Outcome of novel pulp capping modalities after full pulpotomy in teeth diagnosed with irreversible pulpitis: A prospective randomized clinical trial

Sneh Mishra; Sonali Taneja; Vidhi Kiran Bhalla; Akshay Rathore

doi:10.4103/JCDE.JCDE_257_23

Outcome of novel pulp capping modalities after full pulpotomy in teeth diagnosed with irreversible pulpitis: A prospective randomized clinical trial

J Conserv Dent Endod. 2024 Feb;27(2):205-213. doi: 10.4103/JCDE.JCDE_257_23. Epub 2024 Feb 8.

Authors

Sneh Mishra¹, Sonali Taneja², Vidhi Kiran Bhalla², Akshay Rathore³

Affiliations

¹ Private Practitioner, I.T.S Centre for Dental Studies and Research, Ghaziabad, Uttar Pradesh, India.
² Department of Conservative Dentistry and Endodontics, I.T.S Centre for Dental Studies and Research, Ghaziabad, Uttar Pradesh, India.
³ Department of Oral Medicine and Radiology, I.T.S Centre for Dental Studies and Research, Ghaziabad, Uttar Pradesh, India.

Abstract

Objective: The study aimed to compare and evaluate the effect of biodentine (BD) alone, BD along with Lyophilised freeze dried platelet rich concentrate (LPC + BD), and BD along with low-level laser therapy (BD + LLLT) after pulpotomy in mature permanent molars with irreversible pulpitis.

Materials and methods: The study was designed as a randomized, pragmatic, parallel, double-blinded clinical trial registered under the Clinical Trial Registry-India (CTRI/2020/02/023245). 120 permanent molars fulfilling the inclusion and exclusion criteria with symptoms of irreversible pulpitis were randomized after performing pulpotomy into three pulp capping groups: Group 1, BD; Group 2, lyophilized freeze-dried platelet-rich concentrate + BD (LPC + BD); and Group 3, Low level laser therapy + BD Group 3, LLLT + BD. The intergroup comparison was done using one-way analysis of variance followed by the Bonferroni test. The level of significance and confidence interval were 5% and 95%, respectively. Interobserver reliability was measured using Cohen's kappa analysis.

Results: At 1 week, there was a significant difference (P < 0.005) observed in the mean postoperative pain levels between the three groups with Group 1 (BD) exhibiting the highest postoperative pain followed by Group 2 (LPC + BD) and least pain was exhibited by Group 3 (LLLT + BD). A similar pattern was observed regarding the analgesic intake with maximum frequency in Group 1 (BD) and least with Group 3 (LLLT + BD). No significant difference in success rates was reported among the groups.

Conclusion: Pulpotomy as a treatment option for mandibular molars with irreversible pulpitis has an acceptable clinical success rate; however, long-term overall success rate remains questionable. The outcomes of incorporating adjunctive modalities with BD are remarkable and show tremendous potential for continued development and research.

Keywords: Biodentine; irreversible pulpitis; low-level laser therapy; lyophilized freeze-dried platelet-rich concentrate; pulpotomy.