A Randomized Controlled Clinical Trial of Pulpotomy versus Root Canal Therapy in Mature Teeth with Irreversible Pulpitis: Outcome,Quality of Life,and Patients’ Satisfaction

IntroductionVital pulp therapy is increasingly practiced as an alternative treatment to root canal therapy (RCT) in teeth with carious pulp exposure. The aim of this study was to compare the outcome, quality of life (QOL), and patients’ satisfaction after full pulpotomy and RCT in mature teeth with irreversible pulpitis.MethodsSixty mature permanent molar teeth with carious pulp exposure and a diagnosis of irreversible pulpitis were randomly divided into 2 groups (n = 30). The first group was treated with full pulpotomy using Biodentine (Septodont, Saint Maur des Fosses, France), and the second group was treated with RCT. The pain level was recorded preoperatively and at 1, 2, 3, 5, and 7 days. Clinical and radiographic assessments were performed at the 6- and 12-month follow-ups; 1 case in each group did not attend. Based on the Oral Health Impact Profile questionnaire and 7 semantic differential scales, QOL, and patients’ satisfaction were evaluated and compared statistically.ResultsPulpotomy and RCT had comparable success rates (27/29, 93%). Pain levels at day 1 after pulpotomy were significantly lower than after RCT (P = .037), less patients required analgesics (P = .028), and pulpotomy provided pain relief in a shorter time compared with RCT. Both treatments improved the Oral Health Impact Profile QOL of patients without significant differences (60.29, 64.1% at 1 year). Patients’ satisfaction with pulpotomy was higher than RCT in terms of the time involved, intraoperative pain, pleasantness, and cost (P < .05).ConclusionsFull pulpotomy could be an alternative treatment to RCT in mature teeth with carious pulp exposure and symptomatic irreversible pulpitis based on the clinical and radiographic success rates and patients’ satisfaction.     

Effect of full pulpotomy using a calcium silicate–based bioactive ceramic in adult permanent teeth with symptoms indicative of irreversible pulpitis: A retrospective study

BackgroundThe authors studied the treatment effect of full pulpotomy using a calcium silicate–based bioactive ceramic in adult permanent teeth with symptoms indicative of irreversible pulpitis.MethodsEighty-one adult permanent teeth with symptoms indicative of irreversible pulpitis in 78 patients aged 18 through 72 years were evaluated for inclusion in the study. After caries excavation, the pulp was amputated to the level of the canal orifices. After hemostasis was achieved, calcium silicate–based bioactive ceramic was placed as the capping agent. The cavity was sealed temporarily with a glass ionomer cement and then restored with flowable resin and composite resin after 2 weeks if no positive symptoms were reported or detected. Postoperative evaluation was performed by means of clinical and radiographic examination at 2 weeks and 3, 6, and 12 months.ResultsOverall success rates of the procedure were 96.3% (78 of 81), 93.8% (76 of 81), 92.6% (75 of 81), and 92.6% (75 of 81) at the 2-week, 3-month, 6-month, and 12-month recall visits, respectively. Six of the 81 teeth failed and required root canal therapy. In these 6 teeth, 3 exhibited severe cold stimuli pain and spontaneous pain at the 2-week follow-up, 2 had no response to electric pulp testing with apical percussion pain and periapical rarefaction at the 3-month follow-up, and 1 tooth exhibited periapical rarefaction and labial mucosal fistula at the 6-month follow-up.ConclusionsUnder the conditions of this study, full pulpotomy using a calcium silicate–based bioactive ceramic was a successful option for the treatment of adult permanent teeth with carious originated symptoms indicative of irreversible pulpitis.Practical ImplicationsVital pulp therapy is no longer impossible for adult permanent teeth with carious originated symptoms indicative of irreversible pulpitis.     

Pulp preservation in immature permanent teeth

New treatment strategies for direct pulp capping and pulpotomy have shown promising potentials for improved outcomes in immature teeth with extensive caries, traumatic pulp exposures, or anatomical anomalies. Preservation and protection of the dental pulp in developing teeth promote root maturation and extend tooth survivability by postponing or even preventing more complex endodontic and restorative care. Early intervention using hydraulic calcium silicate cements such as mineral trioxide aggregate (MTA) stimulates pulpal cell recruitment and differentiation, up‐regulates transformation factors (gene expression), and promotes dentinogenesis. Calcium hydroxide, resin‐modified glass ionomer cements, hydrophilic resins, and formocresol have been shown to be less effective as bioactive agents when used in vital pulp therapy. Improved treatment procedures for pulp preservation include the use of caries detector dye to preserve the remineralizable inner carious layer and the use of sodium hypochlorite as a hemostatic and diagnostic agent to differentiate reversible from irreversible pulpitis. Although stepwise excavation and the use of calcium hydroxide is still being advocated, pulp capping and pulpotomy procedures using calcium silicate‐based cements are becoming widely accepted as more effective procedures. MTA and new hydraulic calcium silicate cements provide biocompatible environments that predictably promote reparative dentin bridge formation when placed under properly bonded and sealed composite restorations. Hydraulic calcium silicate cements appear to provide a promising future for the preservation of pulpal integrity in immature teeth when used with modified and conservative treatment protocols.     

Mineral trioxide aggregate pulpotomies: a case series outcomes assessment

BACKGROUND: The greatest threats to developing teeth are dental caries and traumatic injury. A primary goal of all restorative treatment is to maintain pulp vitality so that normal root development or apexogenesis can occur. If pulpal exposure occurs, then a pulpotomy procedure aims to preserve pulp vitality to allow for normal root development. Historically, calcium hydroxide has been the material of choice for pulpotomy procedures. Recently, an alternative material called mineral trioxide aggregate (MTA) has demonstrated the ability to induce hard-tissue formation in pulpal tissue. The authors describe the clinical and radiographic outcome of a series of cases involving the use of MTA in pulpotomy procedures. METHODS: Twenty-three cases in 18 patients were treated with MTA pulpotomy procedures in an endodontic private practice. All of the patients had been referred to the practice for diagnosis and treatment of a symptomatic tooth. All of the authors provided treatment. Pulpal exposures were either due to caries or complicated enamel dentin fractures. RESULTS: Nineteen teeth in 14 patients were available for recall. The mean time of recall was 19.7 months. Of the 19 cases, 15 involved healed teeth, and three involved teeth that were healing. One of 19 cases involved a tooth with persistent disease. CONCLUSIONS: MTA may be useful as a substitute for calcium hydroxide in pulpotomy procedures. Further research, however, is required to clarify this conclusion. CLINICAL IMPLICATIONS: MTA conceivably could replace calcium hydroxide as the material of choice for pulpotomy procedures, if future research continues to show promising results.     

Clinical, radiographic and histological analysis of the effects of mineral trioxide aggregate used in direct pulp capping and pulpotomies of primary teeth

Background : Primary teeth pulp exposures have traditionally been treated with formocresol or ferric sulphate pulpotomies or calcium hydroxide pulp capping. The aim of this study was to observe the tissue response when mineral trioxide aggregate (MTA) was used.
Methods : Ten primary teeth had direct pulp caps and 11 had a pulpotomy with MTA. The teeth were restored and then clinically reviewed monthly for five months and before extraction. Radiographs were taken prior to treatment, after one month and prior to extraction. After extraction, the teeth were examined histologically and the responses to treatment were assessed.
Results : One pulpotomy and two pulp capping cases had postoperative pain and signs of pulp degeneration. Radiographs showed no root resorption, no periodontal pockets and no furcation radiolucencies. No cases had draining sinuses or increased mobility. Most pulps responded favourably from a clinical perspective although a variety of responses were noted Histologicallyormal odontoblasts, irregular odontoblasts, intrapulpal calcifications, dentinal bridges, cementum formation, internal resorption, inflammatory infiltrate and pulp necrosis.
Conclusions : The responses of pulps in primary teeth to MTA pulpotomies and pulp caps were favourable from clinical and radiographic perspectives although a variety of histological responses were noted. MTA may be a favourable material for pulp capping and pulpotomies in primary teeth.     

Emergency pulpotomy: pain relieving effect with and without the use of sedative dressings

Seventy-three teeth with acute irreversible pulpitis were subjected to emergency pulpotomies. After removal of the coronal portion of the pulp, a sterile cotton pellet or zinc oxide-eugenol cement was placed against the remaining pulp tissue. The cotton pellet was either dry or moistened with camphorated phenol, cresatin, eugenol, or isotonic saline. This gave six different groups of treatment following the pulpotomy. All teeth were sealed with zinc oxide-eugenol cement. By means of questionnaires, symptoms were recorded after the anesthetic effect was gone and also at 1, 7, and 30 days after treatment. A total of 70 patients (96%) reported pain relief. Three patients did not experience relief and returned for pulpectomy. After the first postoperative day, no pain was reported by any of the patients. The frequency of discomfort decreased from 11% 1 day postoperatively to 1% 30 days after the emergency treatment. There was no difference in recorded symptoms among the six treatment groups. Thus, removal of caries, pulpotomy, and sealing of the cavity apparently was a reliable means to relieve pain. The use of the various dressings did not contribute to the relief of pain.     

Treatment outcomes of pulpotomy in permanent molars with irreversible pulpitis using biomaterials: A multi-center randomized controlled trial

Abstract

Objective. To conduct a randomized clinical trial to compare the post-operative pain experience as well as clinical and radiographic outcomes of pulpotomy in human permanent molars with irreversible pulpitis using calcium enriched mixture (CEM) cement or mineral trioxide aggregate (MTA). Materials and mcethods. A total of 413 patients met the inclusion criteria and consented to participate. The patients were randomly allocated into two study arms: MTA pulpotomy (PMTA: n = 208) and CEM pulpotomy (PCEM: n = 205). Numerical rating scale questionnaires were utilized by the patients to record pain intensity (PI) over 7 days post-operatively. The patients were followed-up for 12 months to assess the clinical and radiographic outcomes of treatment. The data was analyzed using Chi-square, Cohen's kappa and t-tests. Results. There was no significant difference in the mean PI recorded during the 7 post-operative days between the two study arms (p = 0.221). The clinical and radiographic success rates for PMTA at 12-month follow-up were 98 and 95%, respectively; and 97 and 92% for PCEM, respectively. There was no significant differences in clinical (p = 0.7) and radiographic (p = 0.4) success rates between the two arms. Conclusions. Excellent treatment outcomes occurred in molar teeth with irreversible pulpitis undergoing pulpotomy with MTA and CEM biomaterials.     

Response to Pulp Sensibility Tests after Full Pulpotomy in Permanent Mandibular Teeth with Symptomatic Irreversible Pulpitis: A Retrospective Data Analysis

IntroductionThis retrospective study analyzed the 12-month pulp sensibility (cold and electric) test response after mineral trioxide aggregate (MTA) full pulpotomy in mature permanent teeth with symptomatic irreversible pulpitis.MethodsThe records of 120 subjects from 3 completed and 1 ongoing clinical study on MTA full pulpotomy were retrieved. Ninety-six first and second mandibular molar teeth with a diagnosis of symptomatic irreversible pulpitis that underwent a single-visit MTA full pulpotomy and had completed a 12-month clinical, radiographic, and pulp sensibility (cold and electric) test follow-up were included. The data were analyzed using the Fisher exact test, the Pearson chi-square test, and the McNemar test. The significance level was predetermined at P < .05.ResultsA higher percentage of teeth (94.7%) responded to the electric pulp test in comparison with the cold test (13.5%) (P < .05). Sex-based responses to the electric pulp test (P > .05) and the cold test were similar (P > .05). The age-based response was similar for the electric pulp test (P > .05) but was significant for the cold test (P < .05). The tooth quadrant (left and right), the tooth (mandibular first and second molar), and the location of restoration (proximal or occlusal) did not influence the response of either the electric pulp test (P > .05) or the cold test (P > .05). At the 1-year follow-up, all the teeth that were classified as clinically and radiographically successful responded to the electric pulp test; however, only 13 teeth responded to the cold test (P = .00).ConclusionsThe majority (94.7%) of the teeth that underwent MTA full pulpotomy responded to the electric pulp test at a 1-year time interval.     

4-Year Follow-up of Full Pulpotomy in Symptomatic Mature Permanent Teeth with Carious Pulp Exposure Using a Stainproof Calcium Silicate–based Material

IntroductionThis study aimed to assess the pulpal and restorative outcome of full pulpotomy in symptomatic mature permanent teeth with carious pulp exposure over 4 years.MethodsUnder local anesthesia, full pulpotomy was performed using the aseptic technique and a stainproof calcium silicate–based material (NeoMTA Plus; Avalon Biomed Inc, Bradenton, FL). The pain level was scored preoperatively and at 1 week posttreatment. Clinical and radiographic evaluation was performed at 6 months, 1, 2, and 4 years. Kaplan-Meier survival analysis and Cox proportional hazards regression were used to analyze the data. Failed cases were classified as endodontic or restorative failure.ResultsFull pulpotomy was completed in 109 teeth in 90 patients with an age range of 14–60 years (mean = 25 years). The study sample available for follow-up was 100 teeth in 86 patients with a recall rate above 90%. Preoperative pulp diagnosis was reversible pulpitis in 39 teeth and irreversible pulpitis in 61 teeth. The cumulative survival rates of pulpotomy were generally high (ie, 98%, 97.4%, 93%, and 83.8% at 6 months and 1, 2, and 4 years, respectively). The overall mean survival time of pulpotomy was 3.89 years (95% confidence interval, 3.84–3.95). The mean survival time was significantly higher for patients aged ≤25 years. However, in the multivariate analysis, the only significant predictor of pulpotomy failure was severe preoperative pain. Over the 4 years, 23 cases failed; only 10 of 23 failures were classified as endodontic failure, and the success of pulpotomy can be assumed to be 90%.ConclusionsFull pulpotomy in cariously exposed pulp of mature permanent teeth sustained a high success rate over 4 years. The coronal seal is crucial for long-term survival.     

Full Pulpotomy with Biodentine in Symptomatic Young Permanent Teeth with Carious Exposure

Introduction

This prospective study evaluated the outcome of Biodentine (Septodont, Saint Maur des Fosses, France) pulpotomy in young permanent teeth with carious exposure.

不同年龄成年患者活髓切断治疗临床疗效研究

目的 研究统计活髓切断术应用于不同年龄成年人成熟恒牙的成功率。 方法 收集61例18～76岁患者中因深龋或重度磨耗导致牙髓炎的67颗活髓后牙,根据患者年龄分为青年组（18～39岁）,中年组（40～59岁）,老年组（60岁及以上）。使用MTA作为盖髓材料对患牙进行活髓切断术。在术后6个月进行临床和影像学评估。 结果 共对52颗龋源性牙髓炎以及15颗重度磨耗患牙进行了活髓切断治疗。老年组的成功率（80%）显著低于青年组（100%）,而中年组（89%）和其余两组之间均未发现显著差异。成熟恒牙活髓切断术的总体成功率为92％。 结论 活髓切断治疗在成年人龋源性牙髓炎和重度磨耗患牙中获得了良好的疗效,但60岁以上老年患者活髓切断治疗成功率相对较低,临床应用时需严格把握适应证。     

Pulpotomy in caries-exposed immature permanent molars using calcium-enriched mixture cement or mineral trioxide aggregate: a randomized clinical trial

International Journal of Paediatric Dentistry 2013; 23: 56–63 Objective. To compare clinical and radiographic outcomes of pulpotomy treatment using calcium‐enriched mixture (CEM) cement and mineral trioxide aggregate (MTA) in carious‐exposed vital immature permanent first molars. Design. Fifty‐one immature molars with clinical carious exposure with symptomatic/asymptomatic pulpitis met the inclusion criteria and randomly assigned to one of the treatment groups (CEM [26 teeth; 59 roots], MTA [25 teeth; 59 roots]). After performing pulpotomy and covering the radicular pulps with the biomaterials, all teeth were permanently restored. Blinded clinical and radiographic evaluations were performed at 6 and 12 months after operation for signs of success or failure. Radiographs were evaluated for complete/partial apical closure. The data were analysed using chi‐square test and generalized estimating equation (GEE) model. Results. There was no significant difference at the baseline between the two experimental groups. All available cases (49 teeth) showed pulp survival and signs of continuous root development after 12 months. Overall, complete apical closure (apexogenesis) occurred in 76.8% and 73.8% of radiographically interpreted roots in CEM cement and MTA groups, respectively. There was no statistical difference in terms of radiographic outcomes between two groups. Conclusions. Calcium‐enriched mixture cement and MTA showed similar performance in pulpotomy of immature caries‐exposed permanent molars.     

中老年人重度磨耗患牙活髓切断治疗临床疗效研究

目的 研究中老年人重度磨耗患牙活髓切断治疗的临床疗效。方法 收集28例40岁以上患者中因重度磨耗引起牙髓炎症状的患牙56颗,每名患者均有2颗患牙,同一患者的2颗患牙,随机1颗为试验组,另1颗为对照组,对照组患牙行根管治疗,试验组患牙使用MTA作为盖髓材料进行活髓切断治疗,术后观察6个月,比较两组的临床疗效。结果 对照组有4颗患牙失败,总成功率为85.2%,试验组失败的患牙有3颗,总成功率为88.9%,两者间差异无统计学意义(P>0.05)。结论 中老年人重度磨耗患牙进行活髓切断治疗具有良好的短期疗效,与根管治疗的成功率无显著差异,严格把控适应证是治疗成功的关键所在。     

Management of open apices in thirteen traumatized permanent incisors using mineral trioxide aggregate: Case series

AimThe partial pulpotomy can offer a successful outcome for the treatment of traumatic complicated crown fractures. The aim of this clinical report was to evaluate the effect of mineral trioxide aggregate (MTA) in apexogenesis of traumatized immature permanent incisors with pulp exposure.Case reportAccording to clinical and radiological examinations complicated crown fractures and open apices were identified in 13 permanent upper incisors in ten patients (age range 7–10 years). Partial pulpotomy procedures were performed and the teeth were treated with MTA. In this report, periodic clinical and radiological follow-ups were performed. At recall examinations, all teeth were asymptomatic, and clinical and radiological investigations revealed excellent healing patterns with continued apexogenesis.ConclusionRegular examination of immature traumatized permanent teeth is critical for vitality and apexification. In this report, clinical and radiological findings confirm that partial pulpotomy with MTA is a reliable and effective treatment approach in apexogenesis of traumatized immature permanent incisors with pulp exposure.     

A prospective clinical study of mineral trioxide aggregate for partial pulpotomy in cariously exposed permanent teeth

The aim of this study was to evaluate the success of using gray mineral trioxide aggregate (MTA) for partial pulpotomy in cariously exposed young permanent first molars. Thirty-one first permanent molars of 23 patients with a carious exposure were treated using a partial pulpotomy technique. The age of the patients ranged from 7.2 to 13.1 yr with an average of 10 yr. Clinical and radiographic examination revealed a pulpal response within normal limits and normal appearance of the periradicular area respectively. A diagnosis of reversible pulpitis and normal periapex was established. After isolation, caries removal and carious exposure, the exposed pulp tissue was removed with a diamond bur to a depth of 2 to 4 mm. After hemostasis, 2 to 4 mm of gray MTA paste was placed against the fresh wound. The floor of the cavity was covered with a base of glass ionomer. The teeth were restored with amalgam or stainless steel crowns. Teeth were reviewed radiographically and clinically at 3, 6, 12, and 24 month intervals. Twenty-two of the treated teeth did not show any clinical or radiographic signs of failure during the follow-up evaluation period. Six teeth did not respond to vitality testing at the final follow-up period; however, no radiographic signs of failure or clinical symptoms were detected. Gray MTA was a suitable dressing agent for parital pulpotomy in cariously exposed young permanent first molars.     

Bradykinin levels in dental pulp by microdialysis

Bradykinin is a potent mediator of pain and inflammation. To examine extracellular levels of bradykinin in human dental pulp, CMA/20 microdialysis probes were inserted into the pulp tissue of 22 teeth diagnosed with normal pulp or with irreversible pulpitis before their extraction or endodontic therapy. Probes were perfused with a modified Locke-Ringer's buffer and bradykinin levels in the dialysate evaluated using a radioimmunoassay. Mean extracellular levels of bradykinin within pulp tissue diagnosed with irreversible pulpitis were significantly higher (262.26 +/- 83.79 fmol/ml) than that found within normal pulp (19.41 +/- 6.47 fmol/ml). Highest levels of bradykinin were detected in pulp tissue diagnosed with irreversible pulpitis when the patient had reported pain in the past, compared with patients who were in pain just before their visit. These observations suggest that the bradykinin system is activated during pulpitis and may contribute to pain and inflammation.     

Comparison of Neurokinin A,Substance P,Interleukin 8, and Matrix Metalloproteinase-8 Changes in Pulp tissue and Gingival Crevicular Fluid Samples of Healthy and Symptomatic Irreversible Pulpitis Teeth

IntrodutionThe aim of this study was to compare levels of neurokinin A (NKA), substance P (SP), interleukin (IL)-8, and matrix metalloproteinase-8 (MMP-8) in pulp tissue and gingival crevicular fluid (GCF) samples of healthy and symptomatic irreversible pulpitis teeth.MethodsForty patients diagnosed with healthy and symptomatic irreversible pulpitis teeth were included in this study. NKA, SP, IL-8, and MMP-8 levels were measured using the enzyme-linked immunosorbent assay test after pulp and GCF samples were obtained from healthy (n = 20) and symptomatic irreversible pulpitis teeth (n = 20). GCF sampling of 40 teeth was repeated 1 week later. Routine root canal treatment procedures of the teeth were performed, and the treatment process was completed. As a control group, GCF samples were taken from the contralateral teeth in both groups. Statistical analysis was performed using dependent and independent t tests, analysis of variance, Kruskal-Wallis, Mann-Whitney U tests, and Pearson correlation analysis.ResultsComparing the groups, all mediator levels were significantly higher in the pulp samples in the pulpitis group compared with the healthy group (NKA: P < .001, SP: P = .005, IL-8: P < .001, and MMP-8: P < .001). Likewise, in the pulpitis group, all mediator levels were significantly higher in the first GCF samples compared with the healthy group (NKA: P = .01, SP: P < .001, IL-8: P = .001, and MMP-8: P < .001).ConclusionsIt was observed that NKA, SP, IL-8, and MMP-8 increased significantly in pulp tissue and GCF specimens of symptomatic irreversible pulpitis teeth compared with pulp tissue and GCF specimens of healthy teeth. Second, it was determined that NKA, SP, IL-8, and MMP-8 levels decreased significantly in GCF samples in teeth diagnosed with symptomatic irreversible pulpitis 1 week after the removal of inflamed pulp. Finally, SP, IL-8, and MMP-8 levels were found to be higher in pulp tissue samples of the patients with symptomatic irreversible pulpitis with higher pain scores than those with low pain scores.     

MTA用于龋源性露髓年轻恒牙部分活髓切断治疗的初步研究

目的：应用三氧化矿化聚合物（MTA）对龋源性露髓的年轻恒牙进行部分活髓切断术治疗并评价临床效果。方法：采用MTA作活髓保存剂,对26例29颗因龋露髓的年轻恒磨牙采用部分活髓切断术治疗,随访18个月,评价其疗效。结果：MTA部分活髓切断术治疗龋源性露髓年轻恒磨牙成功率为96.55%,67.85%治疗成功患牙有牙本质桥形成。结论：部分活髓切断术是治疗龋源性露髓年轻恒牙的有效方法,MTA是可供选用的较为理想的活髓保存剂。     

Calcitonin gene-related peptide receptor expression in healthy and inflamed human pulp tissue

AIM: To use radioreceptor analysis for comparing calcitonin gene-related peptide (CGRP) receptor expression in human pulp tissue samples collected from teeth having a clinical diagnosis of acute irreversible pulpitis, healthy pulps and teeth with induced inflammation. METHODOLOGY: Six pulp samples were obtained from teeth having a clinical diagnosis of acute irreversible pulpitis. Another eight pulp samples were obtained from healthy premolars where extraction was indicated for orthodontic purposes. In four of these premolars, inflammation was induced prior to pulp collection. All the samples were processed and labelled with 125I-CGRP. Binding sites were identified by 125I-CGRP and standard CGRP competition assays. RESULTS: CGRP receptor expression was found in all human pulp tissue samples. Most receptors were found in the group of pulps from teeth having a clinical diagnosis of acute irreversible pulpitis, followed by the group of pulps having induced inflammation. The least number of receptors was expressed in the group of healthy pulps. The Kruskal-Wallis and Mann-Whitney (post-hoc) tests showed statistically significant differences between the groups (P < 0.05). CONCLUSION: CGRP receptor expression in human pulp tissue is significantly increased during inflammatory phenomena such as acute irreversible pulpitis.     

应用牙髓切断术与牙髓摘除术治疗深龋机械性露髓乳磨牙的临床效果对比研究

 目的　对比研究应用矿物三氧化物凝聚体（mineral trioxide aggragate，MTA）牙髓切断术与Vitapex牙髓摘除术治疗深龋机械性露髓乳磨牙的临床效果。方法　选取2014年6—12月于第四军医大学口腔医院就诊并符合纳入标准的深龋患儿108例，共计患牙224颗。将所有患儿随机均分为牙髓切断组（119颗患牙）和牙髓摘除组（105颗患牙），分别采用MTA牙髓切断术和Vitapex牙髓摘除术进行治疗。术后6、12、18个月随访观察两组治疗效果，并进行治疗成功率评价。结果　随访患者共92例，共计患牙192颗，其中牙髓切断组患牙101颗，牙髓摘除组患牙91颗。术后6、12、18个月牙髓切断组治疗效果均优于牙髓摘除组；比较术后18个月两组治疗成功率发现，牙髓切断组治疗成功率（90.10%）高于牙髓摘除组（79.12%），差异有统计学意义（χ2 = 4.50，P = 0.04）。结论　相较于Vitapex牙髓摘除术，MTA牙髓切断术治疗深龋机械性露髓乳磨牙的短期疗效更好，推荐临床医生应用。