Outcome of full pulpotomy using Biodentine in adult patients with symptoms indicative of irreversible pulpitis

Abstract

Aim

To assess the outcome of full pulpotomy using Biodentine in permanent teeth with carious exposures and symptoms indicative of irreversible pulpitis.

Methodology

Sixty-four permanent molar teeth with symptomatic vital pulps in 52 patients aged 19-69 years were included. Preoperative pulpal and periapical diagnosis was established. After informed consent the tooth was anaesthetized, isolated using rubber dam and disinfected with 5% NaOCl before caries excavation; subsequently the pulp was amputated to the level of the canal orifices. Haemostasis was achieved and a 3 mm layer of Biodentine (Septodont, Saint-Maur-des-Fosses, France) was placed as the pulpotomy agent. Resin modified glass ionomer liner was placed and the tooth restored with either resin composite or amalgam, and a postoperative periapical radiograph exposed. Clinical and radiographic evaluation was completed at 6 months and 1 year postoperatively. Pain levels were scored preoperatively and 2 days post treatment.

Results

Clinical signs and symptoms indicative of irreversible pulpitis were established in all teeth, and periapical rarefaction was present in 9 teeth. After 2 days 93.8% reported complete relief of pain. At 6 months 63/64 attended recall with 98.4% clinical and radiographic success. At 1 year 59/63 attended recall, with 100% clinical and 98.4 radiographic success. Seven out of eight cases with periapical rarefaction who attended recall had improvement in the periapical index (PAI) score. A hard tissue barrier was detected radiographically in 4 cases.

Conclusion

Full pulpotomy using Biodentine was a successful treatment option for cariously exposed pulps in mature permanent molar teeth with clinical signs and symptoms indicative of irreversible pulpitis, up to one year.

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