Mineral trioxide aggregate produces superior outcomes in vital primary molar pulpotomy

Abstract

Purpose: The purpose of this study was to investigate the outcomes of vital primary molar pulpotomy when there is no direct contact between eugenol and the vital pulp. Four pulpotomy techniques were compared: (1) ferric sulfate (FS) pulpotomy; (2) eugenol-free FS pulpotomy; (3) mineral trioxide aggregate (MTA) pulpotomy; and (4) FS/MTA pulpotomy.

Methods: The pulpotomy technique assigned to each molar was determined by random selection. Two blinded, disinterested raters classified each molar into 1 of 3 radiographic outcomes: (1) N=normal molar without pathologic change; (2) Po=pathologic change present, follow-up recommended; (3) Px=pathologic change present, extract.

Results: A total of 92 patients with 227 pulpotomy-treated molars returned for at least 1 recall examination. Median follow-up for molars was 24 months (range=12-38 months). MTA molars demonstrated significantly fewer Px radiographic outcomes than FS molars (P=.002, chi-square test). Eugenol-free FS molars demonstrated significantly more Px radiographic outcomes than MTA (P<.001, chi-square test) or FS/MTA (P=.002, chi-square test) molars. Significantly lower survival was demonstrated for eugenol-free FS molars compared to MTA molars (P=.02, log-rank test) over 6 to 38 months.

Conclusions: Outcomes for mineral trioxide aggregate pulpotomy were superior to ferric sulfate and eugenol-free ferric sulfate pulpotomy after a median follow-up of 2 years.