Partial pulpotomy without age restriction: a retrospective assessment of permanent teeth with carious pulp exposure

Clin Oral Investig. 2022 Jan;26(1):365-373. doi: 10.1007/s00784-021-04007-2. Epub 2021 Jun 2.

Abstract

Objectives: This study aimed to retrospectively evaluate clinical and radiographic outcomes of partial pulpotomy performed in permanent teeth with carious pulp exposure.

Materials and methods: Records of patients undergoing treatment at an undergraduate dental clinic between 2010 and 2019 were screened for partial pulpotomies in teeth with a presumptive diagnosis of normal pulp or reversible pulpitis. The follow-up had to be ≥ 1 year. Patient data were retrieved and analyzed using Mantel-Cox chi square tests and Kaplan-Meier statistics. The level of significance was set at α = 0.05.

Results: Partial pulpotomy was performed in 111 cases, of which 64 (58%) fulfilled the eligibility criteria. At the time of partial pulpotomy, the mean age was 37.3 (± 13.5) years (age range 18-85). The mean observation period was 3.1 (± 2.0) years. Two early failures (3.1%) and five late failures (7.7%) were recorded. The overall success rate of maintaining pulp vitality was 89.1%, with 98.4% tooth survival. The cumulative pulp survival rates of partial pulpotomy in patients aged < 30 years, between 30 and 40 years, and > 40 years were 100%, 75.5%, and 90.5%, respectively, with no significant difference between the age groups (p = 0.225). At follow-up, narrowing of the pulp canal space and tooth discoloration were observed in 10.9% and 3.1% of cases, respectively.

Conclusions: Across age groups, partial pulpotomy achieved favorable short and medium-term outcomes in teeth with carious pulp exposure.

Clinical relevance: Adequate case selection provided, partial pulpotomy is a viable operative approach to treat permanent teeth with deep carious lesions irrespective of patients' age.

Keywords: Dental caries; Mineral trioxide aggregate; Pulpitis; Pulpotomy; Vital pulp therapy.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Aluminum Compounds
  • Calcium Compounds
  • Dental Caries*
  • Drug Combinations
  • Humans
  • Middle Aged
  • Oxides
  • Pulpotomy*
  • Retrospective Studies
  • Silicates
  • Treatment Outcome
  • Young Adult

Substances

  • Aluminum Compounds
  • Calcium Compounds
  • Drug Combinations
  • Oxides
  • Silicates