Treatment Outcome of Mineral Trioxide Aggregate or Calcium Hydroxide Direct Pulp Capping: Long-term Results

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• 作者：Johannes Mente ; Priv-Doz ; Dr med dent^&lowast ; ; ^{johannes.mente@med.uni-heidelberg.de" class="auth_mail" title="E-mail the corresponding author} ; Sarah Hufnagel^&lowast ; ; Meltem Leo ; Dr med dent^&lowast ; ; Annemarie Michel ; Dr med dent^&lowast ; ; Holger Gehrig ; Dr med dent ; MSc^&lowast ; ; Dimos Panagidis ; Dr med dent^&dagger ; ; Daniel Saure ; MSc^&Dagger ; ; Thorsten Pfefferle ; Dr med dent^&lowast ;
• 关键词：Calcium hydroxide ; dental pulp capping ; dental pulp exposure ; human ; mineral trioxide aggregate ; treatment outcome
• 刊名：Journal of Endodontics
• 出版年：2014
• 出版时间：November 2014
• 年：2014
• 卷：40
• 期：11
• 页码：1746-1751
• 全文大小：215 K

文摘

This controlled, historic cohort study project continues a previously reported trial aiming to assess treatment outcome of direct pulp capping with mineral trioxide aggregate (MTA) versus calcium hydroxide (CH). Potential prognostic factors were re-evaluated on the basis of a larger sample size and longer follow-up periods.

Methods

Clinical and radiographic outcomes of 229 teeth treated with direct pulp capping between 2001 and 2011 were investigated 24 up to 123 months post-treatment (median = 42 months). Pre-, intra-, and postoperative information was evaluated and statistically analyzed using a logistic regression model as well as generalized estimating equation logit models.

Results

Two hundred five patients (229 teeth) were available for follow-up (74% recall rate). The overall success rates were 80.5% (95% confidence interval [CI], 74.5–86.5) of teeth in the MTA group (137/170) and 59% (95% CI, 46.5–71.5) of teeth in the CH group (35/59). Multivariate analyses (generalized estimating equation logit model) indicated a significantly increased risk of failure for teeth that were directly pulp capped with CH compared with MTA (odds ratio = 2.67; 95% CI, 1.36–5.25; P = .001). Teeth that were permanently restored ≥2 days after direct pulp capping had a significantly worse prognosis irrespective of the pulp capping material chosen (odds ratio = 3.18; 95% CI, 1.61–6.3; P = .004).

Conclusions

The results of this study indicate that MTA provides better long-term results after direct pulp capping compared with CH. Placing a permanent restoration immediately after direct pulp capping is recommended.