A Randomised Clinical Radiological Study using Platelet Rich Fibrin and MTA in Pulpotomy of First Permanent Immature Molars

Abstract

Introduction: Maintaining a vital pulp of immature permanent teeth is an essential and important requirement for dentin formation. Every effort must be made to preserve the vitality of teeth with incomplete apices to maintain the physiological apex generation process as much as possible. Pulpotomy is considered as one of the successful procedures to maintain this process in immature teeth. Aim: To evaluate the treatment success of pulpotomy of first immature molars with irreversible pulpitis using Platelet-Rich Fibrin (PRF) or Mineral Trioxide Aggregate (MTA) and monitoring the teeth for one year. Materials and Methods: A randomised clinical and radiological double-blinded evaluation was conducted in the Department of Paediatric Dentistry at Damascus University, Damascus, Syria. The research sample consisted of 24 first permanent immature molars in 20 children between age group of 6-8 years. Each of them had at least one first permanent immature molar with irreversible pulpitis. The research sample was randomly divided into two equal groups according to the treatment method: 1) pulpotomy with PRF; and 2) pulpotomy using MTA. Treatment were evaluated through periodic reviews and clinical and radiological examinations of the treated teeth by three specialists to assess treatment success. The treatment outcome was determined in terms of success or failure during two study periods (after six months and after one year). McNemar’s and Chi-square tests were applied using IBM SPSS version 20.0. The significance level was set at p-value <0.05. Results: Chi-square test showed that there were no statistically significant differences in the treatment success or failure between the treatment groups after six months and one year follow-up, p>0.05. After analysing the results statistically using McNemar’s test, it was observed that the treatment success rate after one year (50%, n=6) was lesser than that after six months (100%, n=12) in the MTA treatment group (p=0.031). In the treatment group using PRF, no significant difference (p=0.125) was observed in the success or failure of treatment between the two studied time periods (after six months and one year). Overall, the success rate of MTA was slightly higher than the success rate of PRF at the two study time periods (after six months and one year), the difference however was not statistically significant. Conclusion: Performing first immature molar pulpotomy using MTA had a slightly higher success rate than PRF pulpotomy.

Comparative efficacy of materials used in patients undergoing pulpotomy or direct pulp capping in carious teeth: A systematic review and meta‐analysis

“…The Gwet's AC1 was equal to 0.86 (95% CI: 0.77−0.94, standard error [SE] = 0.04), indicating a very good level of agreement between the two reviewers that performed screening. Thirty records representing 21 different studies (Alawwad et al, 2020 ; Asgary et al, 2017 ; Awawdeh et al, 2018 ; Brizuela et al, 2017 ; Cengiz & Yilmaz, 2016 ; Chailertvanitkul et al, 2014 ; El‐Meligy & Avery, 2006 ; Eppa et al, 2018 ; Keswani et al, 2014 ; Kumar et al, 2016 ; Kundzina et al, 2017 ; Nosrat et al, 2013 ; Ozgur et al, 2017 ; Parinyaprom et al, 2018 ; Peskersoy et al, 2021 ; Qudeimat et al, 2007 ; Suhag et al, 2019 ; Taha & Khazali, 2017 ; Uesrichai et al, 2019 ; Vu et al, 2020 ; Wei et al, 2010 ) were further introduced for data extraction. The remaining 24 records were protocols of potentially eligible studies.…”

“…For instance, the comparison of BD with MTA was informed by five trials that differed in the duration and treatment performed. The two trials on PRF versus MTA (Alawwad et al, 2020 ; Keswani et al, 2014 ) provided contradictory evidence, and they also differed in the RoB level. The trials on CH versus MTA exhibited the most considerable heterogeneity in the magnitude, direction, and uncertainty of OR and their characteristics.…”

Evaluation of Bioceramic Putty in Pulpotomy of Immature Permanent Molars With Symptoms of Irreversible Pulpitis

“…A randomized controlled trial was conducted in 30 immature permanent molars to study the pulpotomy effectiveness in case of irreversible pulpitis. [16]. Sample size calculation produced a required sample size of 15 immature permanent molars per group to detect a significant difference (90% power, two-sided 5% significance level).…”

“…The sample size was calculated using G*Power software (PS Power and Sample Size Calculation program, version 3.0.43, https://biostat.app.vumc.org/wiki/Main/PowerSampleSize ) based on a previous study [ 16 ]. Sample size calculation produced a required sample size of 15 immature permanent molars per group to detect a significant difference (90% power, two-sided 5% significance level).…”