Comparative Evaluation of Postoperative Pain and Success Rate after Pulpotomy and Root Canal Treatment in Cariously Exposed Mature Permanent Molars: A Randomized Controlled Trial

Galani, Mohit; Tewari, Sanjay; Sangwan, Pankaj; Mittal, Shweta; Kumar, Veerendra; Duhan, Jigyasa

doi:10.1016/j.joen.2017.08.007

Cited by 83 publications

(80 citation statements)

References 39 publications

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“…The second aim of this review was to evaluate whether coronal pulpotomy is as clinically effective as root canal treatment using outcomes described above in the method section. Initial search identified two randomised control trials that compared pulpotomy and root canal treatment [22,23,28,29] months. However, at 24 months the radiographic success rate is reduced for the two interventions (86.7 and 79.5%), but the clinical success rate remains high at 98.1%.…”

Section: Coronal Pulpotomy Versus Root Canal Treatmentmentioning

confidence: 99%

Pulpotomy for mature carious teeth with symptoms of irreversible pulpitis: A systematic review

Cushley

Duncan

Lappin

et al. 2019

Journal of Dentistry

135

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was reduced to 93.97% clinical and 88.39% radiographic success at 36 months follow-up. Results from the only comparative clinical trial showed pulpotomy to have comparable success to root canal treatment at 12, 24 and 60 month follow-up. Conclusions The evidence suggests high success for pulpotomy for teeth with signs and symptoms of irreversible pulpitis, however, results are based on heterogeneous studies with high risk of bias. Well-designed, adequately powered randomised controlled trials are required for evidence to change clinical practice. Clinical significance: Management of carious teeth with irreversible pulpitis is traditionally invasive, but emerging evidence suggests potentially successful treatment outcomes with less invasive therapies such as coronal pulpotomy

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Section: Coronal Pulpotomy Versus Root Canal Treatmentmentioning

confidence: 99%

Pulpotomy for mature carious teeth with symptoms of irreversible pulpitis: A systematic review

Cushley

Duncan

Lappin

et al. 2019

Journal of Dentistry

135

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“…A large noninferiority open-labelled clinical trial revealed that when general dentists treated cases with irreversible pulpitis, the pain-reducing effect of CEM pulpotomy (PCEM) was considerably more than that of RCT using hand instrumentation techniques [24]. Moreover, a recent randomized controlled trial reported that, in managing symptomatic permanent teeth with extremely deep caries lesions, in comparison with RCT, MTA pulpotomy (PMTA) effectively reduced postoperative endodontic pain [25]. A quadruple blinded randomized controlled trial also showed the comparable pain relief effect of PMTA and PCEM [26].…”

Section: Introductionmentioning

confidence: 99%

Postendodontic Pain after Pulpotomy or Root Canal Treatment in Mature Teeth with Carious Pulp Exposure: A Multicenter Randomized Controlled Trial

Eghbal

Haeri

Shahravan

et al. 2020

Pain Research and Management

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This equivalence, randomized, clinical trial aimed to compare the postoperative pain of root canal therapy (RCT) with pulpotomy with mineral trioxide aggregate (PMTA) or calcium-enriched mixture (PCEM) in permanent mature teeth. In seven academic centers, 550 cariously exposed pulps were included and randomly allocated into PMTA (n = 188), PCEM (n = 194), or RCT (n = 168) arms. Preoperative “Pain Intensity” (PI) on Numerical Rating Scale and postoperative PIs until day 7 were recorded. Patients’ demographic and pre-/intra-/postoperative factors/conditions were recorded/analysed. The arms were homogeneous in terms of demographics. The mean preoperative PIs were similar (P=0.998), the mean sum PIs recorded during 10 postoperative intervals were comparable (P=0.939), and the trend/changes in pain relief were parallel (P=0.821) in all study arms. The incidences of preoperative moderate-severe pain in RCT, PMTA, and PCEM arms were 56.5%, 55.7%, and 56.7%, which after 24 hours considerably decreased to 13.1%, 10.6%, and 12.9%, respectively (P=0.578). The time span of endodontic procedures was statistically different; RCT = 69.73, PMTA = 35.37, and PCEM = 33.62 minutes (P<0.001). Patients with greater preoperative pain, symptomatic apical periodontitis, or presence of PDL widening suffered more pain (P=0.002, 0.035, and 0.023, resp.); however, other pre-/intra-/postoperative factors/conditions were comparable. Pulpotomy with MTA/CEM and RCT demonstrate comparable and effective postoperative pain relief.

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“…Most of the identified trials examined the influence of the capping material (23/27) on pulp vitality in VPT [17,23,25,[27][28][29][30][32][33][34][35][36][37][38][39][40][41][42][43][44][45][46]48], one of them also randomized the method used for pulp wound lavage [41]. The use of NaOCl solutions for pulp wound lavage was reported in 11 of the 27 included trials [17,25,31,33,34,36,39,41,42,45,46]. However, it was assessed as the randomized factor in just one of these 11 trials [41].…”

Section: Resultsmentioning

confidence: 99%

“…A clinical trial assessed the effect of glutaraldehyde in VPT in a non-randomized manner [47]. All the trials were carried out using conventional rotating instruments, except one in which an Erbium laser was also used in combination with saline lavage [28] Most studies (16/27) reported a high percentage (>80%) of pulp survival after a recall duration of at least six months [17,[23][24][25]27,29,[31][32][33]36,37,[40][41][42][43]47].…”

Section: Resultsmentioning

confidence: 99%

Wound Lavage in Studies on Vital Pulp Therapy of Permanent Teeth with Carious Exposures: A Qualitative Systematic Review

Munir

Zehnder

Rechenberg

2020

JCM

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The aim of this study was to systematically review pulp wound lavage in vital pulp therapy (VPT). A search was conducted in six life science databases to identify clinical trials carried out on permanent teeth with a carious pulp exposure and a recall interval of at least six months. Twenty-seven trials of low to moderate risk of bias (RoB-2 and ROBINS-I) were included. Data was extracted and analyzed regarding study characteristics and methods used for pulp wound lavage. The agent used for pulp wound lavage was specified in all included trials. Most of the identified trials (23/27) randomized the pulp capping material. Many (14/27) reported the use of sodium hypochlorite (NaOCl); ten used only saline or water. One trial was identified that compared pulp wound lavage with 2.5% (NaOCl) to saline, another compared 5% glutaraldehyde to water, both in immature molar pulpotomies. Both studies were underpowered. Neither showed a significant difference between treatments. The use of NaOCl was positively correlated to recent year of publication and use of hydraulic calcium silicate cements for pulp capping (p < 0.05). In conclusion, despite a lack of well-designed trials on pulp wound lavage in VPT, a trend towards using NaOCl for this purpose was observed.

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Comparative Evaluation of Postoperative Pain and Success Rate after Pulpotomy and Root Canal Treatment in Cariously Exposed Mature Permanent Molars: A Randomized Controlled Trial

Cited by 83 publications

References 39 publications

Pulpotomy for mature carious teeth with symptoms of irreversible pulpitis: A systematic review

Pulpotomy for mature carious teeth with symptoms of irreversible pulpitis: A systematic review

Postendodontic Pain after Pulpotomy or Root Canal Treatment in Mature Teeth with Carious Pulp Exposure: A Multicenter Randomized Controlled Trial

Wound Lavage in Studies on Vital Pulp Therapy of Permanent Teeth with Carious Exposures: A Qualitative Systematic Review

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