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03 April 2019

The evaluation of MTA and Biodentine as a pulpotomy materials for carious exposure in primary teeth

Lucia Sardi

The aim of the present study was to compare the long term clinical and radiographic success rates of Biodentine and MTA pulpotomies, performed on primary teeth with carious pulpal exposure.  

For the study, 44 mandibular primary vital molars requiring pulpotomy were selected. The inclusion criteria were the presence of carious dentin surrounding the site of pulpal exposure, spontaneous pain absence, no tenderness to percussion or palpation, no history of swelling or sinus tract, no radiographic sign of internal/external root resorption, no widened periodontal space, no furcal or periapical radiolucency and finally the possibility of a stainless steel crown restoration. 24 teeth were treated with MTA, and 20 teeth were treated with Biodentine. 
The children were recalled periodically for 2 years post treatment. At each follow-up visit, clinical and radiographic examinations were performed by two calibrated blinded examiners. The clinical success criteria were the absence of spontaneous pain, pathologic mobility, tenderness to percussion, swelling , fistula and gingival inflammation, whereas the absence of internal/ external root resorption and periapical/furcal radiolucency was considered as a radiographic success.

Clinical and radiographic success rates, after two follow up years, were 100% for MTA group and 89,4% for Biodentine group. The difference between the groups in the success rates wasn’t statistically significant (p=0,646).  

As Biodentine and MTA showed no statistically significant difference in the success rates when applied on the canal orifices during pulpotomy procedures, Authors concluded that the shorter setting time and the easier handling make Biodentine to be preferred to MTA. However, clinical trials with longer follow up periods are required before any conclusive recommendation could be made.  

As already stated and accepted, carious tissue around the site of exposure means pulpal contamination and inflammation, resulting in an uncertain and unpredictable prognosis for the treated teeth. MTA and Biodentine are expected to transform the inflammation process into a healing process due to their tricalcium silicate contents and their biointeractive properties. 

For additional informations: 
Çelik, B.N., Mutluay, M.S., Arıkan, V. et al. Clin Oral Invest (2019) Volume 23 Issue 2, pages 661-666 Published online 10th May 2018  

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