Long-term radiologic pulp evaluation after partial pulpotomy in young permanent molars

Quintessence Int. 2011 Jul-Aug;42(7):547-54.

Abstract

Objective: Radiographic appearance of pulp reactions to partial pulpotomy in young permanent molars with deep caries may determine the efficiency of the procedure. The objective of this study was to determine the value of this procedure by analyzing the pulpal and periapical appearance of permanent molars after long-term follow-up periods.

Method and materials: Based on predetermined radiologic criteria, periapical radiographs of 49 young permanent molars of 31 females and 13 males, aged 6.9 to 17.7 years (mean, 11.4 years) treated with partial pulpotomy were evaluated and compared to their antimeres. Follow-up time ranged from 7 to 154 months (mean, 49 months).

Results: Based on clinical and radiographic findings, the success rate was considered 93.9% (46 of 49 teeth). Three teeth had chronic pulpitis with periapical exacerbation. In 14 (30.4%) of the 46 teeth, normal radiographic pulp appearance was found, and in 2 (4.3%), pulpal calcifications were similar to their antimere tooth. Dentinal bridges were observed underneath the partial pulpotomy site in 27 molars (58.7%), while radiopacities in the pulpotomized pulp horns of 5 teeth (10.9%) suggested development of obstructive calcifications. Increased calcifications of the pulp were seen in 13 (28.3%) molars, in comparison with their antimeres. Six of the 46 molars with immature root development completed full apexogenesis. No periapical pathoses, total pulp obliteration, or resorption were observed.

Conclusion: The long-term radiologic interpretation of the pulp after partial pulpotomy in young permanent molars supports the clinical impression that it is a warranted treatment in well-chosen cases.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Apexification
  • Calcium Hydroxide / therapeutic use
  • Child
  • Dental Caries / therapy
  • Dental Pulp / diagnostic imaging*
  • Dental Pulp Calcification / diagnostic imaging
  • Dental Pulp Exposure / therapy
  • Dentin, Secondary / diagnostic imaging
  • Female
  • Follow-Up Studies
  • Glass Ionomer Cements / therapeutic use
  • Humans
  • Longitudinal Studies
  • Male
  • Methylmethacrylates / therapeutic use
  • Molar / diagnostic imaging*
  • Molar / surgery
  • Odontogenesis / physiology
  • Periapical Diseases / diagnostic imaging
  • Periapical Tissue / diagnostic imaging
  • Pulpitis / diagnostic imaging
  • Pulpotomy / methods*
  • Radiography
  • Root Canal Filling Materials / therapeutic use
  • Tooth Root / physiology
  • Treatment Outcome
  • Zinc Oxide-Eugenol Cement / therapeutic use

Substances

  • Glass Ionomer Cements
  • Methylmethacrylates
  • Root Canal Filling Materials
  • Zinc Oxide-Eugenol Cement
  • Vitrabond
  • IRM cement
  • Calcium Hydroxide