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Journal of Peking University (Health Sciences) ›› 2024, Vol. 56 ›› Issue (1): 138-143. doi: 10.19723/j.issn.1671-167X.2024.01.021

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Efficacy and radiology evaluation of pulpotomy in mature permanent teeth

Xiaoyi ZHAO*(),Chang LIU,Kun QIAN,Jie PAN   

  1. Department of General Dentistry, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing 100081, China
  • Received:2023-10-10 Online:2024-02-18 Published:2024-02-06
  • Contact: Xiaoyi ZHAO E-mail:xy724@613.com

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Abstract:

Objective: To observe the clinical efficacy of pulpotomy in patients of different ages and to explore the occurrence and characteristics of pulpal calcification. Methods: A total of 77 patients who underwent pulpotomy for mature permanent premolars and molars with caries-derived pulp exposure in the Department of General Dentistry, Peking University School and Hospital of Stomatology from October 2019 to August 2022 were selected. Pulpotomies were performed in a single visit using iRoot BP Plus bioceramic material as pulp capping agent. The patients were divided into three groups according to age: 25 cases in the adolescent group (11-20 years old) with a mean age of (15.88±2.19) years; 27 cases in the middle-aged group (21-50 years old) with a mean age of (34.59±8.67) years; and 25 cases in the elder-aged group (51-83 years old) with a mean age of (63.84±7.40) years. The patients were reviewed 1 year after the operation to evaluate the clinical efficacy and to record the formation of calcified bridge, thickness of calcified bridge, and pulp calcification index (PCI). Results: There was no statistically significant difference between the three groups in terms of gender, dentition, and tooth position (P > 0.05). The 1-year postoperative follow-up rate was 85.71% (66/77), including 88.00% (22/25) in the adolescent group, 85.19% (23/27) in the middle-aged group, and 84.00% (21/25) in the elder-aged group. The 1-year follow-up clinical success rates of the three groups were 95.45% (21/22), 91.30% (21/23), and 95.24% (20/21), respectively, with no statistically significant difference (P>0.05). Among the clinical success cases, calcified bridges appeared in 12 cases (57.14%, 12/21) in the adolescent group, 8 cases (38.10%, 8/21) in the middle-aged group, and 3 cases (15.00%, 3/20) in the elder-aged group, with statistically significant differences (χ2= 7.810, P = 0.020 < 0.05). The difference was statistically significant (F = 4.434, P = 0.020 < 0.05) when comparing the thickness of calcified bridges among the three groups. Calcified bridge thickness was negatively correlated with age (r = -0.516, P < 0.05). The changes in pulpal calcification index ΔPCI were 0.67 ± 0.58, 0.43 ± 0.51, and 0.25 ± 0.52, respectively, with statistically significant differences among the three groups (F = 3.404, P = 0.040 < 0.05). Conclusion: Pulpotomy for caries-derived pulp exposure in elderly patients could also achieve a high success rate. The incidence of calcified bri-dges after pulpotomy and the acceleration of pulpal calcification were age-related. The adolescent group was more likely to form calcified bridges and also showed more pronounced accelerated root canal calcification.

Key words: Pulpotomy, Age, Mature permanent teeth, Radiology

CLC Number: 

  • R781.3

Table 1

Descriptive data of cases"

Items Adolescent group
(n=25)		 Middle-aged group
(n=27)		 Elder-aged group
(n=25)		 χ2 P
Gender, n 0.092 0.955
    Male 10 10 9
    Female 15 17 16
Jaw, n 3.121 0.210
    Upper 16 15 10
    Lower 9 11 15
Tooth position, n 1.217 0.544
    Premolar 9 10 6
    Molar 16 17 19

Figure 1

Pearson correlation analysis between thickness of calcification bridge and age"

Table 2

and changes before and after pulpotomy of the adolescent group, middle-aged group and elder-aged group"

Items PCI ΔPCI
Preoperative Postoperative
Adolescent group (n=21) 1.10±0.30 1.76±0.62 0.67±0.58
Middle-aged group (n=21) 1.67±0.58 2.10±0.70 0.43±0.51
Elder-aged group (n=20) 2.55±0.51 2.80±0.52 0.25±0.44
F 48.217 14.809 3.404
P ＜0.001 ＜0.001 0.040

Figure 2

Typical cases X-ray films before pulpotomy and 1-year follow-up after operation of the adolescent group, middle-aged group and elder-aged group A, mandibular left first molar in adolescent group, preoperative X-ray, PCI=1; B, mandibular left first molar in adolescent group, 1-year follow-up X-ray, PCI=3, calcified bridges occurred; C, mandibular right second molar in middle-aged group, preoperative X-ray, PCI=2; D, mandibular right second molar in middle-aged group, 1-year follow-up X-ray, PCI=3, calcified bridges occurred; E, mandibular right first molar in elder-aged group, preoperative X-ray, PCI=3; F, mandibular right first molar in elder-aged group, 1-year follow-up X-ray, PCI=3, calcified bridges not occurred. Red arrow indicated calcified bridges. PCI, pulp calcification index."

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