Assessment of the Number of Missing Tooth Surfaces and the Molecular Findings on the Outcomes of Vital Pulp Therapy Using 2 Calcium Silicate Materials: A Randomized Clinical Study

Abstract

Introduction

This study aimed to evaluate the clinical and radiographic outcomes of full pulpotomy in mandibular molar teeth with symptomatic irreversible pulpitis. It compared class I and class II cavity defects and correlated these outcomes with the quantification of 2 biomolecules (tumor necrosis factor-alpha [TNF-α] and matrix metalloproteinase-9 [MMP-9]) using 2 types of pulpotomy dressing materials (MTA+ and Well-Root PT).

Methods

Sixty patients were selected and categorized based on cavity class. Full pulpotomy was conducted under aseptic conditions and rubber dam isolation. Pulpal blood samples were taken for TNF-α and MMP-9 quantification. Sodium hypochlorite was used as a hemostatic agent. The teeth were randomly divided based on the pulpotomy dressing material, MTA+, or Well-Root PT. Clinical and radiographic assessments were conducted after 1 week, 3, 6, and 12 months.

Results

The overall clinical and radiographic success rate of pulpotomy procedures after a 1-year follow-up was 88.3%. There were nonsignificant differences in the success rates between the groups and subgroups (93.3% in MTA class I, 86.7% in Well-Root PT class I, 80.0% in MTA class II, and 93.3% in Well-Root PT class II). TNF-α and MMP-9 showed a significant correlation with the outcomes.

Conclusion

Class I and II cavity defects do not significantly impact the pulpotomy success rate. TNF-α and MMP-9 levels are potential indicators of pulpotomy outcomes. Well-Root PT offers easier handling and lacks the discoloration effect associated with MTA+.