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

Vital Pulp Therapy Outcomes in Children's First Permanent Molars Under General Anesthesia: A Retrospective Study

INTRODUCTION

Pulpotomy is a proven treatment option for permanent teeth with pulp involvement, showing high success rates similar to root canal treatment. General anesthesia (GA) is used when traditional dental procedures are not feasible, especially in pediatric cases. Despite its effectiveness, limited data on endodontic treatments under GA is available, with many guidelines favoring extractions. This study aimed to evaluate the success rate of pulpotomies performed under GA on children's first permanent molars and to identify factors influencing treatment outcomes.

METHODS

The study involved 171 pediatric patients, aged 8 to 12, who underwent pulpotomy procedures on 197 teeth at a public dentistry clinic between January 2018 and July 2022. Clinical and radiographic follow-ups were conducted at different intervals to assess the effectiveness of the treatments, achieving a recall rate of 83%.

RESULTS

The overall success rate of pulpotomies performed under GA was 93.36%. Success rates varied according to the follow-up period: 100% at 1-12 months, 97.70% at 13-24 months, and 87.76% at 25-36 months. The etiology of the tooth's condition significantly affected outcomes, whereas patient age, sex, and tooth maturity did not have a significant impact.

CONCLUSION

Pulpotomy in permanent molars is an effective treatment option for managing carious lesions, especially when performed under GA.

Efficacy of pulpotomy in managing irreversible pulpitis in mature permanent teeth: A systematic review and meta-analysis

OBJECTIVES

This paper evaluated the success rates of pulpotomy, compared its efficacy with non-surgical root canal treatment (NSRCT), evaluated different pulpotomy techniques, and analyzed the effectiveness of contemporary bioactive materials in managing irreversible pulpitis in mature permanent teeth.

DATA SOURCES

A comprehensive literature search was conducted across multiple databases including PubMed, Web of Science, Scopus, and the Cochrane Library. Search was conducted from the inception of each database to the present, adhering to PRISMA 2020 guidelines.

STUDY SELECTION

Studies were selected through a multi-step screening process, focusing on adult populations, randomized controlled trials, and single-arm trials.

DATA

Fifteen randomized controlled trials and eight single-arm trials were included. For a follow-up period of more than 24 months, pooled clinical success rate of pulpotomy was 92.9 % (95 %CI;82.1-99.0 %), whereas pooled radiographic success rate was 78.5 % (95 %CI;66.7-88.4 %). Meta-analyses showed that there was no significant difference in success rates between pulpotomy and NSRCT, between full and partial pulpotomy techniques, or between Mineral Trioxide Aggregate pulpotomy and Calcium Enriched Mixture pulpotomy. The results indicated comparable efficacy across these variables.

CONCLUSIONS

The study highlights the potential of less invasive treatments. Pulpotomy may be a viable alternative to NSRCT for managing irreversible pulpitis in mature permanent teeth. Limitations such as the low quality of some single-arm trials and the high risk of bias in some randomized controlled trials highlight the need for further research to standardize methodologies and broaden literature inclusion for a more comprehensive understanding of the efficacy of pulpotomy, considering the high success rates reported. Clinical Significance This quantitative systematic review recognizes the potential of full or partial pulpotomy as a viable treatment alternative to root canal therapy for managing irreversible pulpitis in mature permanent teeth. Future studies should aim for standardized protocols to validate these findings and improve patient treatment outcomes.