Postendodontic Pain after Pulpotomy or Root Canal Treatment in Mature Teeth with Carious Pulp Exposure: A Multicenter Randomized Controlled Trial

摘要

This equivalence, randomized, clinical trial aimed to compare the postoperative pain of root canal therapy (RCT) with pulpotomy with mineral trioxide aggregate (PMTA) or calcium-enriched mixture (PCEM) in permanent mature teeth. In seven academic centers, 550 cariously exposed pulps were included and randomly allocated into PMTA ( n =?188), PCEM ( n =?194), or RCT ( n =?168) arms. Preoperative “Pain Intensity” (PI) on Numerical Rating Scale and postoperative PIs until day 7 were recorded. Patients’ demographic and pre-/intra-/postoperative factors/conditions were recorded/analysed. The arms were homogeneous in terms of demographics. The mean preoperative PIs were similar ( P = 0.998 ), the mean sum PIs recorded during 10 postoperative intervals were comparable ( P = 0.939 ), and the trend/changes in pain relief were parallel ( P = 0.821 ) in all study arms. The incidences of preoperative moderate-severe pain in RCT, PMTA, and PCEM arms were 56.5%, 55.7%, and 56.7%, which after 24 hours considerably decreased to 13.1%, 10.6%, and 12.9%, respectively ( P = 0.578 ). The time span of endodontic procedures was statistically different; RCT?=?69.73, PMTA?=?35.37, and PCEM?=?33.62 minutes ( P 0.001 ). Patients with greater preoperative pain, symptomatic apical periodontitis, or presence of PDL widening suffered more pain ( P = 0.002 , 0.035, and 0.023, resp.); however, other pre-/intra-/postoperative factors/conditions were comparable. Pulpotomy with MTA/CEM and RCT demonstrate comparable and effective postoperative pain relief.