Comparative Evaluation of MTA Pulpotomy and Laser-Assisted MTA Pulpotomy in Primary Teeth: A Randomized Clinical Trial

Kranthi Kumar, M. Das, Gautam Singh, M. L. Madhu, Jeswin M Thomas, A. Prabha
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Abstract

Context and Aim: Formocresol has been used as the material of choice (gold standard) for pulpotomy procedures because of the ease of use but was discouraged due to its potential immune sensitization and mutagenic effects. Laser irradiation was first applied for pulpotomy procedure in the year 1985. Recently, diode lasers have been used for pulpotomy in primary teeth and have shown clinical success rates comparable to formocresol. The present in-vivo study was carried out to compare the clinical and radiographic success rates of Mineral Trioxide Aggregate (MTA) alone and diode laser-MTA for pulpotomy in human primary molars. Materials and Methods: The present study was a randomized clinical trial in design wherein forty primary teeth requiring pulpotomy treatment which met the selection criteria (clinical and radiographic) were divided into two groups, group 1 (n=20) wherein the pulpotomy was performed with MTA alone and group 2 (n=20) wherein laser-assisted pulpotomy was performed with MTA (L-MTA). The patients were recalled after 3, 6 and 9 months respectively and evaluated clinically and radiographically. Statistical Analysis Used: The data were analyzed using the Statistical Package for the Social Sciences (SPSS) Version 22 (IBM corporation, Washington DC, United States). Descriptive statistics were used to analyze the data while the Pearson's correlation coefficient test was used to analyze the statistical correlation between the overall success rates observed in the clinical and radiographic findings of both the groups. p<0.05 was considered statistically significant. Results: The clinical success rate in the MTA group was 90%, 84.21% and 88.23% at 3, 6 and 9 months respectively with no clinical signs or, symptoms reported at the said follow-up visits while the radiographic success rate was found to be 85%, 84.21%, and 82.3% respectively. On the contrary, the clinical success rate in the L-MTA group was found to be 95%, 94.74% and 94.44% at 3, 6 and 9 months respectively with the radiographic success rate reported being 90%, 89.47%, and 88.89% respectively. Conclusion: The combination of diode laser and MTA yielded better clinical and radiographic success rates over the pulpotomy procedures done with the help of MTA alone.
MTA牙髓切开术与激光辅助MTA牙髓切开术在乳牙治疗中的比较评价:一项随机临床试验
背景和目的:由于使用方便,福摩甲酚已被用作髓切开术的首选材料(金标准),但由于其潜在的免疫致敏和致突变作用,不鼓励使用。激光照射于1985年首次应用于牙髓切开术。最近,二极管激光被用于乳牙的切髓术,并显示出与福摩甲酚相当的临床成功率。本研究比较了三氧化二矿骨料(Mineral Trioxide Aggregate, MTA)和二极管激光-MTA在人类第一磨牙髓切开术中的临床和影像学成功率。材料与方法:本研究是一项随机临床设计试验,将40颗符合临床和影像学选择标准的需要切髓治疗的乳牙分为两组,第1组(n=20)单独使用MTA进行切髓,第2组(n=20)使用激光辅助的MTA (L-MTA)进行切髓。分别于3个月、6个月和9个月后召回患者,并进行临床和影像学评估。使用的统计分析:使用社会科学统计软件包(SPSS)版本22 (IBM公司,华盛顿特区,美国)对数据进行分析。采用描述性统计对资料进行分析,采用Pearson相关系数检验分析两组临床观察到的总成功率与影像学表现之间的统计学相关性。P <0.05为差异有统计学意义。结果:MTA组3个月、6个月、9个月的临床成功率分别为90%、84.21%、88.23%,随访时无临床体征、症状报告,影像学成功率分别为85%、84.21%、82.3%。相反,L-MTA组在3个月、6个月和9个月的临床成功率分别为95%、94.74%和94.44%,影像学成功率分别为90%、89.47%和88.89%。结论:二极管激光联合MTA比单用MTA治疗有更好的临床和影像学成功率。
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