Résumé
Background and Purpose: Microbial, physical and chemical irritants may lead to dental pulp inflammation. For irreversible pulpitis, root canal therapy is the only option. In these situations, vital pulp therapy is usually uncomplicated and inexpensive. The main aim of the present study was comparing three different treatments of dental pulp inflammation, including root canal therapy and pulpotomy. Since there were missing data in the 6 and 12 months follow-ups, the missing mechanism was considered in data analysis process
Methods and Materials: In this clinical trial, 615 patients were randomly allocated into three arms: RCT [n=203], pulpotomy with CEM cement [n=205], and with MTA [n=207]. The presence of periapical lesion in the baseline, 6th and 12th month was assessed radiographically. After evaluating the mechanism of the missing data, weighted generalized estimating equations [WGEE] methodology was utilized for the analysis of data. To do this, the SAS software, version 9.1 was used
Results: The success rate of pulpotomy with MTA in 6 and 12 months follow-up was 96% and 95%, respectively. These rates were 92% and 93% for pulpotomy with CEM. Additionally, the success rate of root canal therapy was 78% and 82% in the above mentioned follow-up periods respectively, which indicate the significant superiority of pulpotomy with MTA and CEM over RCT [P<0.05]; but no significant difference was found between MTA and CEM success rates. Presence rate of periapical lesion were 8%, 4% and 22% of CEM, MTA and RCT groups, respectively, in six months follow-up. These figures were 7%, 5% and 18% respectively, in one-year follow-up; however, no significant difference was observed between the two pulpotomy methods, but the difference was significant for pulpotomy techniques and RCT [P<0.05]. Also, the effect of age and sex on periapical lesion were not significant [P>0.05]
Conclusion: Results of multiple statistical modeling on comparing the success rate of three therapies indicated that pulpotomy using two biomaterials [CEM and MTA] seems to be more successful than the traditional RCT