COMPARISON BETWEEN WHITE PRO-ROOT MTA AND A NEW MINERAL TIROXIDE AGGREGATE IN PULPOTOMIES OF PRIMARY MOLARS. A CLINICAL STUDY.

Aim: The purpose of this study was to conduct a clinical and radiographic evaluation of pulpotomy in temporary molars performed with White ProRoot MTA (Tulsa Dental Products, Tulsa, OK, USA) and Tech Biosealer Capping (Isasan, Rovello Porro, Como) and compare the results in a sample of 38 primary molars with a maximum follow-up of 12 months. Materials and Methods: Calcium silicate cements, conventionally defined MTA cements, are hydraulic materials able to set in the presence of blood and other biological fluids. MTA form calcium hydroxide during their hydration, release calcium and hydroxyl ions and induce the formation of calcium phosphate deposits (apatite).Calcium silicate MTA materials may provide epigenetic signals to induce the formation of reparative dentin and dentinal bridge by pulp stem cells. Twenty-eight patients were treated at the Department of Pediatric Dentistry, “Sapienza” University of Rome, Italy. This prospective study was designed to include first and second primary molars that had been treated by pulpotomy, in patients 5 to 9 year old patients, with White ProRoot MTA (Tulsa Dental Products, Tulsa, OK, USA) as control group and a new MTA material Tech Biosealer Capping (Isasan, Rovello Porro, Como) as test group. The authors had been previously involved in several pulpotomy studies and used a standardized technique. The inclusion criteria included subjects with no systemic pathology or allergies; primary molars which needed a pulpotomy treatment due to caries, that revealed no clinical or radiographic signs of radicular pulp degeneration and undergo vitality test. Primary molars which had not been previously treated and that presented, at treatment time, at least half of the root length. All primary molars pulpotomy were selected and randomly assigned to Pro-Root (n=17) or Tc-Capping (n=21)groups. After coronal pulp removal, the remaining radicular pulp was covered with two MTA material; then the teeth were permanently restored with a glass ionomer cement Equia (GC Europe N.V., Leuven, BEL) following the farmaceutical instructions. Clinical and radiographic success or failures were evaluate at 1, 6 and 12 month. Results: The sample consisted of 38 primary molars. Seven molars were not included in the study: three molars belonged to two patients who did not show up to follow-up visits and four molars were not included as three patients underwent a repeated antibiotic therapy after the pulpotomy because of systemic pathology. Therefore, our final sample included 31 primary molars. The Radiografic and clinical evaluation at 12 months of the 31 molars revealed total success rates in Tc-Capping groups and unfavourable pulp response in 1 molar treated with White Pro-Root MTA. In this case, it was verified the presence of an abscess and internal root resorption. After a second retreatment of the pulp chamber, an incomplete hardening of the material used was detected. Conclusions: White ProRoot MTA (Tulsa Dental Products, Tulsa, OK, USA), Tech Biosealer Capping (Isasan, Rovello Porro, Como) presented hight levels of clinical and radiographic success, showing a very good biologic response with this kind of materials. The Tc-Capping proved to be more easily worked by simplifying end speeding up the operative procedures.