LAUSR

AIM To compare the outcome of full pulpotomy using 2 calcium silicate-based materials compared to MTA in symptomatic mature permanent teeth with carious pulp exposure. METHODOLOGY This study was designed as a parallel, double blind, randomized controlled trial where symptomatic mature permanent teeth with carious pulp exposure meeting the inclusion criteria were randomly treated with full pulpotomy using one of 3 calcium silicate-based materials (ProRoot MTA, Biodentine, and TotalFill). Full pulpotomy was performed and haemostasis was achieved via a cotton pellet moistened with 2.5% NaOCl. A 3-mm layer of the calcium silicate-based material was randomly placed as the pulpotomy agent through a block randomization process followed by a resin-based composite restoration. Postoperative periapical radiograph was taken. Clinical and radiographic evaluation was completed after 6 months and 1 year. The patient and evaluator were blinded to the type of materials used. Pain levels were scored preoperatively and 7 days after treatment. Effect of potential prognosis factors including gender, age, diagnosis, bleeding time and type of caries were also analyzed. RESULTS One hundred and sixty-four teeth in 146 patients received full pulpotomy and were randomly assigned to either the tested or control material through block randomization technique; (50 MTA, 50 Biodentine, 64 TotalFill). The age ranged from 10-70 years. The diagnosis was irreversible pulpitis in 112 teeth (72%) and reversible pulpitis in 28 teeth (28%). The majority of patients presented with severe pain, during the first week 96.9% reported complete relief of pain or mild pain. Four cases had immediate failure. At six months the overall success rate was 92.2%, over 1 year 156/164 teeth attended follow up with 12 failures (2 restorative failures and 10 endodontic failures), the overall success of pulpotomy at 1 year was 92.3 % (144/156); 91.8% in MTA, 93.3% in Biodentine and 91.9 % in TotalFill with no significant difference among the groups and no side-effects observed. No significant association was evident between outcome and the investigated variables. CONCLUSIONS The 1-year success rate of full pulpotomy did not differ significantly between Biodentine pulpotomy, TotalFill pulpotomy, and MTA pulpotomy.