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This randomized controlled trial sought to evaluate postoperative pain after total pulpotomy (TP) versus root canal treatment (RCT) in mature molar teeth having irreversible pulpitis, while also comparing two pulpitis classification systems for analyzing postoperative pain.
Tooth pulpotomy offers quicker symptom relief in moderate pulpitis and leads to lower pain scores than root canal treatment in severe pulpitis at both 24 and 72 hours.
This randomized controlled trial sought to evaluate postoperative pain after total pulpotomy (TP) versus root canal treatment (RCT) in mature molar teeth having irreversible pulpitis, while also comparing two pulpitis classification systems for analyzing postoperative pain.
Overall, 80 mandibular molars were classified as moderate or severe pulpitis according to the Wolters system and randomly assigned to either the TP or RCT group. TP involved removing pulp up to the canal orifices, achieving hemostasis with sodium hypochlorite (2.5%), and placing mineral trioxide aggregate, glass ionomer cement and composite for restoration. RCT was performed as per standard protocol. Pain was assessed preoperatively and at 6, 12, 24, 48, and 72 h and 7 days post-treatment.
In the final analysis, 64 participants (age between 18 and 50 years) were enrolled. According to Wolters, 22 teeth were classified as having moderate pulpitis, while 42 teeth were classified as having severe pulpitis. There was no significant pain difference in moderate pulpitis cases. However, in severe pulpitis cases, RCT resulted in higher pain scores at 24 and 72 hours compared to TP.
In patients suffering from moderate pulpitis, the TP procedure elicited quicker symptom relief when compared to RCT. For those dealing with severe pulpitis, TP resulted in markedly lower pain scores than RCT at both 24 and 72 hours.
BMC Oral Health
Postoperative pain after total pulpotomy and root canal treatment in mature molars according to the new and traditional classifications of pulpitis: a prospective, randomized controlled trial
Merve Sarı et al.
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