doi:10.1111/iej.

12225

Randomized control trial comparing calcium

hydroxide and mineral trioxide aggregate for
partial pulpotomies in cariously exposed pulps of
permanent molars

P. Chailertvanitkul1, J. Paphangkorakit1, N. Sooksantisakoonchai1, N. Pumas1,

W. Pairojamornyoot1, N. Leela-apiradee1 & P. V. Abbott2
1
Faculty of Dentistry, Khon Kaen University, Khon Kaen, Thailand; and 2School of Dentistry, The University of Western
Australia, Nedlands, WA, Australia

Abstract after 24 h, 3 months, 6 months, 1 year and 2 years.

Chailertvanitkul P, Paphangkorakit J, Sooksanti-
sakoonchai N, Pumas N, Pairojamornyoot W, Leela-
apiradee N, Abbott PV. Randomized control trial
comparing calcium hydroxide and mineral trioxide aggregate
for partial pulpotomies in cariously exposed pulps of permanent
molars. International Endodontic Journal, 47, 835–842, 2014.
Aim To compare the treatment outcomes when
calcium hydroxide and mineral trioxide aggregate are
used for partial pulpotomy in cariously exposed young
permanent molars in a randomized control trial.
Methodology Eighty-four teeth in 80 volunteers
(aged 7–10 years) with reversible pulpitis and carious
pulp exposures were randomly divided into two groups.
Exposed pulps were severed using high-speed round
burs until fresh pulp was seen. Cavities were irrigated
with 2.5% sodium hypochlorite, and the pulp exposures
were photographed and measured. Dycal or ProRoot
MTA was placed on the pulp. Vitremer was placed over
the material until the remaining cavity was 2 mm deep;
amalgam was then placed. Teeth were evaluated for
clinical symptoms and radiographic periapical changes
Mean survival times and incidence of extraction were
calculated using exact binomial confidence intervals.
Results The median survival time for both ProRoot
MTA and Dycal groups was 24 months. Three teeth
had unfavourable outcomes with the incidence rate of
0.20/100 tooth-months with ProRoot MTA (95% CI:
0.02–0.71) and 0.11/100 tooth-months with Dycal
(95% CI: 0.001–0.60). The incidence of unfavourable
outcomes was 0.05/100 (95% CI: 0.001–0.30) and
2.38/100 (95% CI: 0.29–8.34) tooth-months in teeth
with small (<5 mm2) and large (>5 mm2) pulp
exposure areas, respectively.
Conclusions Partial pulpotomy in teeth of young
patients with reversible pulpitis, either using ProRoot
MTA or Dycal, resulted in favourable treatment out-
comes for up to 2 years. The incidence of unfavour-
able outcomes tended to be higher in teeth with pulp
exposure areas larger than 5 mm2.
Keywords: calcium hydroxide, mineral trioxide
aggregate, pulp exposure, pulpotomy.
Received 29 January 2013; accepted 30 November 2013

pulp tissue. This treatment preserves pulp function,

Introduction
Partial pulpotomy is generally regarded as the
treatment of choice for immature teeth with exposed
Correspondence: Paul V. Abbott, School of Dentistry, The
University of Western Australia, Nedlands, WA 6009, Aus-
tralia (Tel.: +61 8 9346 7636; Fax: +61 8 9346 7666;
e-mail: paul.v.abbott@uwa.edu.au).
thus allowing continued root development (Webber
1984). Cvek (1978) reported that 96% of teeth healed
after being treated with partial pulpotomies associated
with complicated crown fractures. This technique
consists of the surgical amputation of 2–3 mm of
inflamed coronal pulp tissue. The wound surface is
treated with a capping agent to promote healing and
maintain viability of the remaining pulp tissue. It has
been suggested that partial pulpotomy, compared

© 2013 International Endodontic Journal. Published by John Wiley & Sons Ltd International Endodontic Journal, 47, 835–842, 2014 835
 Calcium hydroxide versus MTA for pulpotomies Chailertvanitkul et al.
with cervical pulpotomy, has many advantages
including preservation of the cell-rich coronal pulp
tissue, a necessary element for better healing (Fong &
Davis 2002), and the physiologic apposition of
dentine in the coronal area. In contrast, cervical
pulpotomy removes all the coronal pulp tissue, leav-
ing the crown without the possibility of physiologic
apposition of dentine, thereby increasing the risk of
cervical fracture (Camp et al. 2002, Pitt Ford &
Shabahang 2002).
Whilst high rates of pulp survival have been
reported for partial pulpotomies in traumatized teeth,
the outcomes of treatment of cariously exposed pulps
with partial pulpotomy in permanent teeth have not
been extensively reported. In a systematic review, Ag-
uilar & Linsuwanont (2011) found only six articles
that met their inclusion criteria, and they all had low
average scores for quality of methodology. The studies
included in their review were reported in the litera-
ture from 1989 to 2007, with half being published in
the 1990s. Only 199 teeth were included in these
studies, and the follow-up period ranged from
6 months to 3 years. The only materials reported in
this review for use as the capping agent were calcium
hydroxide and mineral trioxide aggregate (MTA). Suc-
cess rates at 6–12 months ranged from 100% with
calcium hydroxide (Baratieri et al. 1989) to 82.1%
with MTA (Barrieshi-Nusair & Qudeimat 2006). Suc-
cess rates after more than 3 years were reported to be
from 98.8% (Mej are & Cvek 1993) to 100% (Mass &
Zilberman 1993), both with calcium hydroxide. The
outcomes with MTA were only reported up to 1–
2 years with success in 95.2% (Barrieshi-Nusair &
Qudeimat 2006) and 96% (Qudeimat et al. 2007).
For many decades, calcium hydroxide has been the
material of choice amongst the various pulp-capping
materials that are available. Clinical studies have
reported a high rate of favourable outcomes of partial
pulpotomies carried out with calcium hydroxide in
cariously exposed young permanent molars (Baratieri
et al. 1989, Mass & Zilberman 1993, Mej are & Cvek
1993, Nosrat & Nosrat 1998). Despite the wide use of
calcium hydroxide, many studies have shown that it
has physical limitations such as nonadherence to den-
tine, dissolution in tissue fluids and degradation upon
tooth flexure (Cox & Suzuki 1994, Silva et al. 2006).
Cox et al. (1996) demonstrated that the hard tissue
bridge that formed under calcium hydroxide had
many imperfections and tunnel defects that may per-
mit bacterial penetration. Aeinehchi et al. (2002)
reported that a thicker dentinal bridge and the more
836 International Endodontic Journal, 47, 835–842, 2014
frequent presence of an odontoblastic layer were
evident when human teeth were capped with MTA
compared with calcium hydroxide. After 6 months,
0.43-mm-thick dentine bridges were evident when
MTA was placed compared with 0.15 mm with no
odontoblastic layer when calcium hydroxide was used.
Several studies have reported that mineral trioxide
aggregate (MTA) has good physical characteristics
(Torabinejad et al. 1995a,b) and is biocompatible
(Kettering & Torabinejad 1995). It provides a good
seal, has excellent marginal adaptation and maintains
a high pH for a long period of time (Torabinejad et al.
1995a,b). In addition, an in vitro study (Moghad-
dame-Jafari et al. 2005) has shown that MTA did not
induce apoptosis of pulp cells but instead induced pro-
liferation of these cells. These authors stated that their
findings suggested a potential mechanism to explain
the regenerative effect seen in the pulp when MTA is
used for direct pulp capping. Barrieshi-Nusair & Qude-
imat (2006) clinically and radiographically evaluated
the outcome of using grey-MTA for partial pulpoto-
mies in young permanent teeth in which pulps were
exposed by caries. They concluded that grey-MTA
was a suitable material for partial pulpotomy in cari-
ously exposed young permanent first molars.
The aim of this in vivo study was to clinically and
radiographically compare the outcome of partial
pulpotomies in cariously exposed pulps of young per-
manent molars using mineral trioxide aggregate and
calcium hydroxide in a randomized controlled trial.
Materials and methods
The research protocol was reviewed and approved by
the Ethics Committee of the Khon Kaen University in
Thailand. Informed consent was obtained from the
parents of all volunteers before the initiation of
clinical procedures. Figure 1 shows the CONSORT
flowchart summarizing the design of the study.
Eighty-four teeth in 80 volunteers having one or two
first permanent molars with deep occlusal carious
lesions that resulted in cariously exposed pulps were
included in this study. The ages of the volunteers ran-
ged from 7 to 10 years, and none of the participants
had any medical problems to contraindicate or alter
the treatment procedures. The patients were offered
root canal treatment or extraction if any adverse
symptoms of irreversible pulpitis, apical periodontitis
or infection occurred at any time during the study.
On examination, all teeth had Black’s classification
class I cavities that could be restored with amalgam.
© 2013 International Endodontic Journal. Published by John Wiley & Sons Ltd
 Chailertvanitkul et al. Calcium hydroxide versus MTA for pulpotomies

Enrolment Assessed for eligibility (n = *)

Excluded (n = **)
♦ Not meeting inclusion criteria (n = **)
♦ Declined to participate (n = **)
♦ Other reasons (n = **)

Randomized (n = 80)

Allocation
Dycal group
Allocated to intervention (n = 40 patients)
♦ Received allocated intervention (n = 40 teeth)
♦ Did not receive allocated intervention (n = 0)
MTA group
Allocated to intervention (n = 40 patients)
♦ Received allocated intervention (n = 44 teeth)
♦ Did not receive allocated intervention (n = 0)

Follow -Up
Lost to follow-up (give reasons) (n = 4) Lost to follow-up (give reasons) (n = 2)
REASON: Did not attend follow-up appointment REASON: Did not attend follow-up appointment

Discontinued intervention (give reasons) (n = 0) Discontinued intervention (give reasons) (n = 0)

Analysis
Analysed (n = 35 teeth) Analysed (n = 41 teeth)
♦ Excluded from analysis (give reasons) (n = 0) ♦ Excluded from analysis (give reasons) (n = 0)
NOTE: 1 tooth extracted before 24 month review NOTE: 1 tooth extracted before 12 month review

* Note: Volunteer children were screened for possible inclusion unl a total of 80 parcipants were
found. The total number of children screened was not recorded.

** Note: All possible teeth that might have met the inclusion criteria were treated – but some did
not have pulp exposures and therefore they were excluded. Some teeth required root canal
treatment (for varying reasons) and were therefore excluded. The numbers of teeth excluded in
these ways were not included but the children’s teeth were treated appropriately.

Figure 1 CONSORT flow chart outlining the study design.

The teeth had no previous operative procedures, no

history of spontaneous pain, and they responded nor-
mally to an electric pulp tester (Analytic Technology
Corp, Redmond, WA, USA). The teeth demonstrated
no mobility or swelling, and no tenderness to percus-
sion or palpation. Radiographs showed normal
appearance of the periradicular tissues. In all cases,
the diagnosis was reversible pulpitis with normal
periradicular tissues.
To control the angulations of the radiographs
taken, a jig for each participant was made using an
impression material (Fig. 2). This jig was attached to
a Rinn XCP film holder (Rinn Corporation, Elgin, IL,
USA.) and used for radiographs taken at every Figure 2 A jig was constructed for each tooth using impres-
follow-up appointment (Figs 3 and 4). Following sion material attached to a Rinn XCP film holder to ensure
administration of mepivacaine hydrochloride 3% that reproducible angles were used for each follow-up radio-
without vasoconstrictor (Septodontâ, Saint-Maur- graph.
des-Fosses, France), the tooth was isolated with rub-
ber dam. A cavity was prepared using a fissure bur in excavators were used to excavate all of the carious
a high-speed handpiece with water coolant. A large dentine. Exposed pulp tissue was removed using a
round bur in a low-speed handpiece and spoon sterile round bur with a high-speed handpiece under

© 2013 International Endodontic Journal. Published by John Wiley & Sons Ltd International Endodontic Journal, 47, 835–842, 2014 837
 Calcium hydroxide versus MTA for pulpotomies Chailertvanitkul et al.

exposed pulp and cavity were photographed with a

Sirocam camera (Sirona Dental Systems GmbH, Bens-
heim, Germany). A sterile ball bearing with known
diameter was placed in the cavity to enable the area
of the pulp exposure to be calculated later (Fig. 5).
Once the pulp exposure was confirmed, each tooth
was randomly allocated to a pulp-capping material
using pre-prepared envelopes so that 40 volunteers
(44 teeth) received MTA (ProRootâ; Dentsply Tulsa
Dental, Tulsa, OK, USA) and the other 40 volunteers
(40 teeth) received calcium hydroxide (Dycalâ; L.D.
Caulk, Milford, DE, USA). Each participant chose one
of the sealed envelopes to allocate the material to be
used.
Figure 3 The jig attached to the XCP film holder was used The ProRoot MTA and Dycal were freshly mixed
for radiographs taken at each follow-up. according to manufacturer’s directions immediately
prior to use. The material was gently placed against
(a) the fresh pulp wound with a plastic instrument, and
the excess material was scraped off. Light-cured
Vitremer (3M ESPE, St. Paul, MN, USA) was placed to
cover the capping material with a thickness of 2–
3 mm, and the remaining cavity was restored with
amalgam. All procedures (including screening,
diagnosis and treatment) were carried out by two
clinicians (WP and NL). Immediate postoperative
periapical radiographs were taken to serve as compar-
isons for further postoperative evaluations.
Twenty-four hours after treatment, each tooth was
reviewed for any clinical symptoms and the amalgam
restorations were polished. The teeth were then
(b)
reviewed radiographically and clinically after 3-, 6-,

Figure 4 Radiographs of a representative case in the study.

(a) Preoperative radiograph of tooth 36; (b) follow-up
radiograph of tooth 36 after 24 months.

water coolant to a depth of 2–3 mm. The pulp wound

was gently flushed, and bleeding was controlled using Figure 5 The exposed pulp cavity was photographed using a
a cotton pellet saturated with 2.5% sodium Sirocam camera by placing a sterile ball bearing with known
hypochlorite solution applied for 1–2 min. The diameter as the reference.

838 International Endodontic Journal, 47, 835–842, 2014 © 2013 International Endodontic Journal. Published by John Wiley & Sons Ltd
 Chailertvanitkul et al. Calcium hydroxide versus MTA for pulpotomies

12- and 24-month intervals. All recall examinations
were performed by another investigator (PC) who was
blinded with respect to the type of capping material
used. All periapical radiographs were examined by a
further investigator (JP) who was also blinded regard-
ing the capping materials used. The treatment out-
come was considered as unfavourable if one or more
of the following were present: pain, swelling, sinus
tract, tenderness to percussion, evidence of periradicu-
lar or furcation pathosis, root resorption or a lack of
continuation of root development in immature teeth.
Median survival time and the incidence of tooth
extraction per 100 tooth-months with 95% exact
binomial confidence interval (CI) were calculated. Par-
ticipants who dropped out during the follow-up period
were treated as censored data (i.e. they were used in
the survival analysis up to the time they left the
study) as it could not be assured that those teeth
would be present after the 2-year follow-up time.
Results
The median survival time for both ProRoot MTA and
Dycal groups was 24 months, and these were not
statistically significantly different. Table 1 summarizes
Table 1 Area of pulp exposure and outcome of partial pulpotomy treatment over the 24-month follow-up period. Numbers
indicate the number of teeth with a favourable outcome at each review for each material and area of exposure
the findings at each recall appointment for each
material grouped according to the areas of the pulp
exposures. Two teeth from the ProRoot MTA group
and one tooth from the Dycal group were extracted
due to unfavourable treatment outcomes. The inci-
dence rate of unfavourable outcomes was 0.20/100
tooth-months (95% CI: 0.02–0.71) in the ProRoot
MTA group and 0.11/100 tooth-months (95% CI:
0.001–0.60) when Dycal was used.
When the sizes of the pulp exposures were grouped
into small (<5 mm2) and large (>5 mm2) areas, the
incidence rates of unfavourable outcomes were 0.05/
100 (95% CI: 0.001–0.30) and 2.38/100 (95% CI:
0.29–8.34) tooth-months for ProRoot MTA and
Dycal, respectively (Table 2).
Six participants (four from the Dycal group; two
from the ProRoot MTA group) were removed from
the study – five because they did not attend the 12-
month review appointments and one who did not
attend the 24-month appointment. One tooth from
the ProRoot MTA group had been extracted by the
time of the 12-month recall appointment, and one
tooth from the Dycal group had been extracted by the
time of the 24-month appointment. The volunteers
and their parents chose to extract these teeth rather

Capping Review at Review at Review at Review at

material used 3 months 6 months 12 months 24 months

Area of pulp exposure (mm2) Dycal MTA Dycal MTA Dycal MTA Dycal MTA Dycal MTA

0.01–1.0 23 23 23 23 23 23 21 22a 21 22
1.01–2.0 5 11 5 11 5 11 5 10a 5 10
2.01–3.0 4 2 4 2 4 2 4 2 4 2
3.01–4.0 2 2 2 2 2 2 2 2 2 2
4.01–5.0 4 4 4 4 4 4 3a 4 3 4
5.01–6.0
6.01–7.0
7.01–8.0 1 1 1 1 1
a
8.01–9.0 1 1 1 1
b b
9.01–10.0 1 1 1 1 1 1 1
Totals 40 44 40 44 40 44 37 41 35 41
a
Indicates participants who had withdrawn from the study and did not attend any further review appointments.
b
Indicates a tooth had been extracted prior to the review appointment.

Table 2 Median survival time and incidence rate (tooth extraction rate)/100 tooth-month

Number Time at risk/ Median survival Incidence rate/100

Variables of teeth tooth-months time (month) tooth-month (95% CI)

Dycal 40 924 24 0.11 (0.001–0.60)

MTA 44 1020 24 0.20 (0.02–0.71)
Exposure area <5 mm2 80 1860 24 0.05 (0.001–0.30)
Exposure area >5 mm2 4 84 24 2.38 (0.29–8.34)

© 2013 International Endodontic Journal. Published by John Wiley & Sons Ltd International Endodontic Journal, 47, 835–842, 2014 839
 Calcium hydroxide versus MTA for pulpotomies Chailertvanitkul et al.
than having root canal treatment because of the costs
and the time constraints.
Discussion
Root canal treatment in first permanent molars in
young children can present difficulties and is affected
by the child’s ability to cooperate with, and tolerate,
a long treatment time. Moreover, if the tooth is only
partially erupted and/or if the root is not fully formed,
then the treatment can be even more difficult. Instead
of performing endodontic treatment at a very early
age, partial pulpotomy might be the treatment of
choice for many teeth. The teeth in this study were
immature at the time of treatment and maintaining
the pulp in the radicular portion allowed further root
development.
Trope et al. (2002a,b) suggested that partial pulpoto-
my with a calcium hydroxide dressing and a good coro-
nal restoration was a preferable procedure over direct
pulp capping for the inflamed pulp. Barthel et al.
(2000) in a retrospective study found that the success
rate of capping cariously exposed pulps in permanent
teeth after 5 and 10 years was only 37% and 13%,
respectively, in patients across a broad range of ages
(10–70 years old). Bjørndal et al. (2010) also reported
low success rates for both direct pulp capping (31.8%)
and partial pulpotomy (34.5%) when treating cariously
exposed pulps in adult teeth with no statistical
difference between the two groups. On the other hand,
a higher success rate (91.4–93.5%) was obtained by
partial pulpotomy when performed on cariously
exposed pulps of permanent teeth in patients aged 6–
15 years (Mej are & Cvek 1993). A systematic review
by Aguilar & Linsuwanont (2011) has shown that par-
tial pulpotomy and full pulpotomy in permanent teeth
with cariously exposed pulp had a high success rate
over 3 years or more. Complete pulpotomy was not
chosen in this study because it may destroy cell-rich
coronal pulp tissue, will arrest dentine formation at the
cervical area and can result in calcification of the root
canals (Fong & Davis 2002). Furthermore, a 10-year
radiographic review of pulps after partial pulpotomy in
young permanent molars by Mass & Zilberman (2011)
supported the clinical impression that partial
pulpotomy is warranted in well-chosen cases.
When encountering a cariously exposed pulp, it is
difficult to assess the condition of the pulp, which
plays a critical role in the outcome of the pulp ther-
apy. In this study, strict criteria were followed to
select cases and strict aseptic techniques were used
840 International Endodontic Journal, 47, 835–842, 2014
for all patients. The teeth were restored immediately
after the pulp treatment with a definitive restoration,
which may have played an important role in the suc-
cess rate obtained, since it is well documented that
preventing bacterial ingress is a determinant factor
for the success of pulp treatment (Cox et al. 1987).
Barthel et al. (2000) reported that the success rate of
pulp capping of carious exposures in permanent teeth
was significantly affected by placing a definitive resto-
ration within the first 2 days after the pulp exposure.
In the study by Bjørndal et al. (2010), the teeth were
not definitively restored until 1 month after the pulp
treatment had been carried out. In addition, rubber
dam was not placed until after the pulps had been
exposed. Both of these factors may have contributed
to the poor treatment outcomes reported in that
study. In addition, the patients’ ages may have played
a role as older pulps are more fibrous, less cellular
and may have less blood supply (Massler 1972). The
studies by Barthel et al. (2000) and Bjørndal et al.
(2010) both involved adult patients with the former
having a small number of patients aged 10–20 years,
but none <10 years old, whereas in the current study
all patients were aged 7–10 years. Undergraduate
dental students performed the procedures in the Bar-
thel et al. (2000) study, and this may have been
another factor affecting the outcome.
Matsuo et al. (1996) suggested observing the
degree of pulp bleeding rather than relying on preop-
erative clinical signs and symptoms. Profuse bleeding
that is difficult to stop indicates severe pulp inflamma-
tion. A study by Hafez et al. (2002) showed that
sodium hypochlorite is an effective haemostatic agent
in direct pulp capping. It is not toxic to pulp tissue
and does not interfere with pulp healing. Therefore,
in this study, the pulp wound was rinsed and
haemorrhage was controlled with a cotton pellet
saturated with 2.5% sodium hypochlorite applied for
1–2 min.
Dycal was selected instead of a Ca(OH)2 paste
because Ca(OH)2 with its very high pH creates super-
ficial obliteration zones and coagulation necrosis
where reparative dentine ultimately begins to form in
the deeper zones. Dycal, with its lower pH, may avoid
major tissue damage and stimulate reparative dentine
more directly (Stanley 1989). The mechanism of
action of calcium hydroxide is similar and comparable
with MTA. Holland et al. (1999) theorized that the
tricalcium oxide in MTA reacts with tissue fluids to
form calcium hydroxide, which can result in hard
tissue formation similar to that of calcium hydroxide.
© 2013 International Endodontic Journal. Published by John Wiley & Sons Ltd
 Chailertvanitkul et al. Calcium hydroxide versus MTA for pulpotomies
Fernandes et al. (2008) analysed the immunohisto-
chemical expression of fibronectin and collagen in
human dental pulps that had been submitted to direct
pulp capping with calcium hydroxide or a single-bond
adhesive system. The results demonstrated that adhe-
sive systems in direct contact with healthy pulps will
not lead to expression of proteins that are believed to
be essential for pulp repair. In contrast, calcium
hydroxide showed good biocompatibility properties
with the pulp tissue, inducing the expression of
reparative molecules. They therefore suggested that
calcium hydroxide still remains the material of choice
for the treatment of clinically normal pulps that have
been accidently exposed.
The length of time necessary for adequate
postoperative follow-up remains unclear although it is
recommended that such teeth should be followed for
longer time periods to evaluate the success rate on a
long-term basis. Many calcium hydroxide studies
showed that failures occur soon after treatment. Ma-
tsuo et al. (1996) reported the success rate after direct
pulp capping of cariously exposed pulps was similar
between groups, which had 3 months and 18 months
follow-up periods (ranging from 80–83.3%). They
suggested that 3 months was adequate for a tentative
assessment of the outcome of the treatment. In this
study, the follow-up time period was 2 years, and one
might expect that if failure was anticipated to happen
then it would have occurred within these 2 years.
The time taken for apexogenesis after pulpotomy
ranges from 1 to 2 years, depending upon the extent of
root development at the time of injury and treatment.
In this study, the patients were recalled at 24 h,
3 months, 6 months, 1 year and 2 years after the
treatment. An absence of clinical symptoms does not
necessary reflect the true state of the pulp and therefore
when evaluating pulpotomies, clinical signs such as
swelling or sinus tract formation and radiographic
signs of pulp and periradicular pathologic changes are
the major means of indicating the state of the pulp.
In this study, three teeth were extracted even
though the research protocol was to perform pulpec-
tomy if the partial pulpotomy had an unfavourable
outcome. The parents of the patients decided to have
the teeth extracted rather than contacting the
researchers because extraction is included in the free
government healthcare system. They preferred not to
spend time and money having further treatment at
the dental hospital.
The most appropriate multivariable statistical
analysis for this time-censored data would be
© 2013 International Endodontic Journal. Published by John Wiley & Sons Ltd
survival analysis with Cox’s proportional hazards
regression model. However, the incidence rates of
unfavourable outcomes were very low in the pres-
ent study, which would affect the validity of such
analysis. Hence, descriptive statistics (median sur-
vival time and the incidence rate) were used
instead. It was found that partial pulpotomy with
either ProRoot MTA or Dycal was highly successful
for treating cariously exposed molars in young
patients.
Conclusions
Within the limited 2-year follow-up period of the pres-
ent study, it can be concluded that:
1. The partial pulpotomy procedure with a strict
aseptic technique resulted in favourable treatment
outcomes for teeth with reversible pulpitis due to
caries in the vast majority of young patients.
2. There was no different in the success rate of the
partial pulpotomy using ProRoot MTA and Dycal.
3. Although there were limited numbers of cases
with large pulp exposure areas (>5 mm2), there
was a tendency towards less favourable outcomes
in these teeth.
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