Comparative evaluation of cervical pulpotomy and pulpectomy for primary molars with irreversible pulpitis: a multicentre randomised controlled trial.

IF 2.3 Q2 DENTISTRY, ORAL SURGERY & MEDICINE European Archives of Paediatric Dentistry Pub Date : 2024-04-01 Epub Date: 2024-03-15 DOI:10.1007/s40368-024-00880-z

S Sabbagh, Z Bahrololoomi, A Sarraf Shirazi, F Zarebidoki, S Salajegheh, F Fotouhi, A Akbarzadeh Baghban, S Asgary

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Abstract

Purpose: The objective of this multicentre randomised controlled trial was to compare the clinical/radiographic outcomes of cervical pulpotomy using calcium-enriched mixture cement (PCEM) and pulpectomy using Metapex (PM) in primary molars with irreversible pulpitis (IP).

Methods: A total of 134 primary molars from 94 children were randomly assigned to two intervention groups: the PCEM group (n = 74) and the PM group (n = 60). Baseline characteristics including age/gender/molar type/tooth type/jaw were recorded. The primary outcome measures were clinical/radiographic success rates assessed at the first and second follow-up appointments. Secondary outcomes included reasons for clinical/radiographic failures. Multiple logistic regression analysis was performed to determine the impact of various factors on the success rates.

Results: The mean age of the participants in both groups was similar (PCEM group: 5.4 years, PM group: 5.5 years). Gender distribution, molar type, tooth type, jaw, and number of practitioners were comparable between the groups. The clinical success rate at the first follow-up was 98.6% in the PCEM group and 96.4% in the PM group. At the second follow-up, the clinical success rate was 97.1% in the PCEM group and 91.1% in the PM group. The radiographic success rates at the first and second follow-up were 98.6% and 96.4% in the PCEM group and 96.4% and 91.1% in the PM group, respectively. Multiple logistic regression analysis did not reveal any significant association between the success rates and age/gender/molar type/jaw, or treatment groups (P > 0.05).

Conclusion: In primary molars with IP, both simple/conservative cervical pulpotomy using calcium-enriched mixture cement and pulpectomy using Metapex demonstrated high clinical/radiographic success rates. No significant differences were observed between the two treatment modalities. These findings suggest that both techniques can be considered effective treatment options for managing primary molars with IP.

Trial registration number: Trial registration number: IRCT20201226049838N1, retrospectively registered on 12 January 2021.

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对患有不可逆牙髓炎的初级磨牙进行颈部牙髓切断术和牙髓切除术的比较评估：一项多中心随机对照试验。

目的：这项多中心随机对照试验的目的是比较在患有不可逆牙髓炎（IP）的初级磨牙中使用富钙混合水门汀（PCEM）进行牙颈部牙髓切断术和使用Metapex（PM）进行牙髓切除术的临床/放射学结果：94名儿童的134颗初级磨牙被随机分配到两个干预组：PCEM组（74人）和PM组（60人）。记录基线特征，包括年龄/性别/臼齿类型/牙齿类型/颌骨。主要结果指标是在第一次和第二次复诊时评估的临床/放射学成功率。次要结果包括临床/放射摄影失败的原因。为确定各种因素对成功率的影响，进行了多元逻辑回归分析：两组参与者的平均年龄相似（PCEM 组：5.4 岁，PM 组：5.5 岁）。两组的性别分布、臼齿类型、牙齿类型、颌骨和医师人数相当。首次随访时，PCEM 组的临床成功率为 98.6%，PM 组为 96.4%。第二次随访时，PCEM 组的临床成功率为 97.1%，PM 组为 91.1%。在第一次和第二次随访中，PCEM 组的放射学成功率分别为 98.6% 和 96.4%，PM 组分别为 96.4% 和 91.1%。多元逻辑回归分析表明，成功率与年龄/性别/臼齿类型/颌骨或治疗组之间没有明显关联（P > 0.05）：对于患有IP的初级磨牙，使用富钙混合水门汀进行简单/保守的颈髓切断术和使用Metapex进行脉冲切除术的临床/放射学成功率都很高。两种治疗方法之间没有明显差异。这些研究结果表明，这两种技术都可被视为治疗患有IP的初级磨牙的有效治疗方案：试验注册号：IRCT20201226049838N1，2021年1月12日回顾性注册。

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来源期刊

European Archives of Paediatric Dentistry DENTISTRY, ORAL SURGERY & MEDICINE-

CiteScore

4.40

自引率

9.10%

发文量

期刊介绍： The aim and scope of European Archives of Paediatric Dentistry (EAPD) is to promote research in all aspects of dentistry for children, including interceptive orthodontics and studies on children and young adults with special needs. The EAPD focuses on the publication and critical evaluation of clinical and basic science research related to children. The EAPD will consider clinical case series reports, followed by the relevant literature review, only where there are new and important findings of interest to Paediatric Dentistry and where details of techniques or treatment carried out and the success of such approaches are given.