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+.