Evaluation of diffErEnt trEatmEnt modalitiEs for vital pulp of immaturE pErmanEnt molars: a randomizEd clinical trial

Abstract

Introduction: An increasing demand for vital pulp therapy with a higher success rate has been observed due to frequent occurrence of pathological pulp exposures in young, immature permanent molars. Objectives: To compare and assess apexogenesis results in young, immature permanent molars following pulpotomy using calcium hydroxide (CH), mineral trioxide aggregate (MTA), laser, and laserassisted MTA. Material and methods: One hundred carious immature permanent molars indicated for pulpotomy in children aged 69 years were randomly allocated into four equally distributed groups (n = 25), i.e., CH, MTA, laser, and laserassisted MTA. At 6 and 12month followup intervals, patients underwent clinical and radiographic assessments with digital periapical radiography. Outcomes were compared using ANOVA and Monte Carlo tests. Results: Throughout the 12month followup period, no statistically significant difference was found. Clinical evaluation at 12 months revealed success rates of 98, 98, 100, and 100% for CH, MTA, laser, and laserassisted MTA groups, respectively. Radiographic evaluation at 12 months revealed periapical lesion and periodontal ligament widening in 8% of patients in CH and MTA groups. The assessment of radiographic changes of the root foramen diameter between 0 and 12 months was the highest for the laserassisted MTA group (44.1%), followed by the laser (38.4%), MTA (35.7%), and CH groups (21.8%). Conclusions: The findings of pulpotomy treatments carried out in this research were positive in four different kinds of pulpotomy techniques used. Laser and laserassisted MTA pulpotomy can be employed as effective substitutes for CH and MTA pulpotomies in immature permanent molars.