One-year outcome of selective caries removal versus pulpotomy treatment of deep caries: A pilot randomized controlled trial.

AIM: This study aimed to compare the outcome of SCR and Pulpotomy in teeth with deep caries extending at least 75% into dentine. METHODOLOGY: This two-armed, parallel-group, randomized, superiority trial included vital mature permanent teeth with deep primary or secondary caries diagnosed radiographically as being at least 75% into the thickness of dentine, without clinical signs of symptomatic irreversible pulpitis or radiographic evidence of a periapical lesion. Carious teeth were blindly allocated to receive either SCR or Pulpotomy using computer-generated randomized patient codes concealed in opaque envelopes. All teeth were reviewed clinically and radiographically at 6 months and 1 year post-treatment. Using a significance level of p < .05, the log rank test and Cox proportional hazards regression were used to compare the outcome of SCR and Pulpotomy and to identify potential prognostic factors, respectively. RESULTS: In all, 58 teeth in the SCR group and 55 teeth in the pulpotomy group completed treatment, after excluding 6 teeth because they did not complete the allocated treatment and another due to severe periodontal disease. At one year, 57/58 (98.3%) teeth from the SCR group and 48/55 (87.3%) teeth from the Pulpotomy group were available for analysis. One tooth in the Pulpotomy group (2.1%) and eight teeth in the SCR group (14.0%) required the further intervention of root canal treatment (p < .05). There were no other significant prognostic factors for survival. Overall, 91.4% of teeth treated with either SCR or Pulpotomy survived without requiring further intervention over a period of one year. No other adverse events occurred over the review period. CONCLUSION: Within the limitations of this study, Pulpotomy fares better than SCR in preserving the remaining pulp and periapical health. As a treatment modality, Pulpotomy carries greater cost outlay to patient and takes a longer time to complete treatment than SCR. Long-term follow-up is needed to study the pulpal and restorative outcomes of Pulpotomy and SCR.

Surface finish of a new hybrid aesthetic restorative material.

This study compared the surface finish of a new hybrid aesthetic restorative material (Reactmer) over time to four different types of existing materials. The latter included a composite (Spectrum TPH), a compomer (Dyract AP) and conventional (Fuji II) and resin-modified glass ionomer cements (Fuji II LC). Six specimens of each material were fabricated and stored in distilled water at 37 degrees C for one week. The materials were subsequently finished with a series of Sof-Lex contouring and polishing disks. The average surface roughness (Ra, microm) of each specimen was measured at three days and three months by a surface profilometer. Storage medium was distilled water at 37 degrees C during the hiatus periods. Data was analyzed by ANOVA/Scheffe's and independent samples t-tests at significance level 0.05. At both time periods, Fuji II and Fuji II LC were significantly rougher than Spectrum, Dyract and Reactmer. For all materials, surface roughness at three days was not significantly different from that at three months. The surface finish of the giomer (Reactmer) was significantly better than conventional/resin-modified glass ionomer cements and comparable to the composite and compomer evaluated. The quality of surface finish for all materials was not significantly affected by long-term storage in water.