Success of an alternative for interim management of irreversible pulpitis.
BACKGROUND
Extraction and endodontic therapy are treatment options for irreversible pulpitis. Extraction often is chosen for financial reasons. The authors conducted a study to investigate an alternative interim therapy.


METHODS
The authors recruited patients (N = 73) with irreversible pulpitis and whose teeth were restorable but who opted for extraction owing to financial reasons. After undergoing pulpotomy, the teeth were restored by random assignment with one of two intermediate restorative materials: Caulk IRM (Dentsply Caulk, Milford, Del.) (Group I, n = 38) or an IRM base with glass ionomer core (Fuji IX GP, GC America, Alsip, Ill.) (Group II, n = 35). The authors monitored the teeth over six and 12 months for pain, integrity of restoration and radiographic periapical status by densitometric analysis.


RESULTS
By six months, 10 percent of subjects remaining in the study (Group I, n = 27; Group II, n = 25) reported pain; by 12 months, 22 percent (Group I, n = 22; Group II, n = 18) reported pain. A two-tailed Fisher exact test showed no significant difference (P > or = .05) between groups at either time interval. No apical radiographic change was noted in 49 percent of teeth at six months (Group I, n = 18; Group II, n = 19) and 42 percent at 12 months (Group I, n = 16; Group II, n = 15). Chi2 analysis demonstrated no significant differences (P > or = .05) between groups. Seven of 22 restorations in Group I and four of 18 in Group II required repair at 12 months with no statistical difference (chi2 analysis, P > or = .05).


CONCLUSIONS
The interim treatment of eugenol pulpotomy using either restorative material reliably prevented pain for six months. For longer periods, both restorations may require repair.


CONCLUSIONS
This option should preserve the integrity of the arch and extend the use of the tooth while the patient finds the means to finance complete endodontic treatment.
McDougal
Roger A
RA
Department of Endodontics, University of North Carolina at Chapel Hill School of Dentistry, USA.
Delano
E Olutayo
EO
Caplan
Dan
D
Sigurdsson
Asgeir
A
Trope
Martin
M
D015502:Absorptiometry, Photon; D000293:Adolescent; D000328:Adult; D000368:Aged; D003763:Dental Leakage / Q000145:classification; D003785:Dental Pulp Capping; D003794:Dental Restoration, Temporary; D005500:Follow-Up Studies; D005899:Glass Ionomer Cements / Q000627:therapeutic use; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008768:Methylmethacrylates / Q000627:therapeutic use; D008875:Middle Aged; D010147:Pain Measurement; D010486:Periapical Tissue / Q000000981:diagnostic imaging; D011671:Pulpitis / Q000628:therapy*; D011672:Pulpotomy; D012387:Root Canal Filling Materials / Q000627:therapeutic use; D016896:Treatment Outcome; D015035:Zinc Oxide-Eugenol Cement / Q000627:therapeutic use
C439808:Fuji IX GP Fast; D005899:Glass Ionomer Cements; D008768:Methylmethacrylates; D012387:Root Canal Filling Materials; D015035:Zinc Oxide-Eugenol Cement; C031667:IRM cement