Endo Resident US Army Dental Activity, Ft Gordon Augusta, Georgia, United States
Asymptomatic deep carious lesions may lead to pulp exposure and require pulpal intervention. The aim of this research was to evaluate if a treatment protocol with bioceramics for full pulpotomy in patients with asymptomatic irreversible pulpitis/normal apical tissues provided short term prevention of pain (assessed during the first month) in a simulated deployed dental setting. After obtaining informed consent patients decided on treatment of full pulpotomy (VPT) or non-surgical root canal therapy (NSRCT). Full pulpotomy removed the diseased pulp tissue to the level of the orifices and restored with mineral trioxide aggregate (MTA) over the pulp stump, followed by glass ionomer and restored with a permanent restoration. Alternatively, NSRCT was completed with VPT post-op care that included taking 4 mg dexamethasone immediately post-operatively, at bedtime and the following morning. Patient completed a pain diary at 4 hrs, 12 hrs, 24 hrs, 72 hrs, one week and one month post operatively using the Defense and Veterans Pain Rating Scale 2.0. Mean pain score for VPT at 4, 12, 24, 72 hrs, 1 week, and one month were 0, 0, 0, 0.5, 2.5, 0, respectively. Mean pain score for NSRCT at same time points were 2, 3, 1, 0, 0, 0, respectively. VPT showed minimal initial pain, but a delayed increase, while NSRCT showed initial pain that tapered by one week. All patients were asymptomatic at one month. There was no significant difference between the two groups (t-test, p>0.05). VPT may be a valuable alternative for a deployed soldier.
