Comparative evaluation of the effectiveness of calcium silicate-based materials with or without platelet-rich fibrin as a pulpotomy medicament in human permanent teeth with irreversible pulpitis: A randomized clinical trial

Abstract

Aim: This randomized clinical trial aimed to compare the effectiveness of mineral trioxide aggregate (MTA), Biodentine, platelet-rich fibrin (PRF) with MTA, and PRF with Biodentine as pulpotomy medicament in the permanent molars with symptomatic irreversible pulpitis clinically and radiographically. Materials and Methods: Sixty permanent first molars with a carious exposed tooth showing signs and symptoms of irreversible pulpitis with caries extending >2/3rd of dentin, but no signs of pulpal necrosis, were randomly allocated in four groups, and full pulpotomy was performed using MTA, Biodentine, PRF with MTA, and PRF with Biodentine as pulpotomy agents. The clinical and radiographic assessment was done after 24 h, 3 months, 6 months, and 9 months postoperatively. Nonparametric tests, including Kruskal–Wallis, Friedman test, and Chi-square test, were used for repeated measures among the biomaterials. For pair-wise comparison of subgroups, the Wilcoxon sum-rank test was used. Results: The clinical success rate was 90.5% at a 9-month interval. There was a nonsignificant result among all the groups (P < 0.05), and all agents were equally effective in providing pain relief at all the intervals tested. No significant difference was observed between the radiographic success rates observed among the groups (P = 0.089 at 6 months and P = 0.095 at 9 months). Conclusion: Pulpotomy dressing agents used proved to be a success in mature permanent teeth with carious exposure with clinical signs and symptoms of irreversible pulpitis.

Keywords

• biodentine
• mineral trioxide aggregate
• platelet-rich fibrin
• pulpotomy
• visual analog scale
• vital pulp therapy