Clinical and Radiographic Assessments of Potassium Nitrate in Polycarboxylate Versus Mineral Trioxide Aggregate as Pulpotomy Biomaterials in Immature Mandibular First Permanent Molars

Summary

The purpose of this RCT is to compare the clinical/radiographic outcomes of Potassium nitrate in polycarboxylate cement and MTA as pulpotomy biomaterials used for asymptomatic vital immature permanent lower first molar and this will help to clinically evaluate the use of alternative capping material in vital pulpotomy in young permanent teeth with pathologic pulpal injuries emphasis is set on avoiding total pupectomy and maintaining radicular pulp vitality and function and therefore maintain the tooth in a viable condition that help root completion.

Timeline

Start

2017-06

Primary completion

2018-07

Completion

2018-08

Publications

• Background Ward J. Vital pulp therapy in cariously exposed permanent teeth and its limitations. Aust Endod J. 2002 Apr;28(1):29-37. doi: 10.1111/j.1747-4477.2002.tb00364.x.
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• Background Al-Hiyasat AS, Barrieshi-Nusair KM, Al-Omari MA. The radiographic outcomes of direct pulp-capping procedures performed by dental students: a retrospective study. J Am Dent Assoc. 2006 Dec;137(12):1699-705. doi: 10.14219/jada.archive.2006.0116.
• Background Caplan DJ, Cai J, Yin G, White BA. Root canal filled versus non-root canal filled teeth: a retrospective comparison of survival times. J Public Health Dent. 2005 Spring;65(2):90-6. doi: 10.1111/j.1752-7325.2005.tb02792.x.
• Background Ricketts D. Management of the deep carious lesion and the vital pulp dentine complex. Br Dent J. 2001 Dec 8;191(11):606-10. doi: 10.1038/sj.bdj.4801246.
• Background Stanley HR. Pulp capping: conserving the dental pulp--can it be done? Is it worth it? Oral Surg Oral Med Oral Pathol. 1989 Nov;68(5):628-39. doi: 10.1016/0030-4220(89)90252-1.
• Background Demarco FF, Rosa MS, Tarquinio SB, Piva E. Influence of the restoration quality on the success of pulpotomy treatment: a preliminary retrospective study. J Appl Oral Sci. 2005 Mar;13(1):72-7. doi: 10.1590/s1678-77572005000100015.
• Background Dammaschke T, Leidinger J, Schafer E. Long-term evaluation of direct pulp capping--treatment outcomes over an average period of 6.1 years. Clin Oral Investig. 2010 Oct;14(5):559-67. doi: 10.1007/s00784-009-0326-9. Epub 2009 Aug 15.
• Background Matsuo T, Nakanishi T, Shimizu H, Ebisu S. A clinical study of direct pulp capping applied to carious-exposed pulps. J Endod. 1996 Oct;22(10):551-6. doi: 10.1016/S0099-2399(96)80017-3.
• Background Mielke CH Jr, Kaneshiro MM, Maher IA, Weiner JM, Rapaport SI. The standardized normal Ivy bleeding time and its prolongation by aspirin. Blood. 1969;34(2):204-215. Blood. 2016 Aug 25;128(8):1023. doi: 10.1182/blood-2016-06-725127. No abstract available.
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• Background Schroder U. Effect of an extra-pulpal blood clot on healing following experimental pulpotomy and capping with calcium hydroxide. Odontol Revy. 1973;24(3):257-68. No abstract available.
• Background Lemon RR, Steele PJ, Jeansonne BG. Ferric sulfate hemostasis: effect on osseous wound healing. Left in situ for maximum exposure. J Endod. 1993 Apr;19(4):170-3. doi: 10.1016/s0099-2399(06)80681-3.
• Background Nosrat IV, Nosrat CA. Reparative hard tissue formation following calcium hydroxide application after partial pulpotomy in cariously exposed pulps of permanent teeth. Int Endod J. 1998 May;31(3):221-6. doi: 10.1046/j.1365-2591.1998.00147.x.
• Background Mass E, Zilberman U. Clinical and radiographic evaluation of partial pulpotomy in carious exposure of permanent molars. Pediatr Dent. 1993 Jul-Aug;15(4):257-9. No abstract available.
• Background Holland R, de Souza V, de Mello W, Nery MJ, Bernabe PF, Otoboni Filho JA. Permeability of the hard tissue bridge formed after pulpotomy with calcium hydroxide: a histologic study. J Am Dent Assoc. 1979 Sep;99(3):472-5. doi: 10.14219/jada.archive.1979.0317.
• Background Witherspoon DE. Vital pulp therapy with new materials: new directions and treatment perspectives--permanent teeth. J Endod. 2008 Jul;34(7 Suppl):S25-8. doi: 10.1016/j.joen.2008.02.030.
• Background Bakland LK, Andreasen JO. Will mineral trioxide aggregate replace calcium hydroxide in treating pulpal and periodontal healing complications subsequent to dental trauma? A review. Dent Traumatol. 2012 Feb;28(1):25-32. doi: 10.1111/j.1600-9657.2011.01049.x. Epub 2011 Sep 5.
• Background Parirokh M, Torabinejad M. Mineral trioxide aggregate: a comprehensive literature review--Part I: chemical, physical, and antibacterial properties. J Endod. 2010 Jan;36(1):16-27. doi: 10.1016/j.joen.2009.09.006.
• Background Barrieshi-Nusair KM, Qudeimat MA. A prospective clinical study of mineral trioxide aggregate for partial pulpotomy in cariously exposed permanent teeth. J Endod. 2006 Aug;32(8):731-5. doi: 10.1016/j.joen.2005.12.008. Epub 2006 Jun 23.
• Background Monteiro Bramante C, Demarchi AC, de Moraes IG, Bernadineli N, Garcia RB, Spangberg LS, Duarte MA. Presence of arsenic in different types of MTA and white and gray Portland cement. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2008 Dec;106(6):909-13. doi: 10.1016/j.tripleo.2008.07.018. Epub 2008 Oct 4.
• Background Santos AD, Moraes JC, Araujo EB, Yukimitu K, Valerio Filho WV. Physico-chemical properties of MTA and a novel experimental cement. Int Endod J. 2005 Jul;38(7):443-7. doi: 10.1111/j.1365-2591.2005.00963.x.
• Background Torabinejad M, Hong CU, McDonald F, Pitt Ford TR. Physical and chemical properties of a new root-end filling material. J Endod. 1995 Jul;21(7):349-53. doi: 10.1016/S0099-2399(06)80967-2.
• Background Belobrov I, Parashos P. Treatment of tooth discoloration after the use of white mineral trioxide aggregate. J Endod. 2011 Jul;37(7):1017-20. doi: 10.1016/j.joen.2011.04.003. Epub 2011 May 28.
• Background Tarbet WJ, Silverman G, Stolman JM, Fratarcangelo PA. Clinical evaluation of a new treatment for dentinal hypersensitivity. J Periodontol. 1980 Sep;51(9):535-40. doi: 10.1902/jop.1980.51.9.535.
• Background Hodosh M, Hodosh SH, Hodosh AJ. Maintenance of pulpal vitality using potassium nitrate-polycarboxylate cement cavity liner. Quintessence Int. 1991 Jun;22(6):495-502.
• Background Hodosh AJ, Hodosh S, Hodosh M. Potassium nitrate-zinc oxide eugenol temporary cement for provisional crowns to diminish postpreparation tooth pain. J Prosthet Dent. 1993 Dec;70(6):493-5. doi: 10.1016/0022-3913(93)90260-u.
• Background Hodosh M, Hodosh SH, Hodosh AJ. Capping carious exposed pulps with potassium nitrate, dimethyl isosorbide, polycarboxylate cement. Dent Today. 2003 Jan;22(1):46-51. No abstract available.
• Background Borissov, S. Tsanova, D. Sivrev. Tissue Response of Dental Pulp in Dogs Following Direct Capping With Potassium Nitrate in Polycarboxylate Cement. Bulgarian Journal of Veterinary Medicine. 2007;10:35-43
• Background Tsanova ST, Kundev KK. Dynamics of potassium and nitrate ions release from polycarboxylate cement with 5% KNO3. Folia Med (Plovdiv). 2000;42(2):61-4.
• Background Gudkina J, Mindere A, Locane G, Brinkmane A. Review of the success of pulp exposure treatment of cariously and traumatically exposed pulps in immature permanent incisors and molars. Stomatologija. 2012;14(3):71-80.
• Background Keswani D, Pandey RK, Ansari A, Gupta S. Comparative evaluation of platelet-rich fibrin and mineral trioxide aggregate as pulpotomy agents in permanent teeth with incomplete root development: a randomized controlled trial. J Endod. 2014 May;40(5):599-605. doi: 10.1016/j.joen.2014.01.009. Epub 2014 Mar 6.
• Background Ghoddusi J, Shahrami F, Alizadeh M, Kianoush K, Forghani M. Clinical and radiographic evaluation of vital pulp therapy in open apex teeth with MTA and ZOE. N Y State Dent J. 2012 Apr;78(3):34-8.
• Background El-Meligy OA, Avery DR. Comparison of mineral trioxide aggregate and calcium hydroxide as pulpotomy agents in young permanent teeth (apexogenesis). Pediatr Dent. 2006 Sep-Oct;28(5):399-404.
• Background Kamel M S, Ahmed G M, Yousef H A, AL-Mogy S A. An Improved Technique OF pulp capping by using the Metal Cap with Different Types of Materials. Cairo dental journal .2014;30:1955-1963.

Drugs

Indications