Journal
CLINICAL ORAL INVESTIGATIONS
Volume 17, Issue 2, Pages 431-439Publisher
SPRINGER HEIDELBERG
DOI: 10.1007/s00784-012-0712-6
Keywords
Biomaterial; Calcium-enriched mixture; CEM cement; Endodontics; Human; Molar; Pulpitis; Pulpotomy; Vital pulp therapy
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Funding
- Iranian Ministry of Health and Medical Education (Health Deputy, Oral Health Office)
- Shahid Beheshti University of Medical Sciences [p/25/17/1/tm/103]
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Root canal therapy (RCT) and tooth extraction have been conventional treatment options for management of human mature teeth with irreversible pulpitis. Excellent short-term treatment outcomes of vital pulp therapy with calcium-enriched mixture cement (VPT/CEM), as a new treatment option, on postoperative pain relief was demonstrated; if intermediate- and long-term treatment outcomes of the new treatment are also non-inferior compared to RCT, then VPT/CEM may become a viable treatment option for management of mature teeth with irreversible pulpitis. In 23 healthcare centers, 407 9- to 65-year-old patients were randomly allocated into two study arms including one-visit RCT (reference treatment; n = 202) and VPT/CEM (alternative treatment; n = 205). Six- and twelve-month clinical and radiographic successes were assessed. Mean follow-up times at 6- and 12-month follow-ups were 6.70 +/- 0.68 and 6.72 +/- 0.71 months and 12.96 +/- 0.67 and 12.90 +/- 0.66 months in the available cases of RCT and VPT/CEM arms, respectively. Favorable clinical success rates in the two study arms did not show statistical difference; however, the radiographic success rate in the VPT/CEM was significantly greater than RCT arm at the two follow-ups (P < 0.001). The patients' age had no effect on the treatment outcomes (P = 0.231). Treatment outcomes of VPT/CEM may be superior to RCT in mature molars with irreversible pulpitis. The performance of biomaterials such CEM cement may assist in the shift towards more biologic treatments. VPT/CEM may be a realistic alternative treatment for human mature molar teeth with symptoms of irreversible pulpitis; the use of VPT/CEM is highly beneficial for patients as well as general dentists.
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