Comparative evaluation of mineral trioxide aggregate pulpotomy and laser-assisted mineral trioxide aggregate pulpotomy: An original research article

Abstract

Context and Aim: Formocresol has been used as the material of choice (gold standard) for pulpotomy procedures because of the ease of use but was discouraged due to its potential immune sensitization and mutagenic effects. Laser irradiation was first applied for pulpotomy procedure in the year 1985. Recently, diode lasers have been used for pulpotomy in primary teeth and have shown clinical success rates comparable to formocresol. The present in vivo study was carried out to compare the clinical and radiographic success rates of mineral trioxide aggregate (MTA) pulpotomy and diode laser-assisted pulpotomy in human primary molars. Materials and Methods: The present study was a randomized clinical trial in design wherein 40 primary teeth requiring pulpotomy treatment which met the selection criteria (clinical and radiographic) were divided into two groups, Group 1 ( n = 20) wherein the pulpotomy was performed with MTA alone and Group 2 ( n = 20) wherein laser-assisted pulpotomy was performed with MTA (L-MTA). The patients were recalled after 3, 6, and 9 months, respectively and evaluated clinically and radiographically. Statistical Analysis Used: The data were analyzed using the Statistical Package for the Social Sciences (SPSS) Version 22 (IBM corporation, Washington DC, United States). Descriptive statistics were used to analyze the data while the Pearson's correlation coefficient test was used to analyze the statistical correlation between the overall success rates observed in the clinical and radiographic findings of both the groups. P < 0.05 was considered statistically significant. Results: The clinical success rate in the MTA group was 90%, 84.21%, and 88.23% at 3, 6, and 9 months, respectively, with no clinical signs or, symptoms reported at the said follow-up visits while the radiographic success rate was found to be 85%, 84.21%, and 82.3%, respectively. On the contrary, the clinical success rate in the L-MTA group was found to be 95%, 94.74%, and 94.44% at 3, 6, and 9, months, respectively with the radiographic success rate reported being 90%, 89.47%, and 88.89%, respectively. Conclusion: The combination of diode laser and MTA yielded better clinical and radiographic success rates over the pulpotomy procedures done with the help of MTA alone, thereby, concluding that lasers may be considered as adjuvant alternatives for vital pulp therapy on human primary teeth.

The application of lasers in vital pulp therapy: clinical and radiographic outcomes

“…However, in a study by Gupta et al, [ 54 ] the clinical and radiographic success of diode laser for pulpotomy of primary teeth was reported to be 100% at 12 months, and significantly higher than that of FS and electrosurgery. In some studies, diode laser was applied on the pulp prior to pulp capping with MTA [ 27 , 28 , 30 , 55 ], Biodentine (BD) [ 41 ], resin-modified glass ionomer [ 12 , 41 ] or resin-modified calcium silicate paste (TheraCal) [ 43 ]. Studies with laser irradiation prior to the application of MTA in pulpotomy of primary teeth, did not show superior clinical and radiographic results [ 27 , 28 , 55 ].…”

“…In some studies, diode laser was applied on the pulp prior to pulp capping with MTA [ 27 , 28 , 30 , 55 ], Biodentine (BD) [ 41 ], resin-modified glass ionomer [ 12 , 41 ] or resin-modified calcium silicate paste (TheraCal) [ 43 ]. Studies with laser irradiation prior to the application of MTA in pulpotomy of primary teeth, did not show superior clinical and radiographic results [ 27 , 28 , 55 ]. Studies with laser irradiation prior to pulp capping with TheraCal increased the clinical success of treatment [ 43 ].…”

“…According to the literature, in assessment of clinical success of laser therapy in primary teeth, the success criteria include asymptomatic tooth (no sensitivity to percussion, palpation, or pressure, and no spontaneous pain), absence of sinus tract, absence of swelling and abscess, and absence of abnormal mobility [ 20 – 23 ]. Some other studies also included absence of premature loss of tooth as a clinical success criterion for primary teeth [ 23 – 28 ].…”

“…Some studies considered calcification a criterion for success in radiography [ 32 , 33 ] while others considered it a criterion for failure [ 34 ]. The failure criteria for vital pulp therapy have also been cited as periodontal ligament widening [ 20 , 24 , 26 , 28 – 30 , 34 – 39 ] and loss of lamina dura integrity [ 40 ]. Shaikh et al, in their study, scored the clinical and radiographic criteria separately by using a 4-point scale.…”

An Updated Review on Properties and Indications of Calcium Silicate-Based Cements in Endodontic Therapy

“…Regarding postoperative pain consequent to pulp therapy, pulpotomy with MTA, CEM, and RCT revealed satisfying relief of postoperative pain [ 137 , 138 ]. A recent research study, which has compared the efficacy of pulpotomy with diode lasers and MTA and MTA alone, stated that incorporation of diode lasers in the pulpotomy procedure promoted the success rate of the treatment and has offered further investigations on the capability of lasers for advancement of pulpotomy treatments [ 139 ].…”