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Complete vs partial pulpotomy for teeth with irreversible pulpitis

Pulpotomy Pulpotomy
Pulpotomy Pulpotomy

A trial was carried out to investigate the outcomes of partial pulpotomy (PP) vs. complete pulpotomy (CP) procedures when used to manage teeth with caries and diagnosis of symptomatic irreversible pulpitis (SIP).

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Key take away

For treatment of cariously exposed mature permanent teeth with signs suggestive of pulpitis, both complete pulpotomy and partial pulpotomy led to beneficial results.

Background

A trial was carried out to investigate the outcomes of partial pulpotomy (PP) vs. complete pulpotomy (CP) procedures when used to manage teeth with caries and diagnosis of symptomatic irreversible pulpitis (SIP).

Method

In this randomized clinical trial, 106 molars (from people aged 18-40 years) with carious pulpal exposure, diagnosis of SIP, and periapical index ≤2 were randomized into CP and PP groups. Utilizing standardized protocols, the allocated protocols were executed. In situations where pulpal bleeding could not be managed within 6 min with the use of cotton pellets soaked in 3% sodium hypochlorite, the allotted protocol was dropped.

Mineral trioxide was utilized as the pulpotomy agent. Restoration of teeth was done employing a base of glass ionomer succeeded by composite restoration. Recording of pain was done utilizing a visual analogue scale (VAS) preoperatively prior to the use of local anaesthesia and postoperatively every 24 hours for one week. Analysis of success was done at 12 months as per radiographic and clinical evaluation.

For assessing age, mean analgesic intake, and pain scores, the Mann-Whitney U test was utilized. Analysis of categorical data was done via a chi-square test. To investigate the occurrence of pain and the radiographic and clinical success, Fisher's exact test was utilized. To evaluate teeth survival, Kaplan-Meier analysis was utilized. At follow-up, an evaluation of 101 participants was done.

Result

When compared to the PP group (80.8%), greater success was seen in the CP group (89.8%). However, the difference was not statistically profound. While there was no substantial difference in the occurrence of pain between the groups at 24 hours, a remarkable difference was seen in pain intensities between the groups at all tested time intervals, with reduced values indicated in the CP group.

Conclusion

Both PP and CP led to pain reduction. Owing to the more conservative nature of PP, PP may be undertaken first prior to proceeding to CP.

Source:

International Endodontic Journal

Article:

Comparative evaluation of complete and partial pulpotomy in mature permanent teeth with symptomatic irreversible pulpitis: A randomized clinical trial

Authors:

Ankita Ramani et al.

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