Direct Pulp Capping Versus Pulpotomy for Primary Molars

Aim: The aim of this study is to evaluate the clinical and radiographic outcomes of direct pulp capping (DPC) when compared to pulpotomy in primary molars with carious pulp exposure using a calcium silicate-based material: neo mineral trioxide aggregate (Neo MTA).

Methods: The study will be a split mouth randomized clinical trial including children between 4-9 years old. Patients will be allocated into two treatment groups; one group will start with DPC first followed by pulpotomy on the second visit, and vice versa for the second group. The time interval between both visits will be 1-2 weeks. The pulp medicament capping material (neo MTA) will be applied over the exposure site, and then tooth will be restored with glass ionomer cement and then a crown will be placed. Cases will be followed up to 24 months after initial treatment.

Inclusion criteria

• Healthy patients.
• Age 4-10 years.
• Primary molar with deep caries present bilaterally.
• Teeth should be restorable.
• Clinically normal asymptomatic tooth or symptoms of reversible pulpitis (No history of pain or provoked pain subsides upon removal of the stimulus).
• Radiographically: caries in the inner half of the dentin approaching the pulp.

Exclusion criteria

• History of spontaneous pain.
• Soft and hard tissue pathology.
• Mobility or exfoliating tooth.
• No pulp exposure after caries excavation.
• Inability to achieve hemostasis after 6 minutes.
• Radiographically: Root resorption exceeding 1/3 of the root, apical pathology.