Pulpotomy for treating primary molars with clinical symptoms indicative of irreversible pulpitis: A prospective single-arm pilot study.

Abstract

Objectives: Assess the treatment outcomes and pain relief afforded by full pulpotomy in vital primary molars with clinical symptoms indicative of irreversible pulpitis.

Methodology: This study was designed as a multi-centre, single-arm, prospective clinical trial registered under ClinicalTrials.gov (NCT06149845). Fifty carious primary molars with clinical symptoms indicative of irreversible pulpitis and pulp intra-operatively assessed to be vital, underwent full coronal pulpotomy following a standardized procedural protocol. Haemostasis was achieved by moderately compressing a 2 % NaOCl-moistened sterile cotton pellet over the radicular pulp stumps for up to 6-minutes. A 2-3 mm layer of mineral trioxide aggregate (MTA) was placed as the pulpotomy medicament and the tooth restored with a pre-formed metal crown. Pre- and post-operative pain scores were evaluated using a validated five-point visual analogue scale (VAS). Clinical and radiographic outcomes were assessed after 6-months. Treatment outcome effects of potential prognostic factors like age, gender, tooth type, site of caries, haemostasis time, and furcal radiolucency were also analysed.

Results: Intra-group analysis of VAS pain scores revealed significant pain reduction 24-h and 7-d after the pulpotomy treatment procedure. The 6-month post-treatment clinical and radiographic success rates of the pulpotomised primary molars were 100 % and 93.9 %, respectively. No significant association was evident between treatment outcomes and the investigated variables.

Conclusions: The pain relief afforded and the 6-month clinical and radiographic outcomes indicate that MTA pulpotomy is a successful treatment option for vital primary molars clinically diagnosed with irreversible pulpitis.

This study strengthens the currently available evidence for pulpotomy to be considered as an alternate treatment modality for cariously exposed vital primary molars presenting with symptomatic irreversible pulpitis.