Direct Pulp Capping Versus Pulpotomy for Primary Molars

NCT06973057 — Not applicable, Enrolling by invitation, 60 participants, King Abdullah University Hospital

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Direct Pulp Capping Versus Pulpotomy Using Neo MTA for Carious Primary Molars: a Split Mouth Randomized Clinical Trial

RegistryNCT06973057, acronym MTA
StatusEnrolling by invitation
PhaseNot applicable
Study typeInterventional; randomized, parallel, masking: double, treatment
Enrollment60 (Estimated)
SponsorKing Abdullah University Hospital (Other); collaborators: Jordan University of Science and Technology
ConditionsVital Pulp Therapies
InterventionsPulpotomy, Direct pulp capping (DPC) (Procedure)
Datesstart 2023-10-01, primary completion 2026-12-01 (estimated), completion 2026-12-01 (estimated), first posted 2025-05-15, last updated 2025-05-15
Locations1 site in Jordan

Related Papers Related Patents Related Grants Related Experts
All trials for Vital Pulp Therapies All trials of Pulpotomy All trials of Direct pulp capping (DPC)

-Summary

Dental caries is one of the most prevalent chronic diseases worldwide. Interventions for treating deep carious lesions in teeth with no history of pain or teeth with reversible pulpitis are referred to as vital pulp therapy; these include indirect pulp treatment (IPC), direct pulp capping (DPC), and pulpotomy. Pulpotomy is considered invasive when treating exposed primary vital pulps due to caries. Less invasive vital pulp treatment methods such as DPC might, therefore, be preferable, as they reduce chair time, less tooth structure removal and a crown might not always be a necessary permanent restoration. The aim of this clinical study is to evaluate the clinical and radiographic outcomes of DPC when compared to pulpotomy in primary molars with carious pulp exposure.

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+Detailed description

Aim: The aim of this study is to evaluate the clinical and radiographic outcomes of direct pulp capping (DPC) when compared to pulpotomy in primary molars with carious pulp exposure using a calcium silicate-based material: neo mineral trioxide aggregate (Neo MTA).

Methods: The study will be a split mouth randomized clinical trial including children between 4-9 years old. Patients will be allocated into two treatment groups; one group will start with DPC first followed by pulpotomy on the second visit, and vice versa for the second group. The time interval between both visits will be 1-2 weeks. The pulp medicament capping material (neo MTA) will be applied over the exposure site, and then tooth will be restored with glass ionomer cement and then a crown will be placed. Cases will be followed up to 24 months after initial treatment.

+Arms and interventions

ArmTypeInterventionsDescription
PulpotomyActive comparatorProcedure: PulpotomyThe entire coronal pulp will be amputated.
Direct pulp cappingActive comparatorProcedure: Direct pulp capping (DPC)The exposure site will be left intact, no amputation of pulp tissue.
  • Pulpotomy (Procedure): The entire coronal pulp will be amputated to the level of canal orifices, after hemostasis, NeoMTA will be placed, then tooth will be restored with glass ionomer cement, and the tooth will be subsequently restored with a crown.
  • Direct pulp capping (DPC) (Procedure): At the exposure site hemostasis will be achieved, neo MTA will be placed, then tooth will be restored with glass ionomer cement, and the tooth will be subsequently restored with a crown.

+Outcome measures

Primary outcomes

  • Clinical success [24 months]: No post-treatment signs or symptoms such as sensitivity, pain, mobility or swelling should be evident.
  • Radiographic success [24 months]: No radiographic evidence of pathologic external or internal root resorption, periapical or furcation radiolucency.

+Eligibility

Sex: All, ages: 4 Years to 10 Years, accepts healthy volunteers

Inclusion Criteria:

* Healthy patients.
* Age 4-10 years.
* Primary molar with deep caries present bilaterally.
* Teeth should be restorable.
* Clinically normal asymptomatic tooth or symptoms of reversible pulpitis (No history of pain or provoked pain subsides upon removal of the stimulus).
* Radiographically: caries in the inner half of the dentin approaching the pulp.

Exclusion Criteria:

* History of spontaneous pain.
* Soft and hard tissue pathology.
* Mobility or exfoliating tooth.
* No pulp exposure after caries excavation.
* Inability to achieve hemostasis after 6 minutes.
* Radiographically: Root resorption exceeding 1/3 of the root, apical pathology.

+Locations (1)

FacilityCityCountryStatus
Jordan Univeristy of Science and TechnologyIrbidJordan

+Publications

  • Results publication: Dimitraki D, Papageorgiou SN, Kotsanos N. Direct pulp capping versus pulpotomy with MTA for carious primary molars: a randomised clinical trial. Eur Arch Paediatr Dent. 2019 Oct;20(5):431-440. doi: 10.1007/s40368-019-00419-7. Epub 2019 Feb 20. PMID 30788777
  • Results publication: Alsanouni M, Bawazir OA. A Randomized Clinical Trial of NeoMTA Plus in Primary Molar Pulpotomies. Pediatr Dent. 2019 Mar 15;41(2):107-111. PMID 30992107
  • Results publication: ElSebaai A, Wahba AH, Grawish ME, Elkalla IH. Calcium Hydroxide Paste, Mineral Trioxide Aggregate, and Formocresol as Direct Pulp Capping Agents in Primary Molars: A Randomized Controlled Clinical Trial. Pediatr Dent. 2022 Nov 15;44(6):411-417. PMID 36947754
  • Results publication: Chatzidimitriou K, Vadiakas G, Koletsi D. Direct pulp capping in asymptomatic carious primary molars using three different pulp capping materials: a prospective clinical trial. Eur Arch Paediatr Dent. 2022 Oct;23(5):803-811. doi: 10.1007/s40368-022-00720-y. Epub 2022 Jul 2. PMID 35780237
  • Results publication: Canoglu E, Gungor HC, Uysal S. Direct Pulp Capping of Primary Molars with Calcium Hydroxide or MTA Following Hemorrhage Control with Different Medicaments: Randomized Clinical Trial. Pediatr Dent. 2022 May 15;44(3):167-173. PMID 35799339

+Investigators

  • OLA Al-Batayneh, Principal investigator, Jordan University of Science and Technology