Evaluation of MTA Versus Biodentine as Pulpotomy Agents in Immature First Permanent Molars

Diagnosis:

• Full history data will be collected, including personal, medical and previous dental data
• Clinical examination using mirror and probe to assess the inclusion criteria.
• Radiographic examination using preoperative digital periapical radiograph to assess the inclusion criteria.
• Preoperative photograph will be taken.

Operative procedure:

Experimental group:

• Injection of local anesthesia and rubber dam isolation.
• caries and roof of the pulp chamber will be removed by a fissure diamond bur (Diatech, Heerbrug, Switzerland) and high-speed handpiece with coolant.
• The pulps will be amputated to the orifice level using a long-shank diamond round bur.
• Haemostasis will be achieved by gentle placement of a saline-moistened cotton pellet over amputated pulps for 5-10 min.
• Calcium silicate-based BiodentineTM (Septodont Ltd., Saint Maur des Fausse´s, France) will be mixed according to the manufacturer's instructions, radicular pulp will be covered by the material using a wet cotton pellet.
• A self-cure glass ionomer (GC; GC Corporation, Tokyo, Japan) will be placed over the pulpotomy agent as a final restoration.
• Immediate post-operative radiograph and photograph will be taken.

Control group:

The same procedures will be carried out as the experimental group, but the pulp stumps will be covered with fast-setting mineral trioxide aggregate (MTA) ENDOCEM MTA (Maruchi, Wonju, Korea) and will be prepared according to the manufacturer's instructions. A 3-mm-thick layer of MTA will be placed over the amputated pulps and will be gently adapted to the dentinal walls using a wet cotton pellet. A self-cure glass ionomer (GC; GC Corporation, Tokyo, Japan) will be placed over the pulpotomy agent as a final restoration.

Postoperative care:

Instructions to avoid lip and cheek biting in addition to oral hygiene measures.

Follow up:

Assess the outcomes clinically and radiographically at (baseline, 6, 12 and 18 months).

Inclusion criteria

• Bilaterally Symptomatic ⁄ asymptomatic vital immature mandibular first permanent molars (with clinical carious exposure of the pulp and presence of bleeding upon exposure)

• Patients with an age range from 7-8 years.
• Absence of sinus tract, soft tissue swelling.

Exclusion criteria

• • Molars were excluded if non-restorable.

• excessive mobility (more than 1 mm horizontally).
• Radiographic evidence of peri- and ⁄or inter-radicular lesions, internal⁄ external root resorption, pulp⁄ canal calcifications.