Comparing MTA Pulpotomy to Root Canal Treatment in Management of Permanent Molars With Irreversible Pulpitis in Children
- Conditions
- Irreversible Pulpitis
- Interventions
- Procedure: MTA PulpotomyProcedure: Root Canal Treatment
- Registration Number
- NCT06488131
- Lead Sponsor
- Ain Shams University
- Brief Summary
Dental caries, highly prevalent amongst children, can cause pulpitis. Coronal pulpotomy provides an easier, cost-effective, conservative and biologically-driven treatment option compared to endodontic treatment in mature permanent teeth with irreversible pulpitis.
The aim of the current study is to evaluate postoperative pain, clinical and radiographic outcomes of MTA pulpotomy compared to root canal treatment in children's first permanent molars suffering from irreversible pulpitis.
- Detailed Description
In this randomized controlled trial, patients aged 10-14 years suffering from irreversible pulpitis in the first permanent molar with closed apex will be randomly divided into two groups. The first group will receive complete coronal MTA pulpotomy, while the second group will receive endodontic treatment.
Recruitment & Eligibility
- Status
- NOT_YET_RECRUITING
- Sex
- All
- Target Recruitment
- 62
- Healthy male and female children, aged 10 to 14 years
- Signs and symptoms of irreversible pulpitis in carious first permanent molar.
- Molars with immature roots
- Non-restorable molars, with abnormal mobility or increased probing pocket depth (normal range = 1-3 mm)
- Any indication of pulpal necrosis, such as sinus tract or swelling or no bleeding from orifices after access opening.
- Any signs of periapical or furcal rarefaction.
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description MTA Pulpotomy MTA Pulpotomy Local anesthesia for pain control will be administered, followed by rubber dam isolation. Then, the tooth and surrounding rubber dam will be flushed with chlorhexidine solution for disinfection. After caries removal, a sterile bur will be used for access opening and complete deroofing of the pulp chamber. Coronal pulp tissue will be removed to the level of canal orifices using a sterile, sharp spoon excavator. A cotton pellet dampened with sodium hypochlorite will be applied on canal orifices to achieve hemostasis. This will be followed by MTA application and glass ionomer restoration. If necessary, the tooth will be restored with stainless steel crown after one week. Root Canal Treatment Root Canal Treatment Local anesthesia for pain control will be administered, followed by rubber dam isolation. Then, the tooth and surrounding rubber dam will be flushed with chlorhexidine solution for disinfection. After caries removal, a sterile bur will be used for access opening and complete deroofing of the pulp chamber. Length of the root canal will be obtained using an apex locator. This will be followed by mechanical shaping using files, and irrigation with 2.5 percent sodium hypochlorite, followed by drying of the canals using paper points. Obturation will then be accomplished using gutta percha and sealer. Finally, the tooth will be restored with conventional glass ionomer restoration. If necessary, the tooth will be restored with stainless steel crown after one week.
- Primary Outcome Measures
Name Time Method Pain Relief preoperatively, immediately postoperatively and every 24 hours for 7 days after the first appointment. A 10 cm visual analogue scale will be used to record pain
- Secondary Outcome Measures
Name Time Method Radiographic Evaluation 6, 12 and 18 months postoperatively * No evident radiographic periapical or furcal pathosis
* No evident root resorption
* Normal lamina duraClinical Evaluation 3, 6, 12 and 18 months postoperatively * Absence of pain or discomfort
* Tooth is functional, with no tenderness to palpation or percussion
* Normal mobility and probing depth
* Soft tissues surrounding the tooth are normal, with no swelling or inflammation