Vital Pulp Therapies
Conditions
Keywords
Vital Pulp therapies, Direct pulp capping, Pulpotomy, Neo MTA, Primary molars, Randomized clinical trial
Brief summary
Dental caries is one of the most prevalent chronic diseases worldwide. Interventions for treating deep carious lesions in teeth with no history of pain or teeth with reversible pulpitis are referred to as vital pulp therapy; these include indirect pulp treatment (IPC), direct pulp capping (DPC), and pulpotomy. Pulpotomy is considered invasive when treating exposed primary vital pulps due to caries. Less invasive vital pulp treatment methods such as DPC might, therefore, be preferable, as they reduce chair time, less tooth structure removal and a crown might not always be a necessary permanent restoration. The aim of this clinical study is to evaluate the clinical and radiographic outcomes of DPC when compared to pulpotomy in primary molars with carious pulp exposure.
Detailed description
Aim: The aim of this study is to evaluate the clinical and radiographic outcomes of direct pulp capping (DPC) when compared to pulpotomy in primary molars with carious pulp exposure using a calcium silicate-based material: neo mineral trioxide aggregate (Neo MTA). Methods: The study will be a split mouth randomized clinical trial including children between 4-9 years old. Patients will be allocated into two treatment groups; one group will start with DPC first followed by pulpotomy on the second visit, and vice versa for the second group. The time interval between both visits will be 1-2 weeks. The pulp medicament capping material (neo MTA) will be applied over the exposure site, and then tooth will be restored with glass ionomer cement and then a crown will be placed. Cases will be followed up to 24 months after initial treatment.
Interventions
PROCEDUREPulpotomy
The entire coronal pulp will be amputated to the level of canal orifices, after hemostasis, NeoMTA will be placed, then tooth will be restored with glass ionomer cement, and the tooth will be subsequently restored with a crown.
PROCEDUREDirect pulp capping (DPC)
At the exposure site hemostasis will be achieved, neo MTA will be placed, then tooth will be restored with glass ionomer cement, and the tooth will be subsequently restored with a crown.
Sponsors
Jordan University of Science and Technology
King Abdullah University Hospital
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
DOUBLE (Subject, Outcomes Assessor)
Intervention model description
A split mouth randomized clinical trial
Eligibility
Sex/Gender
ALL
Age
4 Years to 10 Years
Healthy volunteers
Yes
Inclusion criteria
* Healthy patients. * Age 4-10 years. * Primary molar with deep caries present bilaterally. * Teeth should be restorable. * Clinically normal asymptomatic tooth or symptoms of reversible pulpitis (No history of pain or provoked pain subsides upon removal of the stimulus). * Radiographically: caries in the inner half of the dentin approaching the pulp.
Exclusion criteria
* History of spontaneous pain. * Soft and hard tissue pathology. * Mobility or exfoliating tooth. * No pulp exposure after caries excavation. * Inability to achieve hemostasis after 6 minutes. * Radiographically: Root resorption exceeding 1/3 of the root, apical pathology.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Clinical success | 24 months | No post-treatment signs or symptoms such as sensitivity, pain, mobility or swelling should be evident. |
| Radiographic success | 24 months | No radiographic evidence of pathologic external or internal root resorption, periapical or furcation radiolucency. |
Countries
Jordan
Outcome results
None listed