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Partial pulpotomy on caries-free teeth using enamel matrix derivative or calcium hydroxide: a randomized controlled
T Kiatwateeratana1, S Kintarak, S Piwat
1Department of Preventive Dentistry, Faculty of Dentistry, Prince of Songkla University, Songkla, Thailand.
Aim:
To compare the effect of enamel matrix derivative (EMD) and calcium hydroxide [Ca(OH)(2)] on exposed human pulp.
Methodology:
Fifteen pairs of human contralateral premolars were intentionally and partially pulpotomized. The exposed pulps were randomly capped with either EMDgel (Emdogain) or a mix of Ca(OH)(2) and sterile water. The subjects recorded pain or discomfort during the first 10 days and were also interviewed and examined by a blinded examiner at 1 day, 2 weeks, 3 and 6 months post-operation. Periapical radiographs were taken prior to the operation, and 3 and 6 months post-operation. After 6 months, the teeth were extracted and processed for histological evaluation. The data were described and analysed using McNemar test and Kaplan-Meier survival analysis.
Results:
The EMDgel-treated teeth had significantly less tooth hypersensitivity than the Ca(OH)(2)-treated teeth during the first 2 weeks (P = 0.031) but were not significantly different after 2 weeks (P = 0.125). No detectable periapical radiographic changes were observed in any teeth and radiographic evidence of dentine bridge formation from both groups were not significantly different during the follow-up periods (P > 0.05). Histological evaluation demonstrated that the Ca(OH)(2)-treated teeth had less inflammation and more dentine bridge formation than those in the EMDgel-treated teeth.
Conclusions:
After 6 months, healthy pulps capped with Ca(OH)(2) had more favourable results than counterparts capped with EMDgel. However, similar clinical and radiographic results were seen in both groups.