{Reference Type}: Randomized Controlled Trial
{Title}: One-year outcome of selective caries removal versus pulpotomy treatment of deep caries: A pilot randomized controlled trial.
{Author}: Chua SKX;Sim YF;Wang WC;Mok BYY;Yu VSH;
{Journal}: Int Endod J
{Volume}: 56
{Issue}: 12
{Year}: 2023 Dec 5
{Factor}: 5.165
{DOI}: 10.1111/iej.13978
{Abstract}: <B>OBJECTIVE: </B>This study aimed to compare the outcome of SCR and Pulpotomy in teeth with deep caries extending at least 75% into dentine.<BR><B>METHODS: </B>This two-armed, parallel-group, randomized, superiority trial included vital mature permanent teeth with deep primary or secondary caries diagnosed radiographically as being at least 75% into the thickness of dentine, without clinical signs of symptomatic irreversible pulpitis or radiographic evidence of a periapical lesion. Carious teeth were blindly allocated to receive either SCR or Pulpotomy using computer-generated randomized patient codes concealed in opaque envelopes. All teeth were reviewed clinically and radiographically at 6 months and 1 year post-treatment. Using a significance level of p < .05, the log rank test and Cox proportional hazards regression were used to compare the outcome of SCR and Pulpotomy and to identify potential prognostic factors, respectively.<BR><B>RESULTS: </B>In all, 58 teeth in the SCR group and 55 teeth in the pulpotomy group completed treatment, after excluding 6 teeth because they did not complete the allocated treatment and another due to severe periodontal disease. At one year, 57/58 (98.3%) teeth from the SCR group and 48/55 (87.3%) teeth from the Pulpotomy group were available for analysis. One tooth in the Pulpotomy group (2.1%) and eight teeth in the SCR group (14.0%) required the further intervention of root canal treatment (p < .05). There were no other significant prognostic factors for survival. Overall, 91.4% of teeth treated with either SCR or Pulpotomy survived without requiring further intervention over a period of one year. No other adverse events occurred over the review period.<BR><B>CONCLUSIONS: </B>Within the limitations of this study, Pulpotomy fares better than SCR in preserving the remaining pulp and periapical health. As a treatment modality, Pulpotomy carries greater cost outlay to patient and takes a longer time to complete treatment than SCR. Long-term follow-up is needed to study the pulpal and restorative outcomes of Pulpotomy and SCR.