Outcome of Partial Pulpotomy in Mature Permanent Molars After Lavage With Chlorhexidine or Sodium Hypochlorite: A Randomised Clinical Trial.

AIM: This randomised clinical trial compared the effect of wound lavage using chlorhexidine (CHX) versus sodium hypochlorite (NaOCl) on the outcome of partial pulpotomy (PP) in mature permanent molars with carious pulpal exposure and symptomatic irreversible pulpitis (SIP).

METHODOLOGY: In this double-arm parallel-group randomised clinical trial, 104 mandibular molars undergoing PP were randomised equally to either NaOCl lavage group (NL) (n = 52) or CHX lavage group (CL) (n = 52). The pulpal wound after pulp amputation during PP was irrigated with 3% NaOCl in the NL and 2% CHX in the CL group. After haemostasis, ProRoot Mineral Trioxide Aggregate (ProRoot MTA) was used as a pulpotomy agent. Patients were evaluated for pain experience at every 24 h for 7 days, clinical success at 3, 6 and 12 months, and radiographic success at 6 and 12 months. Data were analysed using Mann-Whitney U test to compare age, duration of haemostasis, pain score and analgesic consumption between groups and Chi-square test/Fisher's exact test to compare gender, the number of tooth surfaces involved by caries, hard tissue barrier, clinical and radiographic success, pain incidence and pulp sensibility responses.

RESULTS

Ninety-nine patients were assessed for clinical and radiographic success at 12 months follow-up. The NL group showed a higher success (91.8%) than the CL group (84%), albeit with no significant difference (p > 0.05). No significant difference was observed between the groups in postoperative pain experience (p > 0.05). Significantly less time was required to achieve haemostasis in NL (p < 0.001), and evidence of hard tissue barrier formation was significantly higher in the CL group (p = 0.024).

CONCLUSION

Comparable success was observed following the use of the two lavage agents during PP in managing cariously exposed adult teeth with SIP. CHX can serve as a suitable alternative to NaOCl as a pulpal wound lavage agent.

TRIAL REGISTRATION: clinicaltrials.gov identifier: NCT06240130.