Evaluation of Success of Pulpotomy in Mature Permanent Teeth with Carious exposure using Mineral Trioxide

Aim: To evaluate the radiographical success of pulpotomy in cariously exposed mature permanent teeth using mineral trioxide aggregate. Methods:This Descriptive case series was conducted at the Department of Operative Dentistry, de’Montmorency College of Dentistry/ Punjab Dental Hospital, Lahore from December 2015 to December 2016.A total of 75 cases were included using non-probability consecutive sampling..Patients of both genders with age range from 15 to 26 years were considered. Performance of procedure and evaluation of success was done in terms of absence of periapical radiolucency on periapical radiographs.Data was entered and analyzed with IBM SPSS 20. Level of significance was kept at p-value ≤ 0.05 Results: Out of 75 patients, 41 were females and 34 were males.Mean age of patients included in this study was 20.5 ±3.60. Follow up at 6 months showed 92% success, with 69 cases showed absence of periapical radiolucency on periapical radiograph. There was no significant relation of success with age and gender of patient with p- value greater that 0.05. Conclusion: It is concluded from current study that the protocol of pulpotomy using Mineral trioxide Aggregate (MTA) in mature permanent teeth with carious exposure of pulp is encouraging and can be recommended for the treatment of mature permanent teeth with carious exposures. Keywords: Pulpotomy, Mineral trioxide aggregate, periapical radiolucency

Case Report: Immediate pain relief after partial pulpotomy of cariously exposed young permanent molar using mineral trioxide aggregate and root maturation, with two years follow-up

Carious exposure of immature first permanent molar is a widespread issue faced in paediatric dentistry. This may be the result of the early eruption of this molar, so parents may think it is replicable to the rest of the deciduous teeth. Preserving pulp vitality is the primary goal in treating those teeth to allow maturation of roots both in length and width. Mineral trioxide aggregate (MTA) is considered a perfect dressing material for pulpotomy (both partial and complete) due to its bio computability and sealing property. We present a case that describes treatment and two years follow-up of a symptomatic immature first permanent molar with a deep carious lesion. For treatment, we started with anaesthesia and rubber dam isolation. After that, the carious lesion was removed, and we performed partial pulpotomy, then applied MTA-Angelos on the fresh wound. Moistened cotton then was lightly packed over MTA for 15 minutes to allow initial setting, followed by application of glass ionomer and final restoration with composite. The following day, the tooth was asymptomatic with the patient reporting pain relief. After three months follow-up, the tooth normally responds to thermal test. After 12 months, a periapical radiograph of the tooth showed root maturation, and after 24 months also, the tooth was clinically and radiographically successful. MTA partial pulpotomy should be considered in the treatment of symptomatic young permanent teeth.

PULPOTOMY;

Objectives: To assess the efficacy of mineral trioxide aggregate (MTA)pulpotomy in mature permanent teeth with irreversible pulpitis due to carious exposure. Placeand Duration: The study was conducted in the Department of Operative Dentistry, AltamashInstitute of Dental Medicine from 05-01-2016 to 05-07-2016. Methodology: A total of 70 teethof 70 patients with irreversible pulpitis were treated with mineral trioxide aggregate (MTA)pulpotomy. The patients were re-evaluated after 2 months. All patients were asked whether theyhad experienced spontaneous pain, pain on chewing or pain stimulated by hot/cold and thetreatment was counted as successful in case of no post-operative symptoms. Results: Efficacyof pulpotomy treatment with mineral trioxide aggregate in symptomatic mature permanentteeth with irreversible pulpitis and normal periapical periodontium was 88.57%. Conclusion:MTA pulputomy is a good alternative treatment for cases of irreversible pulpitis in permanentteeth with mature roots and normal apical periodontium. However, long term clinical trials andhistological assessment is desirable.

Clinical and computed tomographic evaluation of portland cement pulpotomy in primary molar: A case report

<p>The present case describes the clinical &amp; radiographic outcome of a Portland Cement pulpotomy. The 5 years old girl presenting extensive carious exposure in her mandibular left 2nd deciduous molar and was suffering pain in her left lower jaw only on exposure to cold for last 2 days. She was ultimately diagnosed clinic-radio-graphically as a case of irreversible pulpitis. Coronal pulpotomy procedure was carried out in the responsible tooth and Portland cement (PC) was applied as a medicament after pulpotomy. At the 3 &amp; 6-months follow-up appointments, treated tooth was asymptomatic clinically and radiographic examinations revealed no sign of periradicular pathosis in the pulpotomized teeth. Additionally, the formation of a dentin bridge immediately below the PC in the treated tooth was confirmed by RVG and CBCT.</p>

Carious Exposure versus Mechanical Exposure for MTA Pulpotomy in Primary Teeth

Introduction. The etiology of exposure determines pulpal response, making it crucial to distinguish between mechanical and carious exposure. This study clinically and radiographically evaluated the success of MTA pulpotomies conducted to treat carious and mechanical pulp exposure. Materials and Methods. This study was conducted with 50 mandibular primary molar teeth. Teeth were divided into 2 groups according to status of the exposure site, with teeth surrounded by carious dentin placed in a carious exposure group and those surrounded by sound dentin in a mechanical exposure group. MTA pulpotomies were performed for both groups. Treatment was followed up clinically and radiographically for 18 months. Results. Clinical and radiographic success rates at 18 months were 100% for both groups. Success rates did not vary significantly between the groups (p=1.000). Pulp canal obliteration was only seen in the carious exposure group, observed in 2 teeth (8.3%). Conclusion. The long term success rates achieved in this study indicate that MTA can be used as a vital pulpotomy material for the long term success in primary teeth with either mechanical or carious exposure. The findings of the present study highlight the fact that treatment prognosis is dependent upon diagnosis and selection of the appropriate materials for treatment.