Comparing MTA Pulpotomy to Root Canal Treatment in Management of Permanent Molars With Irreversible Pulpitis in Children

Ain Shams University

Status and phase: Not yet enrolling; Phase 4

Conditions: Irreversible Pulpitis

Treatments: Procedure: Root Canal Treatment; Procedure: MTA Pulpotomy

Study type: Interventional

Funder types: Other

Identifiers

NCT06488131

PED2024-D2

Details and patient eligibility

About

Dental caries, highly prevalent amongst children, can cause pulpitis. Coronal pulpotomy provides an easier, cost-effective, conservative and biologically-driven treatment option compared to endodontic treatment in mature permanent teeth with irreversible pulpitis.

The aim of the current study is to evaluate postoperative pain, clinical and radiographic outcomes of MTA pulpotomy compared to root canal treatment in children's first permanent molars suffering from irreversible pulpitis.

Full description

In this randomized controlled trial, patients aged 10-14 years suffering from irreversible pulpitis in the first permanent molar with closed apex will be randomly divided into two groups. The first group will receive complete coronal MTA pulpotomy, while the second group will receive endodontic treatment.

Enrollment: 62 estimated patients

Sex: All

Ages: 10 to 14 years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• Healthy male and female children, aged 10 to 14 years
• Signs and symptoms of irreversible pulpitis in carious first permanent molar.

Exclusion criteria

• Molars with immature roots
• Non-restorable molars, with abnormal mobility or increased probing pocket depth (normal range = 1-3 mm)
• Any indication of pulpal necrosis, such as sinus tract or swelling or no bleeding from orifices after access opening.
• Any signs of periapical or furcal rarefaction.

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Double Blind

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62 participants in 2 patient groups

MTA Pulpotomy

Experimental group

Description:

Local anesthesia for pain control will be administered, followed by rubber dam isolation. Then, the tooth and surrounding rubber dam will be flushed with chlorhexidine solution for disinfection. After caries removal, a sterile bur will be used for access opening and complete deroofing of the pulp chamber. Coronal pulp tissue will be removed to the level of canal orifices using a sterile, sharp spoon excavator. A cotton pellet dampened with sodium hypochlorite will be applied on canal orifices to achieve hemostasis. This will be followed by MTA application and glass ionomer restoration. If necessary, the tooth will be restored with stainless steel crown after one week.

Treatment:

Procedure: MTA Pulpotomy

Root Canal Treatment

Active Comparator group

Description:

Local anesthesia for pain control will be administered, followed by rubber dam isolation. Then, the tooth and surrounding rubber dam will be flushed with chlorhexidine solution for disinfection. After caries removal, a sterile bur will be used for access opening and complete deroofing of the pulp chamber. Length of the root canal will be obtained using an apex locator. This will be followed by mechanical shaping using files, and irrigation with 2.5 percent sodium hypochlorite, followed by drying of the canals using paper points. Obturation will then be accomplished using gutta percha and sealer. Finally, the tooth will be restored with conventional glass ionomer restoration. If necessary, the tooth will be restored with stainless steel crown after one week.

Treatment:

Procedure: Root Canal Treatment