The Role of Matrix Metalloproteinases on the Primary Teeth Pulpotomy Treatments With MTA and Biodentine

A total of 63 mandibular primary second molar teeth of 57 healthy and cooperative children aged between 5-10 years were included in this study. The Ethical Committee of the Medical Faculty of Ege University approved the study (Reference No: 16-7/14). Detailed treatment plan was explained to the children and the parents and written informed consents were obtained.

Periapical radiographs were obtained pre-operatively. Patients with a tooth showing clinical or radiographic evidence of a deep carious lesion extending close or into the pulp chamber were considered for potential inclusion.

The teeth were assigned to different groups according to the clinical diagnosis. The diagnosis were based on strict clinical and radiographic criteria. When the dental pulp was exposed during caries removal, the following clinical and radiographic diagnostic criteria were applied; Group I (teeth with reversible pulpitis): Slight clinical symptoms of minor intensity, slightly exaggerated reaction to cold or sweet stimuli, no history of pain, no sensitivity to chewing or percussion, bleeding time from the exposed pulp tissue less than 5 minutes, and no widening of the periodontal ligament space. In pulpotomy group teeth with pulpal exposure smaller than a pinpoint, teeth with purulent/viscous, dark colored exudate detected at the exposure site, and necrotic teeth were excluded.

Group II (teeth with irreversible pulpitis): Spontanous pain, sensitivity to chewing or percussion, bleeding time from the exposed pulp tissue more than 5 minutes, and widening of the periodontal ligament space, periapical lesion.

For ethical reasons, there was no control group with blood samples from healthy caries-free teeth. All primary molars were distributed between the two treatment groups as pulpotomy (Group I, n=42) and pulpectomy (Group II, n=21).