Should pulp chamber pulpotomy be seen as a permanent treatment? Some preliminary thoughts.
OBJECTIVE
To investigate the benefits of pulpotomy (to the level of the floor of the pulp chamber) as an endodontic treatment for teeth with vital pulps.


METHODS
Seventeen patients, aged 7-54 years (mean of 37.2 year), were treated by pulpotomy and filling with ProRoot MTA(®)  in premolar or molar teeth with vital pulps and without clinical evidence of irreversible pulpitis. The patients were then followed up for 12 to 24 months and the teeth then assessed by clinical and radiographic examination. Statistical analysis was performed with Kaplan-Meier survival probability statistics to estimate the survival of the treated teeth.


RESULTS
At 24 months, the survival rate without any complementary treatment was estimated to be 82%. Two of the 17 treated teeth required root canal treatment for pain control and one for prosthetic reasons.


CONCLUSIONS
Under the conditions of this study, pulpotomy offered a viable alternative to root canal treatment for teeth with vital pulps in the short term. However, there is insufficient clinical evidence to consider this technique for the treatment of every permanent tooth. Nevertheless, it should be considered as a potential alternative approach to be further developed for future applications.
Centre de Recherche des Cordeliers, INSERM UMRS872 Eq.5, Paris, France. simon@univ-paris-diderot.fr
S
S
Simon
M
M
Perard
M
M
Zanini
A J
AJ
Smith
E
E
Charpentier
S X
SX
Djole
P J
PJ
Lumley
D000293:Adolescent; D000328:Adult; D017607:Aluminum Compounds / Q000627:therapeutic use; D001641:Bicuspid / Q000000981:diagnostic imaging / Q000473:pathology; D017610:Calcium Compounds / Q000627:therapeutic use; D002648:Child; D003188:Composite Resins / Q000737:chemistry; D003442:Crowns; D003731:Dental Caries / Q000628:therapy; D003764:Dental Materials / Q000737:chemistry; D003782:Dental Pulp / Q000000981:diagnostic imaging / Q000473:pathology; D003786:Dental Pulp Cavity / Q000000981:diagnostic imaging / Q000473:pathology; D003791:Dental Pulp Test; D004338:Drug Combinations; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007284:Inlays; D008297:Male; D008875:Middle Aged; D008963:Molar / Q000000981:diagnostic imaging / Q000473:pathology; D010087:Oxides / Q000627:therapeutic use; D010147:Pain Measurement; D011176:Post and Core Technique; D057872:Pulp Capping and Pulpectomy Agents / Q000627:therapeutic use; D011672:Pulpotomy / Q000379:methods*; D011859:Radiography; D017640:Silicates / Q000627:therapeutic use; D015996:Survival Rate; D055815:Young Adult
D017607:Aluminum Compounds; D017610:Calcium Compounds; D003188:Composite Resins; D003764:Dental Materials; D004338:Drug Combinations; D010087:Oxides; D057872:Pulp Capping and Pulpectomy Agents; D017640:Silicates; C086631:mineral trioxide aggregate