Efficacy of PRF and MTA as Compared to Calcium Hydroxide for Pulpotomy in Human Irreversibly Inflamed Permanent Teeth

Liaquat College of Medicine and Dentistry114 enrolled

Overview

Of all the various pulpotomy medicaments that have been studied till to date, three agents have been selected for this study to compare their efficacy. CH being the control, MTA being one of the most recommended biomaterial and PRF that in addition to being a biomaterial is an autologous agent. Uptil now there have been no prospective trials using these three pulpotomy agents in mature permanent teeth with irreversible pulpitis in our part of the world and even the international studies that have been done utilized different methodologies with no unanimous conclusion. This is the reason that at present this treatment regime (pulpotomy) showing better perspectives cannot be presented with confidence as a predictable treatment option to the patients with irreversible pulpitis. By virtue of this study this challenge is being undertaken. Hypothesis: ALTERNATE HYPOTHESIS There is a difference between the efficacy of the PRF, MTA and CH when used as pulpotomy medicaments in mature permanent teeth with irreversible pulpitis NULL HPOTHESIS There is no difference in efficacy of the PRF, MTA and CH when used as pulpotomy medicaments in mature permanent teeth with irreversible pulpitis

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

DOUBLE

Enrollment

114

Conditions

Pulpitis - Irreversible Tooth Decay

Interventions

Calcium hydroxideOTHER

Calcium hydroxide in the power/liquid form will be used and placed on the exposed pulp

MTAOTHER

Mineral trioxide aggregate will be used as a powder / liquid form and placed over the exposed pulp

PRFOTHER

PRF will be placed directly over the exposed pulp

Eligibility

Sex: ALLMin age: 10 YearsMax age: 70 YearsHealthy volunteers:

Medical Language ↔ Plain English

Inclusion Criteria: * Patients with permanent teeth with completely formed roots diagnosed with irreversible pulpitis i.e. showing signs and symptoms as spontaneous, lingering pain initiated by hot and cold stimulus and /or radiating. Pulp being exposed or near to exposure by caries or alternatively by trauma. Exclusion Criteria: * CLINICALLY Teeth with * Necrotic pulp * History of swelling, abscess , fistula and/ or sinus tract * Doubtful restorability as indicated by over all Dental Practicality Index- (DPI) \> 2 (Dawood and Patel 2017) will be excluded * Periodontal disease * Uncontrolled bleeding (more that 10 mins.) of pulp after removal of inflamed part. * No bleeding of pulp at all after access into pulp RADIOGRAPHICALLY (with the use of periapical radiographs) Teeth with * Internal/ external pathologic root resorption * Pulp canal obliteration * Periapical / furcal radiolucency * Resorbed roots. * Crestal bone loss Generally patients * With systemic diseases, bleeding disorders, physical or mental disability, pregnant or nursing. * On opioid or steroid therapy or anticoagulants and/or on any kind of antibiotics. * Who have gone through some previous treatment for the same tooth other than filling.

Outcomes

Primary Outcomes

Clinical Success or Failure

Incidence of pain, swelling, sinus tract formation, tenderness to percussion after specified time period after intervention

Time frame: 12 months

Radiographic Success or Failure

Incidence of Periapical radiolucency or widening and Resorption