Clinical and Radiographic Outcomes of Mineral Trioxide Aggregate Pulpotomies in Vital Permanent Teeth with Carious Pulp Exposure: A Pioneering Retrospective Study

Margarita Yoshpe; Arieh Y Kaufman; Shaul Lin; Mikhal Malul; Malka Ashkenazi

doi:10.5005/jp-journals-10005-2483

Clinical and Radiographic Outcomes of Mineral Trioxide Aggregate Pulpotomies in Vital Permanent Teeth with Carious Pulp Exposure: A Pioneering Retrospective Study

Int J Clin Pediatr Dent. 2023 Jul-Aug;16(4):555-559. doi: 10.5005/jp-journals-10005-2483.

Authors

Margarita Yoshpe¹, Arieh Y Kaufman², Shaul Lin³, Mikhal Malul⁴, Malka Ashkenazi⁵

Affiliations

¹ Faculty of Dental Medicine, Hebrew University of Jerusalem, Jerusalem, Israel; Department of Endodontics, Hadassah Medical Center, Jerusalem, Israel; Dental Medical Center, Ashdod, Israel.
² Department of Endodontology, (Professor Emeritus) The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University (TAU), Tel Aviv, Israel.
³ Department of Endodontic, School of Graduate Dentistry, Rambam Health Care Campus, Ruth & Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel; The Israeli National Center for Trauma Emergency & Emergency Medicine Research, Gertner Institute; Sheba Medical Center, Tel Hashomer, Israel.
⁴ Dental Medical Center, Ashdod, Israel.
⁵ Pediatric Dentistry Clinic, Oral Medicine Unit, Sheba Medical Center, Tel Hashomer, Israel.

Abstract

Purpose: Vital partial pulpotomy (PP) or cervical pulpotomy (CP) in carious pulp-exposed permanent teeth preserves tooth vitality, promotes pulp healing, decreases treatment costs, and shortens treatment duration, which is a significant factor in treating noncooperative children. The aim of this retrospective study was to compare clinical and radiographic outcomes of partial and CP in vital carious-exposed permanent teeth.

Materials and methods: All vital permanent teeth with carious pulp exposure, treated by pulpotomy using mineral trioxide aggregate (MTA) during 2017-2019, by two operators in one dental center, were included in the study. Around 118 permanent teeth in 97 children and adolescents (mean age 10.9 years) were evaluated 6-57 months postoperatively.

Results: The total success rates of CP and PP were 82.5 and 80.8%, respectively (p = nonsignificant). The only factor that significantly affected the success rate was the presence of preoperative periapical pathology. Teeth without such pathology showed an 87.3% success rate compared to 74.1 and 58.3% in teeth with preoperative enlarged periodontal ligament (PDL) or with periapical radiolucency, respectively (p = 0.0301). Demographic variables, maturation state of the tooth, type of tooth (incisor, premolar, molar), postoperative variables, such as the presence of radiographic dentinal bridge, partial or full obliteration of the pulp during the follow-up period, and the integrity of the final restoration during the recall examinations did not affect the success rate of the treatment.

Conclusion: Partial and CP in vital permanent teeth with carious pulp exposure in children and adolescents might be a reliable alternative to full root canal treatment (RCT).

How to cite this article: Yoshpe M, Kaufman AY, Lin S, et al. Clinical and Radiographic Outcomes of Mineral Trioxide Aggregate Pulpotomies in Vital Permanent Teeth with Carious Pulp Exposure: A Pioneering Retrospective Study. Int J Clin Pediatr Dent 2023;16(4):555-559.

Keywords: Immature teeth; Mature teeth; Molar; Open apex; Periapical radiolucency; Pulp therapy; Pulpotomy.