Saeed Asgary1, Mohammad Jafar Eghbal2, Alireza Akbarzadeh Bagheban3. 1. Iranian Center for Endodontic Research, Shahid Beheshti University of Medical Sciences, Tehran, Iran. 2. Dental School, Dental Research Center, Research Institute of Dental Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran. 3. Proteomics Research Center, Department of Basic Sciences, School of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Abstract
PURPOSE: To compare success rates of full pulpotomy (FP) with two endodontic biomaterials on symptomatic vital teeth with closed apices in the presence of apical periodontitis. METHODS: In this multicenter controlled clinical trial, 412 volunteers met the inclusion criteria; they were all randomly allocated to either FP/ProRoot mineral trioxide aggregate (MTA) or FP/calcium enriched mixture (CEM) group. The subjects were followed up for 2 and 5 years to evaluate and compare the treatment outcomes. Data were analyzed using Chi square test and the multiple binary logistic regression model. RESULTS: Data for a total number of 344 and 304 subjects were available for 2- and 5-year follow-ups. In terms of clinical outcomes, 2- and 5-year success rates of both groups were ≥ 98%, without significant differences. In terms of radiographic outcomes, the 2-year result of FP/MTA was significantly superior to FP/CEM (P= 0.005); however, the 5-year success rates were similar (P= 0.413). Age and preoperative periapical status did not affect the treatment outcomes. CLINICAL SIGNIFICANCE: Both MTA and CEM biomaterials were found to be equally effective pulpotomy agents for mature permanent molars with irreversible pulpitis and associated apical periodontitis in different age groups. The performance of this novel minimally invasive biotechnology may support a paradigm shift towards more biologic/conservative treatments in dentistry worldwide.
RCT Entities:
PURPOSE: To compare success rates of full pulpotomy (FP) with two endodontic biomaterials on symptomatic vital teeth with closed apices in the presence of apical periodontitis. METHODS: In this multicenter controlled clinical trial, 412 volunteers met the inclusion criteria; they were all randomly allocated to either FP/ProRoot mineral trioxide aggregate (MTA) or FP/calcium enriched mixture (CEM) group. The subjects were followed up for 2 and 5 years to evaluate and compare the treatment outcomes. Data were analyzed using Chi square test and the multiple binary logistic regression model. RESULTS: Data for a total number of 344 and 304 subjects were available for 2- and 5-year follow-ups. In terms of clinical outcomes, 2- and 5-year success rates of both groups were ≥ 98%, without significant differences. In terms of radiographic outcomes, the 2-year result of FP/MTA was significantly superior to FP/CEM (P= 0.005); however, the 5-year success rates were similar (P= 0.413). Age and preoperative periapical status did not affect the treatment outcomes. CLINICAL SIGNIFICANCE: Both MTA and CEM biomaterials were found to be equally effective pulpotomy agents for mature permanent molars with irreversible pulpitis and associated apical periodontitis in different age groups. The performance of this novel minimally invasive biotechnology may support a paradigm shift towards more biologic/conservative treatments in dentistry worldwide.