Comparative evaluation of indirect pulp therapy and amputation treatment in primary teeth with deep dentin caries: A randomised clinical study

The aim of this study was to evaluate the clinical and radiographic success rates of indirect pulp therapy (IPT) and total pulp amputation using MTA material in the treatment of primary second molars with deep dentin caries. For this purpose, a total of 78 primary second molars (42 lower, 36 upper) belonging to 55 patients (22 girls, 33 boys) aged 6-9 years without any systemic disease were included in the study. The teeth were randomly divided into two groups and 39 of them performed IPT with caries cleaning method up to soft dentin. In 39 of them, total pulp amputation was performed for perforations exceeding 1 mm after caries cleaning method up to hard dentin. The teeth in the study were restored with stainless steel crowns. After the completion of the treatments, clinical examinations were performed at 3,6,9,12 months and radiographic examinations at 6 and 12 months. The teeth were evaluated in terms of pain in anamnesis, percussion, palpation, mobility, swelling, presence of abscess in clinical evaluation and continuity of lamina dura, lesion in furcation, periapical lesion, presence of pathological root resorption in radiographic evaluation. The data obtained in the study were analysed with SPSS (22.0) software. Since the data were not normally distributed, Mann-Whitney U test was used for comparisons between paired groups. The relationship between categorical data was analysed by Chi-Square analysis. A significance level of 0.05 was accepted in the statistical evaluation of the obtained data. According to the results, 97.3% clinically and 91.9% radiographically success was achieved in the IPT group, while 71.4% clinically and 54.3% radiographically success was achieved in the amputation group. A statistically significant difference was found between these success rates (p<0.05). In the light of the clinical and radiographic evaluations in our study, it is thought that avoiding pulp perforation by caries removal method up to soft dentin, applying biocompatible materials to this area and providing a sealed coating will increase the success in the treatment of deep dentin caries lesions in deciduous teeth after 12 months of follow-up. It was concluded that the success of the treatment of deciduous molars with DDC without pulp perforation during treatment was higher both clinically and radiographically compared to deciduous molars with DDC with pulp perforation. Keywords: Deep dentin caries, Indirect pulp therapy, MTA, Selective caries removal, Total pulp amputation,