Evaluation of Mineral Trioxide Aggregate Pulpotomy in Primary Molars

MTA has been demonstrated as an excellent endodontic agent and therefore is likely to be a successful pulpotomy medicament.

Objectives: The objective of this study was to compare the clinical outcomes of Mineral Trioxide Aggregate (MTA) pulpotomy and formocresol pulpotomy in primary molars.

Methods: Fifty-eight carious primary molars without clinical and radiographic signs and symptoms in healthy children were treated with the conventional pulpotomy technique using MTA as a pulp dressing. A minimum thickness of 3mm of white MTA was placed against the remnant pulp. The pulpotomised teeth were restored with stainless steel crowns. The children were recalled at 3, 6, 12 and 18 months for radiographic and clinical assessments. A group of formocresol pulpotomised teeth was included for comparison.

Results: Fifty-seven teeth of the MTA pulpotomised teeth were available for evaluation. Eighteen percent of these teeth presented with internal root resorption, of which a third showed subsequent calcific changes. Calcific bridges were found in 9% of all MTA treated teeth, and pulp canal obliteration was noted in a further 6%. No symptoms were associated with the MTA pulpotomised teeth. Formocresol pulpotomised teeth showed expected clinical results with minimal clinical failures. There were no statistically significant differences in overall success rates between the MTA and formocresol pulpotomised teeth.

Conclusions: MTA is as efficacious and clinically successful as a pulpotomy agent compared to formocresol. Longer-term evaluation and histological studies would provide further insight into the effects of MTA pulpotomies in primary teeth.

This study was supported by Queensland Health and the Australian Dental Research Fund