PDF: Clinical and Radiographic Assessment of Partial Pulpotomy versus Complete Pulpotomy in Vital Primary Molars Using MTA: A Randomized Controlled Clinical Trial

The aim of this study is to assess clinically partial pulpotomy versus complete pulpotomy in treatment of vital carious primary molars using MTA after one week, 3 months, 6 months, and 9 months.

Children’s health, growth, and psychology are the main concern of all parents. Pediatric dentists always aim to get a happy, pain-free, and quick dental visit for their young patients. 

Using every effort to apply fast and effective therapy to kids is the target of pediatric dentistry. 

Asymptomatic deeply carious vital primary molars are mainly treated using the pulpotomy technique. 

Special attention while treating deeply carious primary teeth is directed to pulp status. 

The best dental practice must be followed in diagnosing pulp health or disease and providing evidence concerning the efficiency of different therapeutic interventions. 

In children with extensive caries in the primary dentition, pulp treatment is mandatory, especially in molars, which are of major importance for occlusal development. 

Under such circumstances, a partial pulpotomy may simplify pulpal treatment compared to traditional pulpotomy. 

Pulpotomy is the commonly used technique for treating primary molars. 

Its goals are to retain the tooth, maintain arch length and integrity until the eruption of permanent successors into the oral cavity, prevent discomfort and inflammation, and preserve the radicular pulp. 


Recovery of the non-inflamed radicular pulp can occur along one of three therapeutic approaches following amputation of the inflamed coronal pulp; Devitalization: radicular pulp becomes non vital and nonfunctional, Preservation: radicular pulp demonstrates minimal changes and Regeneration: radicular pulp is not only vital and functional, but is also stimulated to form dentin bridge. 

The partial pulpotomy technique was introduced mainly for the treatment of young permanent teeth. 

In 1987, Schröder used partial pulpotomy for treating deeply carious primary teeth with chronic coronal pulpitis, it showed a success rate of 83%. 

In partial pulpotomy, the coronal pulp next to the site of pulp exposure is only partially removed. The type of pulp treatment has been established by Cvek. 

The pulp condition at the time of treatment is critical to the result. It is required to choose teeth where the coronal pulp and the region nearest to the exposure site are the only places with chronic inflammation. 

Dental materials have been developed greatly throughout the years. Mineral trioxide aggregate (MTA) is a bioactive material, which was introduced in 1990. 

It is a fine hydrophilic powder, consisting of tricalcium silicate, tricalcium aluminate, silicate oxide, and bismuth oxide. MTA is proven to be a highly biocompatible material. 

MTA is currently being used in pulp therapy and has provided an enhanced seal over vital pulp and is non-resorbable. It showed a success rate of 100% when used as a dressing material for pulpotomy in primary teeth. 

Complete pulpotomy was the most commonly used therapy in treatment of deeply carious primary molars. It has some limitations in being time consuming. 

So this study is designed to assess the clinical and radiographic effectiveness of partial and complete pulpotomy in primary molars using MTA. 

This clinical trial has potential benefits to patients because its more conservative to the pulp tissue.  

Radiographic assessment of either techniques was done at baseline, and after 6 months follow-up period. 

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