Evaluation of different treatment modalities for vital pulp of immature permanent molars: a randomized clinical trial

Introduction:
An increasing demand for vital pulp therapy with a higher success rate has been observed due to frequent occurrence of pathological pulp exposures in young, immature permanent molars.

Objectives:
To compare and assess apexogenesis results in young, immature permanent molars following pulpo­tomy using calcium hydroxide (CH), mineral trioxide aggregate (MTA), laser, and laser-assisted MTA.

Material and methods:
One hundred carious immature permanent molars indicated for pulpotomy in children aged 6-9 years were randomly allocated into four equally distributed groups (n = 25), i.e., CH, MTA, laser, and laser-assisted MTA. At 6- and 12-month follow-up intervals, patients underwent clinical and radiographic assessments with digital periapical radiography. Outcomes were compared using ANOVA and Monte Carlo tests.

Results:
Throughout the 12-month follow-up period, no statistically significant difference was found. Clinical evaluation at 12 months revealed success rates of 98, 98, 100, and 100% for CH, MTA, laser, and laser-assisted MTA groups, respectively. Radiographic evaluation at 12 months revealed periapical lesion and periodontal liga­ment widening in 8% of patients in CH and MTA groups. The assessment of radiographic changes of the root foramen diameter between 0 and 12 months was the highest for the laser-assisted MTA group (44.1%), followed by the laser (38.4%), MTA (35.7%), and CH groups (21.8%).

Conclusions:
The findings of pulpotomy treatments carried out in this research were positive in four different kinds of pulpotomy techniques used. Laser and laser-assisted MTA pulpotomy can be employed as effective substitutes for CH and MTA pulpotomies in immature permanent molars.