RESUMO
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.
Assuntos
Dor Pós-Operatória/etiologia , Pulpotomia/métodos , Materiais Restauradores do Canal Radicular/uso terapêutico , Tratamento do Canal Radicular/métodos , Adulto , Compostos de Alumínio/uso terapêutico , Compostos de Cálcio/uso terapêutico , Cimentos Dentários/uso terapêutico , Combinação de Medicamentos , Feminino , Humanos , Masculino , Dente Molar , Óxidos/uso terapêutico , Dor Pós-Operatória/epidemiologia , Prevalência , Pulpotomia/efeitos adversos , Tratamento do Canal Radicular/efeitos adversos , Silicatos/uso terapêutico , Resultado do TratamentoRESUMO
This article describes the diagnosis and treatment of bilaterally maxillary first molars with two canals in their distobuccal roots. A 13-year-old male came to the clinic with a severe pain of tooth #14. In the first session, after access and finding the main canals and the second mesio-buccal (MB2) canal, another canal was noticed in the distobuccal root. All teeth were examined and a severe decay was observed in the left maxillary first molar. After preparing the access cavity, another orifice was found between the palatal and distobuccal canals. The presence of the second distobuccal canal was confirmed using an apex locator and radiography.
