Pulpotomy For Cariously Exposed Permanent Teeth:A Preliminary Study

With the improvement of the quality of life,people pay more and more attention to the oral health,oral health has a significantly impact on people’s quality of life.Especially for the cariously exposed permanent teeth,we found that more and more patients have a strong awareness to the preservation of vital pulp and teeth.For cariously exposed permanent teeth with closed apices,root canal therapy is considered as the gold standard of treatment.According to the literature,we know that the pulp tissue has the ability of forming,nutrition,feeling and defense.The survival rate of the vital pulp teeth is higher than the non vital teeth.Therefore,the research which pulpotomy applied to mature permanent teeth is the main content of this study.PURPOSE To observe the clinical effect of pulpotomy for cariously exposed permanent teeth with closed apices and provide a theory and clinical guidance for the clinical application.METHODS Sixty-two cariously exposed permanent teeth with closed apices and vital pulps were included.Preoperative pulpal and periapical diagnosis was established.The teeth were divided into two groups,the experimental group was treated with pulpotomy(32),and the control group was treated with one-visit RCT(one-visit root canal therapy)(30).The experimental group: the tooth was anaesthetized with articaine hydrochloride and epinephrine tartrate injection(Primacaine)and isolated with rubber dam.Infected carious dentin was removed by sterile high speed handpiece.Roof of pulp chamber is completely removed.The inflamed pulp was removed with a sterilized bur or sharp bladed curette.The cutting surface of the pulp is neat.The pulp chamber was irrigated with sterile saline solution to remove any tissue tags.Hemostasis was achieved by sterile wet cotton pellets.MTA powder are mixed with distilled water provided by manufacturer.The pulpal wound was covered with approximately 2-mm layer of MTA.Care was taken to avoid pressure.Then a sterile wet cotton pellet was placed over MTA,and the cavity sealed with GIC.After 24 hours,cotton pellet was removed and we should check the degree of solidification of MTA.Cavity was restored with resin composite and intraoral periapical radiographs were taken.The control group:the tooth was anaesthetized and isolated with rubber dam.Infected carious dentin was removed by sterile high speed handpiece.Pulp was removed by barbed broach.The working length was measured by Apex locator.Canal preparation was conducted using crown-down technique.Root canal were irrigated with adequate amount of 5.25%sodium hypochlorite and saline solution.Wet canal were dried by absorbent paper points and filled with multiple gutta-percha cones.Root canal were sealed with fluid resin composite.Cavity was restored with resin composite and intraoral periapical radiographs were taken.Clinical and radiographic evaluation was completed at1 month、3 months、6 months、12 months postoperatively.All statistical analysis was performed using the SPSS 18.0 statistical package.RESULTS After one year,the success rate of pulpotomy was 93.75%,and the success rate of root canal therapy was 93.10%.There were no significant differences between pulpotomy and RCT(χ2=0.010,P=0.665).CONCLUSION The advantages of pulpotomy were less invasive and tooth destruction.It was a successful treatment option for cariously exposed pulps in mature permanent teeth.