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

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.

CLINICAL SIGNIFICANCE: 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.