Good success rates in pulpotomy of immature caries-exposed permanent molars


The aim of this study was to  compare the  outcomes of pulpotomy treatment using calcium-enriched mixture (CEM) cement and mineral trioxide aggregate (MTA) in carious-exposed vital immature permanent first molars.

Participants (n=51,  1 tooth per patient)  with immature molars with clinical carious exposure with symptomatic/asymptomatic pulpitis were randomised to  undergo pulpotomy using either CEM (n=26) cement or MTA (n=25).  After performing pulpotomy and covering the radicular pulps with the biomaterials, all teeth were permanently restored.  Clinical and radiographic evaluations were performed at 6 and 12 months after operation for signs of success or failure. Radiographs being evaluated for complete/partial apical closure.

The patients were aged between 6- 10 years old.  ( mean = 8.30).  49 participants were available for assessment a 12 months.

They found

  • No significant difference at the baseline between the two groups.
  • All 49 teeth showed pulp survival and signs of continuous root development after 12 months.
  • No statistical difference in terms of radiographic outcomes between two groups.
  • Complete apical closure (apexogenesis) occurred in 76.8%  of the CEM group and 73.8% of MTA group.

The authors concluded

Calcium-enriched mixture cement and MTA showed similar performance in pulpotomy of immature caries-exposed permanent molars.

NOSRAT, A., SEIFI, A. and ASGARY, S. (2012), Pulpotomy in caries-exposed immature permanent molars using calcium-enriched mixture cement or mineral trioxide aggregate: a randomized clinical trial. International Journal of Paediatric Dentistry. doi: 10.1111/j.1365-263X.2012.01224.x


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Derek Richards

Derek Richards is a specialist in dental public health, Director of the Centre for Evidence-Based Dentistry and Specialist Advisor to the Scottish Dental Clinical Effectiveness Programme (SDCEP) Development Team. A former editor of the Evidence-Based Dentistry Journal and chief blogger for the Dental Elf website until December 2023. Derek has been involved with a wide range of evidence-based initiatives both nationally and internationally since 1994. Derek retired from the NHS in 2019 remaining as a part-time senior lecturer at Dundee Dental School until the end of 2023.

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