Article Data

  • Views 2383
  • Dowloads 479

Original Research

Open Access

Vital pulp therapy following pulpotomy in immature permanent teeth with carious exposure

  • Shuguang Han1
  • Qixia Zhang1,*,

1Zhejiang University District, The Second Affiliated Hospital of Zhejiang University School of Medicine, 310009 Hangzhou, Zhejiang, China

DOI: 10.22514/jocpd.2023.054 Vol.47,Issue 5,September 2023 pp.65-72

Submitted: 19 December 2022 Accepted: 03 March 2023

Published: 03 September 2023

*Corresponding Author(s): Qixia Zhang E-mail: 0017618@zju.edu.cn

Abstract

This prospective cohort study aimed to evaluate the clinical outcomes of vital pulp therapy (VPT) with the use of iRoot BP Plus (Innovative Bioceramics, Vancouver, Canada) for immature permanent teeth of patients aged from 6 to 10 years with pulp exposure resulting from dental caries and determine the impact of preoperative factors on VPT. Forty-six immature permanent teeth with dental caries underwent pulpotomy using iRoot BP Plus following a standardized protocol. Postoperative follow-ups were conducted on the first 3, 6 and 12 months post-surgery, then annually afterward. Successful treatment outcomes were defined based on clinical and radiographic evaluations. Statistical analysis was performed using the Fisher exact test, with p < 0.05 considered for statistical significance. Forty-four patients included in this study were 8.48 ± 1.49 years old and were followed up for 6 to 36 months. The overall success rate of pulpotomy was found to be 90.9% (40/44). None of the physical examination findings and symptoms significantly affected VPT prognosis (p > 0.05). Immature permanent teeth with caries-induced pulp exposed in patients aged 6 to 10 years can be effectively treated with pulpotomy using iRoot sBP Plus.


Keywords

Vital pulp therapy; Pulpotomy; Immature permanent teeth


Cite and Share

Shuguang Han,Qixia Zhang. Vital pulp therapy following pulpotomy in immature permanent teeth with carious exposure. Journal of Clinical Pediatric Dentistry. 2023. 47(5);65-72.

References

[1] Wigler R, Kaufman AY, Lin S, Steinbock N, Hazan-Molina H, Torneck CD. Revascularization: a treatment for permanent teeth with necrotic pulp and incomplete root development. Journal of Endodontics. 2013; 39: 319–326.

[2] Wong M, Shelley JJ, Bodey T, Hall R. Delayed root canal therapy: an analysis of treatment over time. Journal of Endodontics. 1992; 18: 387–390.

[3] Mello I, Michaud P, Butt Z. Fracture resistance of immature teeth submitted to different endodontic procedures and restorative protocols. Journal of Endodontics. 2020; 46: 1465–1469.

[4] Chen Y, Chen X, Zhang Y, Zhou F, Deng J, Zou J, et al. Materials for pulpotomy in immature permanent teeth: a systematic review and meta-analysis. BMC Oral Health. 2019; 19: 227.

[5] Sabeti M, Golchert K, Torabinejad M. Regeneration of pulp-dentin complex in a tooth with symptomatic irreversible pulpitis and open apex using regenerative endodontic procedures. Journal of Endodontics. 2021; 47: 247–252.

[6] Özgür B, Uysal S, Güngör HC. Partial pulpotomy in immature permanent molars after carious exposures using different hemorrhage control and capping materials. Pediatric Dentistry. 2017; 39: 364–370.

[7] Farsi N, Alamoudi N, Balto K, Al Mushayt A. Clinical assessment of mineral trioxide aggregate (MTA) as direct pulp capping in young permanent teeth. Journal of Clinical Pediatric Dentistry. 2007; 31: 72–76.

[8] Pedano MS, Li X, Yoshihara K, Landuyt KV, Van Meerbeek B. Cytotoxicity and bioactivity of dental pulp-capping agents towards human tooth-pulp cells: a systematic review of in-vitro studies and meta-analysis of randomized and controlled clinical trials. Materials. 2020; 13: 2670.

[9] Johnson WT. Comparison of mineral trioxide aggregate and calcium hydroxide as pulpotomy agents in young permanent teeth (apexogenesis). Yearbook of Dentistry. 2007; 2007: 228–229.

[10] Uyar DS, Alacam A. Evaluation of partial pulpotomy treatment in cariously exposed immature permanent molars: randomized controlled trial. Nigerian Journal of Clinical Practice. 2021; 24: 1511–1519.

[11] Hu X, Li Y, Xu J, Li Q, Wang R. Immature permanent incisors with complicated crown fractures treated with partial pulpotomy using white mineral trioxide aggregate and IRoot BP plus-a retrospective long-term study. Dental Traumatology. 2023; 39: 165–172.

[12] Rao Q, Kuang J, Mao C, Dai J, Hu L, Lei Z, et al. Comparison of iRoot BP plus and calcium hydroxide as pulpotomy materials in permanent incisors with complicated crown fractures: a retrospective study. Journal of Endodontics. 2020; 46: 352–357.

[13] Wu L, Xue K, Hu G, Du H, Gan K, Zhu J, et al. Effects of iRoot SP on osteogenic differentiation of human stem cells from apical papilla. BMC Oral Health. 2021; 21: 407.

[14] Azimi S, Fazlyab M, Sadri D, Saghiri MA, Khosravanifard B, Asgary S. Comparison of pulp response to mineral trioxide aggregate and a bioceramic paste in partial pulpotomy of sound human premolars: a randomized controlled trial. International Endodontic Journal. 2014; 47: 873–881.

[15] Taha NA, Abdulkhader SZ. Full pulpotomy with biodentine in symptomatic young permanent teeth with carious exposure. Journal of Endodontics. 2018; 44: 932–937.

[16] Fakhri E, Eslami H, Maroufi P, Pakdel F, Taghizadeh S, Ganbarov K, et al. Chitosan biomaterials application in dentistry. International Journal of Biological Macromolecules. 2020; 162: 956–974.

[17] Kim SG, Malek M, Sigurdsson A, Lin LM, Kahler B. Regenerative endodontics: a comprehensive review. International Endodontic Journal. 2018; 51: 1367–1388.

[18] Levin LG, Law AS, Holland GR, Abbott PV, Roda RS. Identify and define all diagnostic terms for pulpal health and disease states. Journal of Endodontics. 2009; 35: 1645–1657.

[19] Tsze DS, von Baeyer CL, Pahalyants V, Dayan PS. Validity and reliability of the verbal numerical rating scale for children aged 4 to 17 years with acute pain. Annals of Emergency Medicine. 2018; 71: 691–702.e3.

[20] NOSRAT A, SEIFI A, ASGARY S. Pulpotomy in caries-exposed immature permanent molars using calcium-enriched mixture cement or mineral trioxide aggregate: a randomized clinical trial. International Journal of Paediatric Dentistry. 2013; 23: 56–63.

[21] Çağlaroğlu M, Kilic N, Erdem A. Effects of early unilateral first molar extraction on skeletal asymmetry. American Journal of Orthodontics and Dentofacial Orthopedics. 2008; 134: 270–275.

[22] Gudkina J, Mindere A, Locane G, Brinkmane A. Review of the success of pulp exposure treatment of cariously and traumatically exposed pulps in immature permanent incisors and molars. Stomatologija. 2012; 14: 71–80.

[23] Santos JM, Pereira JF, Marques A, Sequeira DB, Friedman S. Vital pulp therapy in permanent mature posterior teeth with symptomatic irreversible pulpitis: a systematic review of treatment outcomes. Medicina. 2021; 57: 573.

[24] Ng YL, Mann V, Gulabivala K. Outcome of secondary root canal treatment: a systematic review of the literature. International Endodontic Journal. 2008; 41: 1026–1046.

[25] Mohammadi Z, Shalavi S, Jafarzadeh H. Extra roots and root canals in premolar and molar teeth: review of an endodontic challenge. The Journal of Contemporary Dental Practice. 2013; 14: 980–986.

[26] Ricucci D, Loghin S, Siqueira JF. Correlation between clinical and histologic pulp diagnoses. Journal of Endodontics. 2014; 40: 1932–1939.

[27] Rossi HL, See LP, Foster W, Pitake S, Gibbs J, Schmidt B, et al. Evoked and spontaneous pain assessment during tooth pulp injury. Scientific Reports. 2020; 10: 2759.

[28] Liu SY, Gong WY, Liu MQ, Long YZ, Dong YM. Clinical efficacy observation of direct pulp capping using iRoot BP Plus therapy in mature permanent teeth with carious pulp exposure. Chinese Journal of Stomatology. 2020; 55: 945–951. (In Chinses)

[29] Kundzina R, Stangvaltaite L, Eriksen HM, Kerosuo E. Capping carious exposures in adults: a randomized controlled trial investigating mineral trioxide aggregate versus calcium hydroxide. International Endodontic Journal. 2017; 50: 924–932.

[30] Mainkar A, Kim SG. Diagnostic accuracy of 5 dental pulp tests: a systematic review and meta-analysis. Journal of Endodontics. 2018; 44: 694–702.

[31] Alghaithy RA, Qualtrough AJE. Pulp sensibility and vitality tests for diagnosing pulpal health in permanent teeth: a critical review. International Endodontic Journal. 2017; 50: 135–142.

[32] Taha NA, About I, Sedgley CM, Messer HH. Conservative management of mature permanent teeth with carious pulp exposure. Journal of Endodontics. 2020; 46: S33–S41.

[33] Aguilar P, Linsuwanont P. Vital pulp therapy in vital permanent teeth with cariously exposed pulp: a systematic review. Journal of Endodontics. 2011; 37: 581–587.

[34] Alsubait S, Al-Haidar S, Al-Sharyan N. A comparison of the discoloration potential for endosequence bioceramic root repair material fast set putty and proroot MTA in human teeth: an in vitro study. Journal of Esthetic and Restorative Dentistry. 2017; 29: 59–67.

[35] Parirokh M, Torabinejad M, Dummer PMH. Mineral trioxide aggregate and other bioactive endodontic cements: an updated overview—part I: vital pulp therapy. International Endodontic Journal. 2018; 51: 177–205.

[36] Witherspoon DE, Small JC, Harris GZ. Mineral trioxide aggregate pulpotomies: a case series outcomes assessment. The Journal of the American Dental Association. 2006; 137: 610–618.

[37] Qudeimat MA, Alyahya A, Hasan AA. Mineral trioxide aggregate pulpotomy for permanent molars with clinical signs indicative of irreversible pulpitis: a preliminary study. International Endodontic Journal. 2017; 50: 126–134.


Abstracted / indexed in

Science Citation Index Expanded (SciSearch) Created as SCI in 1964, Science Citation Index Expanded now indexes over 9,500 of the world’s most impactful journals across 178 scientific disciplines. More than 53 million records and 1.18 billion cited references date back from 1900 to present.

Biological Abstracts Easily discover critical journal coverage of the life sciences with Biological Abstracts, produced by the Web of Science Group, with topics ranging from botany to microbiology to pharmacology. Including BIOSIS indexing and MeSH terms, specialized indexing in Biological Abstracts helps you to discover more accurate, context-sensitive results.

Google Scholar Google Scholar is a freely accessible web search engine that indexes the full text or metadata of scholarly literature across an array of publishing formats and disciplines.

JournalSeek Genamics JournalSeek is the largest completely categorized database of freely available journal information available on the internet. The database presently contains 39226 titles. Journal information includes the description (aims and scope), journal abbreviation, journal homepage link, subject category and ISSN.

Current Contents - Clinical Medicine Current Contents - Clinical Medicine provides easy access to complete tables of contents, abstracts, bibliographic information and all other significant items in recently published issues from over 1,000 leading journals in clinical medicine.

BIOSIS Previews BIOSIS Previews is an English-language, bibliographic database service, with abstracts and citation indexing. It is part of Clarivate Analytics Web of Science suite. BIOSIS Previews indexes data from 1926 to the present.

Journal Citation Reports/Science Edition Journal Citation Reports/Science Edition aims to evaluate a journal’s value from multiple perspectives including the journal impact factor, descriptive data about a journal’s open access content as well as contributing authors, and provide readers a transparent and publisher-neutral data & statistics information about the journal.

Scopus: CiteScore 2.0 (2022) Scopus is Elsevier's abstract and citation database launched in 2004. Scopus covers nearly 36,377 titles (22,794 active titles and 13,583 Inactive titles) from approximately 11,678 publishers, of which 34,346 are peer-reviewed journals in top-level subject fields: life sciences, social sciences, physical sciences and health sciences.

Submission Turnaround Time

Conferences

Top