Observation of clinical effect of vital pulpotomy in carious pulp-exposed mature permanent teeth
Objective:To observe the clinical efficacy of pulpotomy in caries exposed pulps of mature permanent teeth,and to compare partial pulpotomy(PP)with full pulpotomy(FP)and root canal treatment(RCT)for pain control effect,clinical success rate and dental function.Methods:Ninety carious pulp exposed mature permanent teeth from 90 patients treated in the Stomatology department of the author's hospital were selected and divided into three groups according to differ-ent treatment measures.Partial coronal pulp was removed during the operation,and fresh pulp section was observed.If hemo-stasis could be achieved within 5 minutes,MTA partial pulpotomy(PP group)was performed.Otherwise,all coronal pulp could be removed to the root canal and hemostasis could be achieved within 5 minutes,MTA full pulpoctomy was performed(FP group).And root canal therapy(RCT group)was performed if hemostasis was not effective.Visual analogue scale(VAS)was used to evaluate the pain of the affected teeth 24,48 and 72 hours after surgery,and the effect of the three treatment methods was compared.Results:The pain score of PP group and FP group decreased gradually with time(P<0.01),and compared with preoperative conditions,the VAS of the three groups significantly decreased at 72 hours after surgery(P<0.01).Compared at the same time point,there were no statistically significant differences in pain scores among the three groups before surgery and 24 hours after surgery(P>0.05).There were no statistically significant differences in pain scores between the PP group and FP group at 48 and 72 hours after surgery(P>0.05),but the pain scores of the PP group and FP group were lower than those of the RCT group,and the differences were statistically significant(P<0.01).There was no sig-nificant difference in the success rate of patients with teeth at 1,3,6 and 12 months among three groups(P>0.05).At 12 months after surgery,there was no significant difference in dental comfort,chewing,stability and language function among three groups(P>0.05).Conclusion:Partial pulpotomy and full pulpotomy are effective in the treatment of mature teeth with caries derived pulp exposure.Compared with root canal therapy,it is more effective in postoperative pain control and can im-prove the long-term curative effect.It is a suitable treatment for mature teeth with caries derived pulp exposure.
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