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- Title
One‐year outcome of selective caries removal versus pulpotomy treatment of deep caries: A pilot randomized controlled trial.
- Authors
Chua, S. K. X.; Sim, Y. F.; Wang, W. C.; Mok, B. Y. Y.; Yu, V. S. H.
- Abstract
Aim: This study aimed to compare the outcome of SCR and Pulpotomy in teeth with deep caries extending at least 75% into dentine. Methodology: This two‐armed, parallel‐group, randomized, superiority trial included vital mature permanent teeth with deep primary or secondary caries diagnosed radiographically as being at least 75% into the thickness of dentine, without clinical signs of symptomatic irreversible pulpitis or radiographic evidence of a periapical lesion. Carious teeth were blindly allocated to receive either SCR or Pulpotomy using computer‐generated randomized patient codes concealed in opaque envelopes. All teeth were reviewed clinically and radiographically at 6 months and 1 year post‐treatment. Using a significance level of p <.05, the log rank test and Cox proportional hazards regression were used to compare the outcome of SCR and Pulpotomy and to identify potential prognostic factors, respectively. Results: In all, 58 teeth in the SCR group and 55 teeth in the pulpotomy group completed treatment, after excluding 6 teeth because they did not complete the allocated treatment and another due to severe periodontal disease. At one year, 57/58 (98.3%) teeth from the SCR group and 48/55 (87.3%) teeth from the Pulpotomy group were available for analysis. One tooth in the Pulpotomy group (2.1%) and eight teeth in the SCR group (14.0%) required the further intervention of root canal treatment (p <.05). There were no other significant prognostic factors for survival. Overall, 91.4% of teeth treated with either SCR or Pulpotomy survived without requiring further intervention over a period of one year. No other adverse events occurred over the review period. Conclusion: Within the limitations of this study, Pulpotomy fares better than SCR in preserving the remaining pulp and periapical health. As a treatment modality, Pulpotomy carries greater cost outlay to patient and takes a longer time to complete treatment than SCR. Long‐term follow‐up is needed to study the pulpal and restorative outcomes of Pulpotomy and SCR.
- Subjects
PULPOTOMY; PERIAPICAL diseases; DENTAL caries; ROOT canal treatment; DECIDUOUS teeth; PROGNOSIS; PERIODONTAL disease; DENTAL pulp
- Publication
International Endodontic Journal, 2023, Vol 56, Issue 12, p1459
- ISSN
0143-2885
- Publication type
Article
- DOI
10.1111/iej.13978