Vital pulp therapy following pulpotomy in immature first permanent molars with deep caries using novel fast-setting calcium silicate cement: A retrospective clinical study

• Published in: Journal of dentistry Vol. 116; p. 103890
• Main Authors: Vafaei, Ali, Nikookhesal, Mahsa, Erfanparast, Leila, Løvschall, Henrik, Ranjkesh, Bahram
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01.01.2022; Elsevier Limited
• Subjects: Aluminum Compounds - therapeutic use; Anesthesia; Apexogenesis; Biocompatibility; Biomaterials; Biomedical materials; Calcium; Calcium Compounds - therapeutic use; Calcium silicate cement; Calcium silicates; Cement; Child; Dental caries; Dental Caries Susceptibility; Dental cement; Dental pulp; Dentistry; Drug Combinations; Fluorides; Gender; General anesthesia; Humans; Ionomers; Jaw; Local anesthesia; Molar - diagnostic imaging; Molars; Oxides - therapeutic use; Patients; Pulpotomy; Restoration; Retrospective Studies; Silicate Cement; Silicates - therapeutic use; Stainless steel; Stainless steels; Statistical analysis; Success; Teeth; Therapy; Treatment Outcome; Vital pulp therapy; Iran; Denmark; Germany; Apexogenesis; Pulpotomy; Vital pulp therapy; Calcium silicate cement
• ISSN: 0300-5712; 1879-176X
• DOI: 10.1016/j.jdent.2021.103890

To compare the success rate of vital pulp therapy following complete pulpotomy in immature first permanent molars, during caries treatment, using novel fast-setting calcium silicate cement (Novel CSC) versus MTA. Six- to eight- years old children, who received pulpotomy of first immature permanent molar using one layer novel CSC (Protooth) or two layers slow-setting MTA (MTA Angelus) covered with glass ionomer were recalled for radiographic and clinical evaluation after two years. The effects of cement type, age, gender, jaw, anesthesia type, and restoration type were assessed on the clinical success of pulpotomy and continued root formation (apexogenesis) as the treatment outcome. Out of 366 included teeth in the study, 316 teeth were available for statistical analysis. The mean observation time was 28.2 ± 2.7 months. Novel CSC showed significantly higher clinical success rate (93.1%) compared to MTA (84.5%). Restored teeth with stainless steel crowns after pulpotomy and treatments performed under general anesthesia had a statistically significant effect on treatment outcome in contrast to age, gender, and jaw type. The observations of this retrospective study suggested that the success rate of vital pulp therapy following complete pulpotomy using one layer fast-setting novel CSC was significantly higher than slow-setting MTA covered with glass ionomer. Treatment under general anesthesia and restoration using stainless steel crowns influenced the treatment outcome. Novel fast-setting calcium silicate cement is a promising new biomaterial for vital pulp therapy in immature permanent molars that allows complete root formation overtime with apexogenesis. Clinicians must also be aware of the importance of immediate definitive restoration and proper sealing and isolation in vital pulp therapy.