Pulpotomy in caries-exposed immature permanent molars using calcium-enriched mixture cement or mineral trioxide aggregate: a randomized clinical trial.

OBJECTIVE: To compare clinical and radiographic outcomes of pulpotomy treatment using calcium-enriched mixture (CEM) cement and mineral trioxide aggregate (MTA) in carious-exposed vital immature permanent first molars.

DESIGN: Fifty-one immature molars with clinical carious exposure with symptomatic/asymptomatic pulpitis met the inclusion criteria and randomly assigned to one of the treatment groups (CEM [26 teeth; 59 roots], MTA [25 teeth; 59 roots]). After performing pulpotomy and covering the radicular pulps with the biomaterials, all teeth were permanently restored. Blinded clinical and radiographic evaluations were performed at 6 and 12 months after operation for signs of success or failure. Radiographs were evaluated for complete/partial apical closure. The data were analysed using chi-square test and generalized estimating equation (GEE) model.

RESULTS: There was no significant difference at the baseline between the two experimental groups. All available cases (49 teeth) showed pulp survival and signs of continuous root development after 12 months. Overall, complete apical closure (apexogenesis) occurred in 76.8% and 73.8% of radiographically interpreted roots in CEM cement and MTA groups, respectively. There was no statistical difference in terms of radiographic outcomes between two groups.

CONCLUSIONS: Calcium-enriched mixture cement and MTA showed similar performance in pulpotomy of immature caries-exposed permanent molars.