Clinical Efficiency of Dental Pulp Caping with Rotseal

Abstract

Aim: The aim of the study was to evaluate the clinical effectiveness of pulp capping with dental Portland cement (Rootseal*) in the treatment of dentine caries and pulp hyperemia.

Methods: In this study the sample of 202 teeth in 130 patients was recruited from all patients who had exposed dental pulps and who attended the 7 Minsk City Dental Clinic during the period 2012 - 2014 and agreed to take part. Patients, who visited the clinic on odd days of the month, were selected for the calcium hydroxide group. Patients who visited the clinic on even days were selected for the Rootseal group. The patients signed “Informed consent for participating in research”. The study was approved by Bioethical Committee of Belarusian State Medical University. The patients were between the ages of 18 - 55 years old. The method of preserving pulp viability with Rootseal was used in 80 patients and 97 teeth. In the control group 105 teeth of 70 patients were treated with calcium hydroxide. In the Rootseal group 51 were treated with indirect pulp capping and 46 were treated with direct pulp capping. In the calcium hydroxide group 69 were treated with indirect pulp capping and 36 with direct pulp capping. Their clinical examination included: establishing the patient complaints, a full oral examination with assessment of oral indices, electric and thermal pulp testing and radiographs. Direct, immediate and long-term results of treatment were evaluated after 2 - 14 days, 3 - 6 months and 1-2 years. The evaluation of the statistical significance of differences between two groups was performed using the Mann-Whitney and the chi-square tests.

Results: Not all the teeth were assessed after 12 – 24 months, because for various reasons not all patients could visit the clinic for follow- up examinations. One to two years after initial therapy. In the indirect pulp capping with calcium hydroxide sub-group, 60 teeth (90%) had symptom-free vital pulps and 7 (10%) had chronic apical periodontitis. In the indirect pulp capping with Rootseal sub group 48 teeth (96%) had symptom-free vital pulps, one (2%) had chronic apical periodontitis and one ( 2%) had chronic pulpitis. In the direct pulp capping with calcium hydroxide sub group 18 (53%) of teeth were symptom-free and had vital pulps, one (3%) had chronic pulpitis, 14 (42%) had chronic apical periodontitis and one (3%) had acute apical periodontitis. In the direct pulp capping with Rootseal sub group 43 (96%) teeth had symptom-free vital pulps and 2 (4%) had chronic apical periodontitis. The success of indirect and direct pulp capping with Rootseal was 48 (96%) and 43 (96%) respectively. In the calcium hydroxide group it was 60 (90%) and 18 (53%), a statistical difference of p<0.05.

Conclusions: In the population studied, Rootseal was superior to calcium hydroxide for retaining pulp vitality after a period of one to two years. Rootseal cement is less expensive than other pulp capping materials, moreover, its use reduces treatment time and number of visits, which is relevant to health economics and Dental Public Health.

*Chemically Rootseal includes a powder portion containing the radiopaque material ( bismuth oxide), cement, comprising dicalcium silicate, tricalcium silicate, tricalcium aluminate, and phosphorus-fluorine material, silicon oxide (SiO2, K2O, Al2O3, Na2O, Fe2O3, SO3, CaO2, Bi2O3, MgO, and the insoluble precipitate CaO, K2SO4, Na2SO4) and a liquid portion containing distilled water. Rootseal is manufactured by the Grodno Institute of the Nitrogen Industry, Grodno, Belarus.