Full pulpotomy using calcium silicate promising for treating adults with irreversible pulpitis
China: A recent study has shown full pulpotomy using a calcium silicate-based bioactive ceramic to be a successful option for treating irreversible pulpitis. This condition affects the dental pulp of adult permanent teeth. The findings were published in The Journal Of The American Dental Association on April 28, 2023.
The study investigated the use of a calcium silicate-based bioactive ceramic in a procedure called full pulpotomy, which involves the removal of the infected pulp tissue and placing the ceramic material to promote healing.
The study by a team of researchers led by Xiaomiao Zhu included 78 patients aged 18 to 72 years, with 81 adult permanent teeth exhibiting symptoms of irreversible pulpitis. Following the removal of caries, the infected pulp tissue was amputated to the level of the canal orifices. Hemostasis was achieved, and the calcium silicate-based bioactive ceramic was placed as a capping agent. After two weeks, The treated teeth were temporarily sealed and restored with resin materials, provided no positive symptoms were reported or detected.
● Over 12 months, the patients underwent regular follow-up examinations to evaluate the procedure's success.
● Clinical and radiographic examinations were performed at 2 weeks and 3, 6, and 12 months to assess the outcomes.
● The results showed high success rates, with 96.3% of cases deemed successful at the 2-week follow-up.
● The success rates remained consistently high at the subsequent recall visits, with rates of 93.8%, 92.6%, and 92.6% at three, six, and 12 months, respectively.
While most cases demonstrated successful outcomes, six out of the 81 teeth required additional root canal therapy due to treatment failure. These cases presented severe cold stimuli pain, spontaneous pain, no response to electric pulp testing with apical percussion pain, periapical rarefaction, and labial mucosal fistula.
Based on the study's findings, the researchers concluded that full pulpotomy using a calcium silicate-based bioactive ceramic is an effective treatment option for adult permanent teeth with carious-originated symptoms indicative of irreversible pulpitis. The success rates observed in this study indicate that vital pulp therapy, which aims to preserve the health and function of the dental pulp, is now a viable option for adult patients suffering from this condition
These findings have practical implications for dental practitioners and patients alike. The availability of an effective treatment option for irreversible pulpitis in adult teeth can help preserve natural teeth, avoiding the need for more invasive procedures such as root canal therapy or tooth extraction. This development represents a significant advancement in dental care, providing new hope and improved outcomes for patients experiencing dental pain and discomfort.
Further research and clinical trials are warranted to confirm and expand upon these findings, paving the way for enhanced treatment approaches and improved quality of life for individuals affected by irreversible pulpitis.
Reference: Zhu, X., Zhang, Y., Wang, J., Wang, Z., Wang, X., Liu, X., Cooper, P. R., Cheng, X., & He, W. (2023). Effect of full pulpotomy using a calcium silicate-based bioactive ceramic in adult permanent teeth with symptoms indicative of irreversible pulpitis: A retrospective study. Journal of the American Dental Association (1939), 154(6), 486–494. https://doi.org/10.1016/j.adaj.2023.02.018
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