Outcome of partial and full pulpotomy in cariously exposed mature molars with symptoms indicative of irreversible pulpitis: A randomized controlled trial

Abstract

Aim The aim of this study was to assess and compare the clinical and radiographic outcome of partial pulpotomy and full pulpotomy using Biodentine in cariously exposed mature molar teeth with symptoms indicative of irreversible pulpitis. Methodology This study is an unicentric, double‐arm, randomized superiority clinical trial with parallel experimental groups, registered under CTRI (CTRI/2019/12/022559). Fifty mature permanent molar teeth with carious exposures with symptoms indicative of irreversible pulpitis were randomly allocated equally into two groups. Partial pulpotomy (PP) and full pulpotomy (FP) were performed in the first and second group, respectively, following standardized protocols. Exposed pulp tissue was removed up to a depth of 2–3 mm for partial pulpotomy, whereas complete coronal pulp tissue was removed up to the level of root orifices for full pulpotomy. Haemostasis was achieved with placement of 2.5% sodium hypochlorite‐moistened cotton pellets placed on amputated pulp tissue for a maximum of 10 min. Biodentine was used as the pulp capping material. Pain scores were evaluated using 11‐point Visual Analogue Scale (VAS) preoperatively, at 24 h, 48 h and 7th day after the intervention(s). Clinical and radiographic evaluation was done at 3 months, 6 months and 1 year. The data were statistically analysed using chi‐squared test, Mann–Whitney U‐test, Friedman's test and Wilcoxon signed‐rank test. The significance level was pre‐determined at p < .05. Cumulative survival probabilities were assessed at 12 months using Kaplan–Meier analysis. Results Intra‐group analysis of pain scores revealed significant reduction in pain scores preoperatively and at 24 h, 48 h and 7th day in both the groups. However, the difference in the pain score(s) reduction between both the groups was not statistically significant at any time interval (p > .05). At 1‐year follow‐up, the success rate was 88% (22/25) and 91.6% (22/24) for PP and FP respectively (p > .05). Conclusions Partial pulpotomy showed comparable results to full pulpotomy in terms of clinical/radiographic treatment outcome. If the long‐term results remain the same, partial pulpotomy can be proposed as an alternative treatment modality for mature teeth with cariously exposed pulp tissue presenting with signs of symptomatic irreversible pulpitis.

Treatment outcome of partial pulpotomy using two different calcium silicate materials in mature permanent teeth with symptoms of irreversible pulpitis: A randomized clinical trial

“…Both capping materials exhibited high and comparable successful outcomes, 89.2% for MTA Angelus and 82.5% for Total Fill BC with no significant differences between them. These results are in accordance with previous findings for ProRoot MTA by Taha and Khazali (2017) and Biodentine by Jassal et al (2023) who described successful outcomes in 85% and 88% in similar cases, respectively. However, such percentages are higher compared to those mentioned by Careddu and Duncan (2021) and Baranwal et al (2022) who reported a successful outcome in the percentage range of 78% to 80% for Biodentine in cases of irreversible pulpitis.…”

One‐year outcome of selective caries removal versus pulpotomy treatment of deep caries: A pilot randomized controlled trial

“…However, partial pulpotomy preserves more tooth structure, and the presence of some coronal pulp can help to facilitate pulp testing during post‐operative reviews and potentially provide more clarity during the determination of the outcome of treatment. To date, there are three studies comparing the outcomes of partial and full pulpotomy (Asgary et al, 2018; Baranwal et al, 2022; Jassal et al, 2022). Although full pulpotomy seemed to perform better than partial pulpotomy the difference was not statistically significant.…”

Vital pulp therapy for permanent teeth with diagnosis of irreversible pulpitis: biological basis and outcome

“…In the hierarchy of evidence, randomized clinical trials are the gold standard for comparison of treatment procedures. A randomized clinical trial compared the outcome of full pulpotomy and partial pulpotomy in management of irreversible pulpitis using Biodentine and considered 10 min as a cut‐off point for achieving haemostasis using 2.5% NaOCl 77 . Similarly, Ramani et al .…”