Evaluation of the efficacy of mineral trioxide aggregate and bioceramic putty in primary molar pulpotomy with symptoms of irreversible pulpitis (a randomized‐controlled trial)

Abstract

Objectives Preserving the primary teeth is important, as they play an important role in the integrity of the dental arch, the development of the craniofacial complex, speech, and chewing. This study aimed to evaluate the effectiveness of both Mineral Trioxide Aggregate (MTA) and Bioceramic putty in primary molar pulpotomy with symptoms of irreversible pulpitis. Materials and Methods In this study, 40 s primary mandibular molars in 40 healthy children aged 6−8 years were examined and classified into 2 groups according to the material: group A, with 20 primary molars capped by MTA, and group B, with 20 teeth capped by Bioceramic putty. Clinical and radiographic evaluation of the treatment results was carried out after 1 week, 3 months, 6 months, 9 months, and 1 year. Results Clinical and radiological success rates in the MTA group reached 95%, where a case of failure was observed after a year of follow‐up. In the Bioceramic group, the success rate reached 100% after a year of follow‐up, without any statistically significant differences between groups ( p = .311). Conclusions Pulpotomy using biocompatibility materials (MTA‐Bioceramic) in primary molars with symptoms of irreversible pulpitis is considered effective due to the better advantages of the use of Bioceramic over MTA. This clinical trial was approved by Australian New Zealand Clinical Trials (12621001631897).

Treatment Outcomes of Pulpotomy in Primary Teeth with Irreversible Pulpitis: A Systematic Review and Meta-Analysis

“…The two-arm meta-analyses were conducted to compare different types of pulpotomy medicaments on the overall treatment success rates using odds ratios. Only two of the five included primary studies were eligible for the two-arm meta-analysis [7,30]. One study, which compared MTA with formocresol and PRF, differed from the other studies and was excluded from the analysis [31].…”

“…The highest weighted mean overall success rates at the 6-month and 12-month follow-up periods were 97.9% (CI: (94.9, 100)) and 96.9% (CI: (93.3, 100)), respectively, when Memarpour M et al [29] was omitted. Meanwhile, the lowest weighted mean overall success rates at the 6-month and 12-month follow-up periods were 96.3% (CI: (92.3, 100)) and 91.2% (CI: (79.9, 100)) when Eshghi A et al [7] and Alnassar I et al [30] were excluded, respectively.…”

“…Overall, the current review comprised a total of 266 primary teeth treated with pulpotomy. Two of the studies were conducted in Iran [7,29], followed by two in Syria [30,31], and one in China [32]. Most of the primary articles were published in 2022, consisting of two randomised clinical studies [7,30], and the remaining three were non-randomised clinical studies.…”

“…Two of the studies were conducted in Iran [7,29], followed by two in Syria [30,31], and one in China [32]. Most of the primary articles were published in 2022, consisting of two randomised clinical studies [7,30], and the remaining three were non-randomised clinical studies. Among the three non-randomised studies, two were prospective cohort studies [29,31], and one was a retrospective cohort study [32].…”

“…For randomised clinical studies, all domains assessed using the RoB 2 tool were determined to have a "low risk of bias". In general, three studies were classified as "low risk of bias" [7,29,30], one study was rated as "moderate risk of bias" [32], with another study rated as "high risk of bias" [31]. Additionally, two of the included studies were ranked as Level 2 evidence [7,30], while the other three studies were ranked as Level 3 evidence [29,31,32], according to the OCEBM criteria (Table 2).…”