Comparative Assessment of Complete Pulpotomy in Mature Permanent Teeth with Carious Exposure Using Calcium Silicate Cement: A Randomized Clinical Trial

Abstract

Aim: To assess the clinical and radiographic outcome of complete pulpotomy procedure with NeoMTA and Biodentine in mature permanent vital teeth with carious exposure after 6 months and 1 year. Materials and methods: A total of 60 mature permanent mandibular molar teeth with a clinical diagnosis of irreversible pulpitis (IP) were included in the study. After the teeth were anesthetized, a complete pulpotomy procedure was performed under an aseptic environment. The cases were randomly divided into two groups [group I = NeoMTA (n = 30) and group II = Biodentine (n = 30)]. The teeth were temporized using type VII pink glass ionomer cement (GIC) for 2 weeks, following which a resin-modified GI (RMGI) was placed as a liner over the pulpotomy agent, and direct composite resin restorations were done. The cases were reevaluated postoperatively, clinically, and radiographically after 6 months and 1 year. Results: Following pulpotomy, complete pain relief was reported in 92.45% of the cases. External root resorptions were observed at the end of 6 months in two cases (group I: n = 1 and group II: n = 1). Radiographic evidence of periapical pathosis was present in three cases in group II at 6 months intervals. Radiographic evidence of periapical pathosis was present in three new cases at the end of a 1-year interval (group I: n = 2 and group II: n = 1). The success rate at 1 year for group I was 85.71%, and for group II was 84%. Conclusion: NeoMTA and Biodentine have favorable and comparable clinical and radiographic outcomes as therapeutic materials for complete pulpotomy procedures in mature permanent teeth with carious exposure. NeoMTA is a promising therapeutic agent for complete pulpotomy procedures in mature permanent teeth with carious exposure. Clinical significance: Considering the outcome of the study, complete pulpotomy procedures with calcium silicate-based cement can be considered a valid treatment alternative to non-surgical endodontic therapy (NSET) for mature permanent vital teeth with carious exposure.