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Partial versus Full Pulpotomy in Primary Molars: 12-Month Clinical and Radiographic Outcomes of a Split-Mouth
Thikrayat Bani-Hani1, Mays M Saleh2, Suhad Al-Jundi1
1Division of Pediatric Dentistry, Preventive Dentistry Department, Faculty of Dentistry, Jordan University of Science and Technology, P.O.Box 3030, Irbid 22110, Jordan.
Background/Aim:
Full pulpotomy is the established treatment for cariously exposed primary molars, but interest in partial pulpotomy has recently increased. Comparison of both in primary molars remains limited. This study's aim was to compare success of partial and full pulpotomy in primary molars and evaluate factors influencing treatment outcomes.
Materials And Methods:
A split-mouth randomized clinical trial involving 4-to-8- year-old children with pair-matched deeply carious primary molars indicated for pulpotomy. Teeth were randomly assigned to receive either partial or full pulpotomy using MTA. Clinical and radiographic evaluations were conducted over 12-months. Data was statistically analyzed using McNemar's and Wilcoxon signed rank Tests, Kaplan-Meier analysis for treatment survival, and Fisher's exact tests for potential predictors of treatment outcomes. Statistical significance was p < 0.05.
Results:
A total of 60 pair-matched molars in 27 children were enrolled. After 12 months, partial and full pulpotomy showed comparable clinical success rates of 96.6% and 93.1%, respectively, whereas radiographic success rates were 89.7% and 86.2%, respectively, with no statistically significant differences between the two treatment groups (p > 0.05). Among the predictors, second primary molars exhibited a significantly higher success rate (100%) compared to first primary molars (72.7%) (p=0.045) in the partial pulpotomy group.
Conclusion:
MTA partial pulpotomy showed clinical and radiographic success comparable to full pulpotomy after 12-months. Success of partial pulpotomy was significantly higher in second than first primary molars, so it may be an alternative to performing full pulpotomy in second primary molars with deep caries.
Clinical Significance:
Partial pulpotomy is a minimally invasive approach that can potentially enhance pulpal healing and repair. The procedure has traditionally been discouraged in primary teeth, largely based on anecdotal reports. Findings of the current study will help support a more conservative pulpotomy approach to vital pulp therapy in primary molars.
