Postendodontic Pain after Pulpotomy or Root Canal Treatment in Mature Teeth with Carious Pulp Exposure: A Multicenter Randomized Controlled Trial

• Published in: Pain research & management Vol. 2020; pp. 1 - 14
• Main Authors: Eghbal, Mohammad Jafar, Haeri, Ali, Shahravan, Arash, Kazemi, Ali, Moazami, Fariborz, Mozayeni, Mohammad Ali, Saberi, Eshaghali, Samiei, Mohammad, Vatanpour, Mehdi, Akbarzade Baghban, Alireza, Fazlyab, Mahta, Parhizkar, Ardavan, Ahmadi, Mahboobe, Akbarian Rad, Nazila, Bijari, Shima, Bineshmarvasti, Delaram, Davoudi, Paria, Dehghan, Roya, Dehghani, Mandana, Ebrahimi, Habibollah, Emami, Nafiseh, Farajian, Nafiseh, Fereidooni, Rahim, Ghobadi, Gelareh, Ghodrati, Mostafa, Gohari, Atefeh, Hashemi, Azadeh, Hosseini, Mohammadreza, Karami, Elham, Kheirabadi, Nasir, Kozegari, Sepideh, Labaf Ghasemi, Hadi, Majidi, Alireza, Malekzadeh, Parastu, Mehrabi, Vahid, Mohammadi, Mehrnush, Moradi Eslami, Leila, Noghani, Atefeh, Omatali, Negin, Pourhatami, Negar, Rahbani Nobar, Behnam, Rahmani, Saeid, Shafaq, Parviz, Soofiabadi, Sara, Teimoori, Somaye, Vatandoost, Farzaneh, Asgary, Saeed
• Format: Journal Article
• Language: English
• Published: Oakville Hindawi 30-06-2020; John Wiley & Sons, Inc; Hindawi Limited
• Subjects: Age; Biomedical materials; Care and treatment; Cement; Clinical trials; Diagnostic tests; Endodontics; Hypotheses; Pain; Patients; Quality of life; Root canal therapy; Teeth; Iran
• ISSN: 1203-6765; 1918-1523
• DOI: 10.1155/2020/5853412

This equivalence, randomized, clinical trial aimed to compare the postoperative pain of root canal therapy (RCT) with pulpotomy with mineral trioxide aggregate (PMTA) or calcium-enriched mixture (PCEM) in permanent mature teeth. In seven academic centers, 550 cariously exposed pulps were included and randomly allocated into PMTA (n = 188), PCEM (n = 194), or RCT (n = 168) arms. Preoperative “Pain Intensity” (PI) on Numerical Rating Scale and postoperative PIs until day 7 were recorded. Patients’ demographic and pre-/intra-/postoperative factors/conditions were recorded/analysed. The arms were homogeneous in terms of demographics. The mean preoperative PIs were similar (P=0.998), the mean sum PIs recorded during 10 postoperative intervals were comparable (P=0.939), and the trend/changes in pain relief were parallel (P=0.821) in all study arms. The incidences of preoperative moderate-severe pain in RCT, PMTA, and PCEM arms were 56.5%, 55.7%, and 56.7%, which after 24 hours considerably decreased to 13.1%, 10.6%, and 12.9%, respectively (P=0.578). The time span of endodontic procedures was statistically different; RCT = 69.73, PMTA = 35.37, and PCEM = 33.62 minutes (P<0.001). Patients with greater preoperative pain, symptomatic apical periodontitis, or presence of PDL widening suffered more pain (P=0.002, 0.035, and 0.023, resp.); however, other pre-/intra-/postoperative factors/conditions were comparable. Pulpotomy with MTA/CEM and RCT demonstrate comparable and effective postoperative pain relief.