International Journal of Science and Research (IJSR) ISSN (Online): 2319-7064 Index Copernicus Value (2013): 6.14 | Impact Factor (2013): 4.438 Volume 4 Issue 2, February 2015 www.ijsr.net Licensed Under Creative Commons Attribution CC BY Success of Direct Pulp Capping and Partial Pulpotomy of Primary Teeth using MTA R. Kabaktchieva 1 , N. Gateva 2 1 Professor, Department of Pediatric Dentistry, Faculty of Dental Medicine, Medical University, Faculty of Dental Medicine,1 G.Sofiisky St.,1431 Sofia, Bulgaria 2 Associate Professor, Faculty of Dental Medicine, Medical University, Department of Pediatric Dentistry Sofia, Bulgaria; Abstract: The purpose of this study was to compare the clinical and radiographic success rate of direct pulp capping (DPC) and partial pulpotomy (PP) treatment using MTA as pulp capping agent in treatment of primary teeth with pulp exposure after direct complete excavation. Methods: In the research were included 88 primary teeth with deep carious lesions without signs and symptoms of irreversible pulpitis and where pulp exposure occur. All teeth were treated under local anaesthesia and direct complete excavation DPC was conducted when the pulp is exposed up to 1 mm. PP is a procedure in which the inflamed tissue is removed to a depth of 1 mm or deeper. The pulp wound was dressed with grey MTA, GIC. Forty-nine teeth were treated with direct pulp capping and MTA; 53 teeth were treated with partial pulpotomy and MTA. The patients were scheduled for follow-up in 6 and 12 months. Results: The difference in the level of success was not statistically significant (p>0.05) for the groups of teeth treated with partial pulpotomy (93.48%-91.30%) versus those treated with direct pulp capping (92.86%-88.09%). Conclusions: Primary teeth with reversible pulpitis can be treated successfully by DPC and PP using MTA. Keywords: dental pulp exposure, reversible pulpitis, pulp dressing agent, calcified tissue barrier, MTA 1. Introduction Despite the large progress in the prevention of dental caries [1, 2, 3] clinicians often diagnose deep caries and exposed dental pulp in both dentitions. Specialized literature discusses different treatment options for vital pulp exposed in primary teeth [2, 4, 5, 6] The purpose of pulp therapy is to maintain the vitality of the pulp. The most preferable method of treatment of reversible pulpitis in primary teeth is direct pulp capping [7, 8, 9] and pulpotomy [10, 11, 12]. Partial pulpotomy, which is widely used for the treatment of exposed pulp in permanent teeth [13, 14, 15] has been already taught [5] and tested as treatment method in primary teeth [16]. Another aspect of pulp treatment is the issue of selecting biological pulp capping material that affects the remaining vital pulp. Current clinical practice abounds with studies demonstrating high success rates of Mineral trioxide aggregate (MTA) administered as pulp capping agent in primary teeth [17, 18, 19, 20]. MTA has been shown to induce less pulp inflammation and more dentine bridge formation when compared with CaOH cement [7, 21, 22, 23, 24]. The aim of this study was to compare the clinical and radiographic success rate of direct pulp therapy (DPC) and partial pulpotomy (PP) treatment in primary teeth with reversible pulpitis using mineral trioxide aggregate as pulp dressing agent. 2. Materials and Methods Ethical approval was obtained from the Human Ethics Research Committee at the Medical University - Sofia, Bulgaria. Financial support was obtained from the Medical Science Council (Medical University-Sofia) through Grant No. 19/2011. Criteria for selection of children were healthy children aged 4-8, without history of allergies and with positive attitude towards dental treatment. Written consent was obtained from the parents of all the participating children. Criteria for selection of primary teeth were teeth with large cavitated carious lesion, visually without pulp exposure, without mobility, no swelling, tenderness to percussion or palpation, no evidence of draining sinus or previously conducted treatment, and they were suitable for adhesive restoration. Symptoms were tooth without pain - no night and spontaneous pain, pain to cold, sweet and pressure while chewing. Bitewing Radiography were used to select teeth with deep dentin carious lesions and a risk of pulp exposure -the demineralized dentin penetrated three fourths or more of the entire dentin thickness, with physiological root resorption up to ½ of the length of the root/s, teeth without internal or external resorption, with no furcation radiolucency or widened periodontal ligament space. These pre-operative clinical and radiographical criteria are typical for reversible pulpitis. Intraoperative Findings. In addition a mechanical pulp exposure did not exceed 1-2 mm in diameter, and a haemorrhage control of pulp exposure site was achieved within one minute. Treatment procedures All teeth were treated under local anaesthesia (Scandonest 2%, Septodont, France; Ubistesin forte , 3M ESPE AG, Germany) isolated with cotton rolls. All cavities were opened with a carbide bur in a high-speed handpiece under constant water spray. A large round bur in a low speed handpiece and spoon excavators were used during caries Paper ID: SUB151086 287