In primary teeth, decay that is near the pulp (tooth nerve)is treated with either a
pulpotomy or indirect pulp treatment if the tooth is not going to be extracted A pulpotomy
involves removing the top 1/2 of the pulp, placing a medication/material on the pulp,
covering the remaining pulp with a cement, and the restoring the tooth. The purpose of this
pilot study is to gain preliminary information regarding the success of Biodentine, MTA, and
IPT in the treatment of deep decay in children's primary molars.
Pediatric patients having deep decay in primary molars seen at UMMC, UMSOD, and University
of Maryland Rehabilitation and Orthopaedic Institute, will be included in the sample. Teeth
with deep caries, >50% into dentin, will be randomly assigned using a table of random
numbers to the three treatment groups:
Group 1 pulpotomy with MTA, Group 2 pulpotomy with Biodentine, Group 3 indirect pulp
treatment. Treatment will be performed by board certified pediatric dentists or they will
directly supervise pediatric dental residents at each site as part of their regular protocol
for treating deep caries.
Radiographs will be taken as prescribed in the Guideline for taking Radiographs in Children
by the American Academy of Pediatric Dentistry.
Twice yearly clinical examinations will be performed by the treating dentists or pediatric
dental residents to check for any soft tissue pathology such as abscess or mobility of
treated tooth/teeth. If treatment success/failure consensus between the blinded dentists is
not reached, a third dentist will be consulted.
The success/failure data will be entered onto spreadsheets and examined statistically using
- Pediatric patients with deep dental decay in primary molars
- Teeth with signs and symptoms of reversible pulpitis
- Teeth with clinical symptoms of irriversible pulpitis or pulp necrosis or acute
- Children with systemic illness that contraindicated vital pulp treatment such a
sickle cell disease
- Teeth that are not restorable