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Journal of Peking University (Health Sciences) ›› 2022, Vol. 54 ›› Issue (6): 1196-1201. doi: 10.19723/j.issn.1671-167X.2022.06.023

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Pulpotomy of human primary molars with novel bioceramic material

Shuang WANG,Chu-fang PENG,He LIU*()   

  1. Department of Pediatric Dentistry, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology & NHC Research Center of Engineering and Technology for Computerized Dentistry & NMPA Key Laboratory for Dental Materials, Beijing 100081, China
  • Received:2020-03-12 Online:2022-12-18 Published:2022-12-19
  • Contact: He LIU E-mail:heliu69@126.com
  • Supported by:
    the New Clinical Technology and New Therapy Project of Peking University Hospital of Stomatology(PKUSSNCT-18B10)

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Abstract:

Objective: To evaluate the efficacy of iRoot BP Plus, a novel bioceramic material, and mineral trioxide aggregate (MTA) by comparing the clinical and radiographic results of pulpotomy in human primary molars, and to find out the influence factor. Methods: Children who had at least one primary molar diagnosed as pulpitis, and received pulpotomy in the Department of Pediatric Dentistry, Peking University School and Hospital of Stomatology from January, 2017 to December, 2018 were searched by the selection criteria in the Electronic Medical Record Database of Peking University School and Hospital of Stomatology. The molars with the pulp capping agents were iRoot BP Plus or MTA were included, and the molars with other pulp capping agents were excluded. Molars using iRoot BP Plus were selected into the experimental group (iRoot BP Plus group). Molars using MTA were selected into the control group (MTA group) using propensity score matching model (1 ∶ 1), considering the gender, age, tooth position, the title of clinician, pulp status, restoration and length of follow-up as the potential influence factor. Basic information, the relevant medical records including symptoms, clinical and radiographic examination before and after operation, intraoperative information and follow up examination records were collected. The success rates were compared and the influence factors were analyzed respectively. Results: The study included 132 children, 178 molars (89 molars from each group) and the mean follow-up time was (462±99) days by December, 2019. In the iRoot BP Plus group, 9 molars failed whilst 6 molars failed in MTA group. The success rate was 89.9% and 93.3%, respectively, showing no significant difference between the two groups. Through Cox proportional risk model analysis, the success rate of iRoot BP Plus was significantly lower when the pulp status was poor, while other factors including age, tooth position, title of clinician and restoration were not found to be associated with the clinical outcome. Conclusion: Pulpotomy of human primary molars with iRoot BP Plus has the same effectiveness with MTA. The pulp status is the main factor that influences the outcome of iRoot BP Plus. Further studies with larger sample sizes and longer follow-up terms are needed.

Key words: Pulpotomy, Novel bioceramic material, Pulpitis

CLC Number: 

  • R788.2

Table 1

Tooth information of iRoot BP Plus group and MTA group before and after PSM (in tooth units)"

ItemsBefore PSMPAfter PSMP
iRoot BP Plus
(n=89)		 MTA
(n=1 434)		 iRoot BP Plus
(n=89)		 MTA
(n=89)
Gender, n(%) 0.750 1.000
  Male 45(51.6) 750(52.3) 45(51.6) 45(51.6)
  Female 44(49.4) 684(47.7) 44(49.4) 44(49.4)
Age/years 5.11±0.98 5.71±1.81 0.008 5.11±0.98 5.21±1.04 0.518
Tooth position, n(%) 0.442 0.812
  Maxillary first primary molar 22(24.7) 387(27.0) 22(24.7) 24(27.0)
  Maxillary second primary molar 14(15.7) 336(23.4) 14(15.7) 18(20.2)
  Mandibular first primary molar 23(25.8) 315(22.0) 23(25.8) 20(22.5)
  Mandibular first primary molar 30(33.7) 396(27.6) 30(33.7) 27(30.3)
Title of clinician, n(%) 0.000 0.524
  Resident doctor & intern 26(29.2) 734(51.2) 26(29.2) 28(31.5)
  Attending doctor 60(67.4) 466(32.5) 60(67.4) 55(61.8)
  Professor 3(3.4) 234(16.3) 3(3.4) 6(6.7)
Pulp status, n(%) 0.035 0.593
  Good 67(75.3) 1180(82.3) 67(75.3) 70(78.7)
  Poor 22(24.7) 254(17.7) 22(24.7) 19(21.3)
Restoration, n(%) 0.000 0.225
  Composite resin 82(92.1) 1017(70.9) 82(92.1) 77(86.5)
  Stainless steel crown 7(7.9) 417(29.1) 7(7.9) 12(13.5)
Length of follow-up/d, $\bar x \pm s$ 454±93 498±268 0.019 454±93 470±104 0.299

Figure 1

Survival curve of iRoot BP Plus group and MTA group MTA, mineral trioxide aggregate."

Table 2

Cox proportional risk regression analysis of iRoot BP Plus group and MTA group"

Influence factorsiRoot BP Plus MTA
Exp(B)95%CI for Exp(B)P Exp(B)95%CI for Exp(B)P
Lower UpperLower Upper
Pulp status 0.081 0.016 0.410 0.002 1.005 0.105 9.642 0.996
Age 0.643 0.251 1.645 0.357 1.349 1.002 3.229 0.439
Title of clinician 0.993 0.369
Tooth position 0.547 0.982
Restoration 20 822 0.000 1.276×108 0.973 0.999 0.085 11.691 1.000
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