COMPARISON OF VITAL PULP THERAPY USING MINERAL TRIOXIDE AGGREGATE (MTA) VERSUS ONE-VISIT ROOT CANAL THERAPY ON POSTOPERATIVE PAIN RELIEF IN IRREVERSIBLE PULPITIS AMONG THE PATIENTS REPORTING TO THE MARGALLA DENTAL HOSPITAL, RAWALPINDI
Main Article Content
Keywords
Irreversible pulpitis, Mineral Trioxide Aggregate (MTA), postoperative pain relief, root canal therapy, Vital Pulp Therapy
Abstract
Objective: to compare vital pulp therapy using mineral trioxide aggregate (MTA) versus one-visit root canal therapy on postoperative pain relief in irreversible pulpitis among the patients reporting to the Margalla Dental Hospital, Rawalpindi
Materials and Methods: This cross-sectional study was conducted in the Operative Dentistry Department of Margalla Institute of Health Sciences, Rawalpindi (MIHS) during six months span from January 2024 to August 2024 by random sampling. The estimated sample size was 138 which was calculated from the previous study. Individuals with vital molar tooth (i.e. vitality test was conducted before anesthesia in particular radicular pulp bleeding after coronal pulp amputation was ascertained to be present), or reported with pain indicating irreversible pulpitis (i.e. a history of spontaneous pain lasting for few second to several hours exacerbation of pain by hot and cold fluids confirmed with hot or cold test, and radiating pain), had opted for extraction for pain relief, were between 9 and 50 years old, willing for follow-up visits, and to provide written informed consent were included in the study. While, individuals with moderate or severe marginal periodontitis, non-restorable tooth, fractured tooth, teeth with internal or external root resorption, prominent radiolucency at the periapical regions, or furcation, root canal calcification, active systemic disease, physical or mental disability, or pregnant or nursing were excluded. The questionnaire or Performa was filled out by the operator to record the pain intensity of the patient. The pain intensity was recorded before the procedure, 24 hours after the procedure, 72 hours after the procedure, and 1 week after the procedure and the data were analyzed by chi-square test was used to compare tooth-related variables and pain-related variables.
Results: This study compared the efficacy of a One-visit root canal and vital pulp therapy using MTA for postoperative pain relief in irreversible pulpitis. In this study, 50 patients were included out of which 11 presented with moderate pain 34 presented with severe pain, and 5 presented with unbearable pain. 25 went through the procedure of one-visit RCT and 25 went through vital pulp therapy. All patients were contacted after 24 hours to inquire about pain intensity among 25 patients who underwent one visit root canal 2 had no pain, 10 had mild pain, and 13 had moderate pain. And people who underwent VPT with MTA 2 had no pain, 22 had mild pain, and 1 had moderate pain. After that patients were contacted after 72 hours patients with one visit RCT 13 had no pain and 12 had mild pain. Patient with VPT with MTA 18 had no pain and 7 had mild pain. After one week all patients had no pain. Both procedures were effective in alleviating pain after one week but VPT with MTA showed an earlier response in alleviating pain.
Conclusion: In management of irreversible pulpitis vital pulp therapy is more effective alternative as compare to RCT.
Materials and Methods: This cross-sectional study was conducted in the Operative Dentistry Department of Margalla Institute of Health Sciences, Rawalpindi (MIHS) during six months span from January 2024 to August 2024 by random sampling. The estimated sample size was 138 which was calculated from the previous study. Individuals with vital molar tooth (i.e. vitality test was conducted before anesthesia in particular radicular pulp bleeding after coronal pulp amputation was ascertained to be present), or reported with pain indicating irreversible pulpitis (i.e. a history of spontaneous pain lasting for few second to several hours exacerbation of pain by hot and cold fluids confirmed with hot or cold test, and radiating pain), had opted for extraction for pain relief, were between 9 and 50 years old, willing for follow-up visits, and to provide written informed consent were included in the study. While, individuals with moderate or severe marginal periodontitis, non-restorable tooth, fractured tooth, teeth with internal or external root resorption, prominent radiolucency at the periapical regions, or furcation, root canal calcification, active systemic disease, physical or mental disability, or pregnant or nursing were excluded. The questionnaire or Performa was filled out by the operator to record the pain intensity of the patient. The pain intensity was recorded before the procedure, 24 hours after the procedure, 72 hours after the procedure, and 1 week after the procedure and the data were analyzed by chi-square test was used to compare tooth-related variables and pain-related variables.
Results: This study compared the efficacy of a One-visit root canal and vital pulp therapy using MTA for postoperative pain relief in irreversible pulpitis. In this study, 50 patients were included out of which 11 presented with moderate pain 34 presented with severe pain, and 5 presented with unbearable pain. 25 went through the procedure of one-visit RCT and 25 went through vital pulp therapy. All patients were contacted after 24 hours to inquire about pain intensity among 25 patients who underwent one visit root canal 2 had no pain, 10 had mild pain, and 13 had moderate pain. And people who underwent VPT with MTA 2 had no pain, 22 had mild pain, and 1 had moderate pain. After that patients were contacted after 72 hours patients with one visit RCT 13 had no pain and 12 had mild pain. Patient with VPT with MTA 18 had no pain and 7 had mild pain. After one week all patients had no pain. Both procedures were effective in alleviating pain after one week but VPT with MTA showed an earlier response in alleviating pain.
Conclusion: In management of irreversible pulpitis vital pulp therapy is more effective alternative as compare to RCT.
References
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8. Signor B, Kopper PMP, Aspesi M, Münchow EA, Scarparo RK. Postoperative pain after single-visit root canal treatment or vital pulp therapy: A systematic review and meta-analysis. The Journal of the American Dental Association. 2024;155(2):118-37. e1.
9. Asgary S, Eghbal MJ, Shahravan A, Saberi E, Baghban AA, Parhizkar A. Outcomes of root canal therapy or full pulpotomy using two endodontic biomaterials in mature permanent teeth: a randomized controlled trial. Clinical oral investigations. 2022;26(3):3287-97.
10. Lin LM, Ricucci D, Saoud TM, Sigurdsson A, Kahler B. Vital pulp therapy of mature permanent teeth with irreversible pulpitis from the perspective of pulp biology. Australian Endodontic Journal. 2020;46(1):154-66.
11. Eghbal MJ, Haeri A, Shahravan A, Kazemi A, Moazami F, Mozayeni MA, et al. Postendodontic pain after pulpotomy or root canal treatment in mature teeth with carious pulp exposure: a multicenter randomized controlled trial. Pain Research and Management. 2020;2020(1):5853412.
12. Krastl G, Galler K, Dammaschke T, Schäfer E. Is pulpotomy a valid treatment option for irreversible pulpitis. Dtsch Zahnärztl Z Int. 2021;3:80-7.
13. Taha NA, Abuzaid AM, Khader YS. A randomized controlled clinical trial of pulpotomy versus root canal therapy in mature teeth with irreversible pulpitis: Outcome, quality of life, and patients’ satisfaction. Journal of Endodontics. 2023;49(6):624-31. e2.
14. Asgary S, Eghbal MJ, Ghoddusi J. Two-year results of vital pulp therapy in permanent molars with irreversible pulpitis: an ongoing multicenter randomized clinical trial. Clinical oral investigations. 2014;18:635-41.
15. Li Y, Sui B, Dahl C, Bergeron B, Shipman P, Niu L, et al. Pulpotomy for carious pulp exposures in permanent teeth: A systematic review and meta-analysis. Journal of dentistry. 2019;84:1-8.
16. Cintra LTA, Benetti F, de Azevedo Queiroz ÍO, de Araújo Lopes JM, de Oliveira SHP, Araújo GS, et al. Cytotoxicity, biocompatibility, and biomineralization of the new high-plasticity MTA material. Journal of endodontics. 2017;43(5):774-8.
17. Guan X, Zhou Y, Yang Q, Zhu T, Chen X, Deng S, et al. Vital pulp therapy in permanent teeth with irreversible pulpitis caused by caries: a prospective cohort study. Journal of Personalized Medicine. 2021;11(11):1125.
18. da Silva AN, Vettore M. Sense of coherence modifies the association between untreated dental caries and dental pain in low-social status women. Community Dent Health. 2016;33(1):54-60.
19. Linas N, Decerle N, Munoz-Sanchez M-L, Faulks D, Collado V, Nicolas E, et al. Long-term outcomes of full pulpotomy in permanent molars for patients treated in a single, short session under special conditions. Journal of Endodontics. 2020;46(11):1597-604.
2. Careddu R, Duncan HF. A prospective clinical study investigating the effectiveness of partial pulpotomy after relating preoperative symptoms to a new and established classification of pulpitis. International Endodontic Journal. 2021;54(12):2156-72.
3. Azuara-Blanco A, Burr J, Ramsay C, Cooper D, Foster PJ, Friedman DS, et al. Effectiveness of early lens extraction for the treatment of primary angle-closure glaucoma (EAGLE): a randomised controlled trial. The Lancet. 2016;388(10052):1389-97.
4. Ricucci D, Siqueira Jr JF, Li Y, Tay FR. Vital pulp therapy: histopathology and histobacteriology-based guidelines to treat teeth with deep caries and pulp exposure. Journal of dentistry. 2019;86:41-52.
5. Camilleri J. Endodontic materials in clinical practice: Wiley Online Library; 2021.
6. Kahler B, Taha N, Lu J, Saoud T. Vital pulp therapy for permanent teeth with diagnosis of irreversible pulpitis: Biological basis and outcome. Australian dental journal. 2023;68:S110-S22.
7. Singh DVV, Taneja S, Fatima S. Comparative evaluation of treatment outcome of partial pulpotomy using different agents in permanent teeth—a randomized controlled trial. Clinical Oral Investigations. 2023;27(9):5171-80.
8. Signor B, Kopper PMP, Aspesi M, Münchow EA, Scarparo RK. Postoperative pain after single-visit root canal treatment or vital pulp therapy: A systematic review and meta-analysis. The Journal of the American Dental Association. 2024;155(2):118-37. e1.
9. Asgary S, Eghbal MJ, Shahravan A, Saberi E, Baghban AA, Parhizkar A. Outcomes of root canal therapy or full pulpotomy using two endodontic biomaterials in mature permanent teeth: a randomized controlled trial. Clinical oral investigations. 2022;26(3):3287-97.
10. Lin LM, Ricucci D, Saoud TM, Sigurdsson A, Kahler B. Vital pulp therapy of mature permanent teeth with irreversible pulpitis from the perspective of pulp biology. Australian Endodontic Journal. 2020;46(1):154-66.
11. Eghbal MJ, Haeri A, Shahravan A, Kazemi A, Moazami F, Mozayeni MA, et al. Postendodontic pain after pulpotomy or root canal treatment in mature teeth with carious pulp exposure: a multicenter randomized controlled trial. Pain Research and Management. 2020;2020(1):5853412.
12. Krastl G, Galler K, Dammaschke T, Schäfer E. Is pulpotomy a valid treatment option for irreversible pulpitis. Dtsch Zahnärztl Z Int. 2021;3:80-7.
13. Taha NA, Abuzaid AM, Khader YS. A randomized controlled clinical trial of pulpotomy versus root canal therapy in mature teeth with irreversible pulpitis: Outcome, quality of life, and patients’ satisfaction. Journal of Endodontics. 2023;49(6):624-31. e2.
14. Asgary S, Eghbal MJ, Ghoddusi J. Two-year results of vital pulp therapy in permanent molars with irreversible pulpitis: an ongoing multicenter randomized clinical trial. Clinical oral investigations. 2014;18:635-41.
15. Li Y, Sui B, Dahl C, Bergeron B, Shipman P, Niu L, et al. Pulpotomy for carious pulp exposures in permanent teeth: A systematic review and meta-analysis. Journal of dentistry. 2019;84:1-8.
16. Cintra LTA, Benetti F, de Azevedo Queiroz ÍO, de Araújo Lopes JM, de Oliveira SHP, Araújo GS, et al. Cytotoxicity, biocompatibility, and biomineralization of the new high-plasticity MTA material. Journal of endodontics. 2017;43(5):774-8.
17. Guan X, Zhou Y, Yang Q, Zhu T, Chen X, Deng S, et al. Vital pulp therapy in permanent teeth with irreversible pulpitis caused by caries: a prospective cohort study. Journal of Personalized Medicine. 2021;11(11):1125.
18. da Silva AN, Vettore M. Sense of coherence modifies the association between untreated dental caries and dental pain in low-social status women. Community Dent Health. 2016;33(1):54-60.
19. Linas N, Decerle N, Munoz-Sanchez M-L, Faulks D, Collado V, Nicolas E, et al. Long-term outcomes of full pulpotomy in permanent molars for patients treated in a single, short session under special conditions. Journal of Endodontics. 2020;46(11):1597-604.
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Published
Dec 02, 2024
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How to Cite
Sana Jalil Hasan, Basima Khan, Lubna Pasha, M Saad Saqib, Ayesha Fazal, & Sana Amjad. (2024). COMPARISON OF VITAL PULP THERAPY USING MINERAL TRIOXIDE AGGREGATE (MTA) VERSUS ONE-VISIT ROOT CANAL THERAPY ON POSTOPERATIVE PAIN RELIEF IN IRREVERSIBLE PULPITIS AMONG THE PATIENTS REPORTING TO THE MARGALLA DENTAL HOSPITAL, RAWALPINDI. Journal of Population Therapeutics and Clinical Pharmacology, 31(11), 1777-1784. https://doi.org/10.53555/vb778c54
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Author Biographies
Sana Jalil Hasan
B.D.S, FCPS Operative Dentistry, CHPE; Assistant Professor, Operative Dentistry and Endodontics; Margalla Institute of Health Sciences, Rawalpindi, Pakistan
Basima Khan
B.D.S; Demonstrator, General Pathology; Margalla Institute of Health Sciences, Rawalpindi, Pakistan
Lubna Pasha
B.D.S, FCPS Operative Dentistry, ACMed; Professor and HOD, Operative Dentistry and Endodontics; Margalla Institute of Health Sciences, Rawalpindi, Pakistan
M Saad Saqib
B.D.S, FCPS Trainee, CHPE, (FCPS Oral & Maxillofacial Surgery), Foundation University College of Dentistry & Hospital, Islamabad, Pakistan
Ayesha Fazal
B.D.S, MSPH, MHPE; Demonstrator; Department of Dental Education, School of Dentistry, Shaheed Zulfiqar Ali Bhutto Medical University, Islamabad, Pakistan
Sana Amjad
B.D.S, Demonstrator; Department of Oral Medicine, Margalla Institute of Health Sciences, Rawalpindi, Pakistan
How to Cite
Sana Jalil Hasan, Basima Khan, Lubna Pasha, M Saad Saqib, Ayesha Fazal, & Sana Amjad. (2024). COMPARISON OF VITAL PULP THERAPY USING MINERAL TRIOXIDE AGGREGATE (MTA) VERSUS ONE-VISIT ROOT CANAL THERAPY ON POSTOPERATIVE PAIN RELIEF IN IRREVERSIBLE PULPITIS AMONG THE PATIENTS REPORTING TO THE MARGALLA DENTAL HOSPITAL, RAWALPINDI. Journal of Population Therapeutics and Clinical Pharmacology, 31(11), 1777-1784. https://doi.org/10.53555/vb778c54