compare them to those of formocresol ( FC ) . METHODS Of 33 children , primary molars treated via a conventional pulpotomy technique  were r and omly assigned to the MTA  group ( 33 teeth ) or FC  group ( 29 teeth ) . Clinical and radiographic follow-up ranged between 4 and 74 months . The mean follow-up time was 38 months , with no difference between the groups . Twenty-nine teeth were followed until uneventful shedding ( mean=33 months ) . Failures were detected after a mean period of 16 months ( range=4 to 30 ) . RESULTS The success rate of pulpotomy was 97 % for MTA ( 1 failure ) and 83 % for FC ( 5 failures ) . Eight teeth presented internal resorption . In 4 of them ( 2 of each group ) , progress of the resorption process stopped and the pulp tissue was replaced by a radioopaque calcified tissue . Pulp canal obliteration was observed in 58 % of the MTA group and in 52 % of the FC group ( total=55 % ) . CONCLUSIONS MTA showed a higher ( though not statistically significant ) long-term clinical and radiographic success rate than formocresol , and can be recommended as its replacement as , unlike FC , MTA does not induce undesirable responses
After 18 - 24 months , in terms of treatment failure , the odds ratio for calcium hydroxide vs. formocresol was 1.94 [ 95 % credible interval ( CI ) : 1.11 , 3.25 ] ; 3.38 ( 95 % CI : 1.37 , 8.61 ) for lasers vs. formocresol ; 2.16 ( 95 % CI : 1.12 , 4.31 ) for calcium hydroxide vs. ferric sulfate ; 3.73 ( 95 % CI : 1.27 , 11.67 ) for lasers vs. ferric sulfate ; 0.47 ( 95 % CI : 0.26 , 0.83 ) for MTA vs. calcium hydroxide ; 3.76 ( 95 % CI : 1.39 , 10.08 ) for lasers vs. MTA CONCLUSIONS After 18 - 24 months , formocresol , ferric sulfate , and MTA showed significantly better clinical and radiographic outcomes than calcium hydroxide and laser therapies in primary molar pulpotomies .
CLINICAL SIGNIFICANCE The network meta-analyses showed that MTA is the first choice for primary molar pulpotomies .
However , if treatment cost is an issue , especially when the treated primary molars are going to be replaced by permanent teeth , ferric sulfate may be the choice
OBJECTIVE Pulpotomy is a common procedure to treat asymptomatic reversible pulpitis in primary molars .
The aim of this study is to undertake a systematic review and a network meta- analysis to compare the clinical and radiographic outcomes of different pulpotomy procedures in primary molars .