• Clin Oral Investig · Mar 2013

    Randomized Controlled Trial Multicenter Study Comparative Study

    One-year results of vital pulp therapy in permanent molars with irreversible pulpitis: an ongoing multicenter, randomized, non-inferiority clinical trial.

    • Saeed Asgary, Mohammad Jafar Eghbal, Jamileh Ghoddusi, and Shahram Yazdani.
    • Iranian Center for Endodontic Research, Shahid Beheshti University of Medical Sciences, Evin, 1983963113 Tehran, Iran. saasgary@yahoo.com
    • Clin Oral Investig. 2013 Mar 1; 17 (2): 431-9.

    ObjectivesRoot canal therapy (RCT) and tooth extraction have been conventional treatment options for management of human mature teeth with irreversible pulpitis. Excellent short-term treatment outcomes of vital pulp therapy with calcium-enriched mixture cement (VPT/CEM), as a new treatment option, on postoperative pain relief was demonstrated; if intermediate- and long-term treatment outcomes of the new treatment are also non-inferior compared to RCT, then VPT/CEM may become a viable treatment option for management of mature teeth with irreversible pulpitis.Materials And MethodsIn 23 healthcare centers, 407 9- to 65-year-old patients were randomly allocated into two study arms including one-visit RCT (reference treatment; n = 202) and VPT/CEM (alternative treatment; n = 205). Six- and twelve-month clinical and radiographic successes were assessed.ResultsMean follow-up times at 6- and 12-month follow-ups were "6.70 ± 0.68 and 6.72 ± 0.71 months" and "12.96 ± 0.67 and 12.90 ± 0.66 months" in the available cases of RCT and VPT/CEM arms, respectively. Favorable clinical success rates in the two study arms did not show statistical difference; however, the radiographic success rate in the VPT/CEM was significantly greater than RCT arm at the two follow-ups (P < 0.001). The patients' age had no effect on the treatment outcomes (P = 0.231).ConclusionsTreatment outcomes of VPT/CEM may be superior to RCT in mature molars with irreversible pulpitis. The performance of biomaterials such CEM cement may assist in the shift towards more biologic treatments.Clinical RelevanceVPT/CEM may be a realistic alternative treatment for human mature molar teeth with symptoms of irreversible pulpitis; the use of VPT/CEM is highly beneficial for patients as well as general dentists.

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