Outcome of Pulpotomy Versus Root Canal Therapy

Permanent molar teeth with carious pulp exposure and mature roots as evident on the preoperative periapical radiograph will be included in the study. The teeth will be randomly divided into 2 groups (n=30). The first group will be treated with Biodentine full pulpotomy and the second group will be endodontically treated. Based on a previously validated questionnaire. The quality of life and satisfaction of patients after pulpotomy treatment will be evaluated compared to those after endodontic treatment. Clinical and radiographic assessment of the treated teeth will be done 3, 6 and 12 months postoperatively. Pain level will be recorded preoperatively and 1, 2, 3, 5 and 7 days after treatment.

The questionnaire consists of five components:

1. Characteristics of the patient; including age, gender, socioeconomic status, smoking, oral hygiene practices, frequency of dental visits, and dental history.
2. Postoperative complications including postoperative pain, discomfort,or swelling.

These symptoms will be evaluated after 1, 2, 3,5 and 7 days by contacting the patient on the phone and at follow up visits at 3, 6, and 12 months.
3. Quality of life instruments designed
4. Semantic scales designed to evaluate patient satisfaction with the treatment received.

Clinical and radiographic assessment of the treated teeth will be recorded. Success will be defined as clinically asymptomatic tooth with no sinus tract or swelling or periapical lesion.

Data will be analysed statistically using appropriate tests based on the distribution of the results.

• Non surgical root canal treatment (Procedure): Complete root canal treatment will be performed followed by direct restoration
• Pulpotomy (Procedure): Full pulpotomy followed by direct restoration

Primary outcomes

• Post operative pain level on numerical pain scale [7 days]: Pain level after treatment will be assessed on a numerical scale from 0-10 where is zero refer to no pain and 10 is the most sever pain.
• Post operative pain level on visual analogue scale [7 days]: Pain level after treatment will be assessed on a visual analogy scale from 0-10, where is zero refer to no pain and 10 is the most sever pain.

Secondary outcomes

• Clinical success [6, 12, 24, 48 months]: The tooth should be pain free, no sinus tract, no tenderness to palpation and no swelling. As measured by clinical examination
• Radiographic success [6, 12, 24, 48 months]: Periapical x-ray will be taken it should show no bone lesions or root resorption

Other outcomes

• The quality of life questionnaire [6,12, 24, 48 months]: A questionnaire validated previously by Dugas et al 2002 will be used to assess Quality of life

Sex: All, ages: 9 Years to 70 Years, accepts healthy volunteers

Inclusion Criteria:

* Medically fit patient
* mature permanent tooth with deep caries
* diagnosis of irreversible pulpits.
* tooth is restored with a direct restoration

Exclusion Criteria:

* immature teeth
* teeth were hemostasis cannot be achieved after pulpotomy
* necrotic teeth
* lack of response to cold test

• Results publication: Taha NA, About I, Sedgley CM, Messer HH. Conservative Management of Mature Permanent Teeth with Carious Pulp Exposure. J Endod. 2020 Sep;46(9S):S33-S41. doi: 10.1016/j.joen.2020.06.025. PMID 32950193

• Nessrin Taha, PhD, Principal investigator, Jordan University of Science and Technology