Partial pulpotomy on caries-free teeth using enamel matrix derivative or calcium hydroxide: a randomized controlled trial.
OBJECTIVE
To compare the effect of enamel matrix derivative (EMD) and calcium hydroxide [Ca(OH)(2)] on exposed human pulp.


METHODS
Fifteen pairs of human contralateral premolars were intentionally and partially pulpotomized. The exposed pulps were randomly capped with either EMDgel (Emdogain) or a mix of Ca(OH)(2) and sterile water. The subjects recorded pain or discomfort during the first 10 days and were also interviewed and examined by a blinded examiner at 1 day, 2 weeks, 3 and 6 months post-operation. Periapical radiographs were taken prior to the operation, and 3 and 6 months post-operation. After 6 months, the teeth were extracted and processed for histological evaluation. The data were described and analysed using McNemar test and Kaplan-Meier survival analysis.


RESULTS
The EMDgel-treated teeth had significantly less tooth hypersensitivity than the Ca(OH)(2)-treated teeth during the first 2 weeks (P = 0.031) but were not significantly different after 2 weeks (P = 0.125). No detectable periapical radiographic changes were observed in any teeth and radiographic evidence of dentine bridge formation from both groups were not significantly different during the follow-up periods (P > 0.05). Histological evaluation demonstrated that the Ca(OH)(2)-treated teeth had less inflammation and more dentine bridge formation than those in the EMDgel-treated teeth.


CONCLUSIONS
After 6 months, healthy pulps capped with Ca(OH)(2) had more favourable results than counterparts capped with EMDgel. However, similar clinical and radiographic results were seen in both groups.
Kiatwateeratana
T
T
Department of Preventive Dentistry, Faculty of Dentistry, Prince of Songkla University, Songkla, Thailand.
Kintarak
S
S
Piwat
S
S
Chankanka
O
O
Kamaolmatyakul
S
S
Thearmontree
A
A
D000293:Adolescent; D002126:Calcium Hydroxide / Q000627:therapeutic use*; D003746:Dental Enamel Proteins / Q000627:therapeutic use*; D003782:Dental Pulp / Q000187:drug effects* / Q000473:pathology; D003785:Dental Pulp Capping / Q000379:methods*; D003789:Dental Pulp Exposure / Q000628:therapy; D003793:Dental Restoration, Permanent; D003807:Dentin Sensitivity / Q000209:etiology; D003809:Dentin, Secondary / Q000000981:diagnostic imaging / Q000473:pathology; D005500:Follow-Up Studies; D005899:Glass Ionomer Cements / Q000737:chemistry; D006801:Humans; D008768:Methylmethacrylates / Q000627:therapeutic use; D010147:Pain Measurement; D010149:Postoperative Pain / Q000209:etiology; D011671:Pulpitis / Q000209:etiology / Q000473:pathology; D011672:Pulpotomy / Q000379:methods*; D016300:Radiography, Bitewing; D012117:Resins, Synthetic / Q000737:chemistry; D012387:Root Canal Filling Materials / Q000627:therapeutic use; D055815:Young Adult; D015035:Zinc Oxide-Eugenol Cement / Q000627:therapeutic use
D003746:Dental Enamel Proteins; C079765:Fuji II LC cement; C439808:Fuji IX GP Fast; D005899:Glass Ionomer Cements; D008768:Methylmethacrylates; D012117:Resins, Synthetic; D012387:Root Canal Filling Materials; D015035:Zinc Oxide-Eugenol Cement; C109069:enamel matrix proteins; C031667:IRM cement; D002126:Calcium Hydroxide