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Five-year results of vital pulp therapy in permanent molars with irreversible pulpitis: a non-inferiority multicenter randomized clinical trial

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Abstract

Objectives

Previous reported results of up to 12 months as well as 24-month follow-ups revealed superior and equivalent treatment outcomes for vital pulp therapy (VPT) using calcium-enriched mixture cement (CEM) in comparison with root canal therapy (RCT) for mature molars with established irreversible pulpitis, respectively. Present non-inferiority multicenter randomized clinical trial assesses the final long-term (5-year) results as well as the effects of patients’ age/gender and the presence of preoperative periapical lesion on the treatment outcomes.

Materials and methods

A total number of 407 patients were blindly allocated into two treatment groups [group 1 (VPT/CEM, n = 205) and group 2 (RCT, n = 202)] treated in 23 health-care centers by calibrated dentists. The treatment outcomes were assessed after 60 months.

Results

The 5-year results revealed no significant differences in the successes of both study arms (P = 0.29); a total number of 271 patients were available (~33 % were lost to follow-up). The patients’ age/gender did not affect the outcomes; the presence of preoperative periapical lesion also did not implement a significant effect in both groups (P > 0.05).

Conclusions

As an alternative for RCT, VPT/CEM can be considered as a valid treatment for vital mature permanent molars clinically diagnosed with irreversible pulpitis.

Clinical relevance

Considering the favorable outcomes of 6- to 60-month follow-ups, as an evidence-based/simple/affordable/effective/biologic approach in cases of irreversible pulpitis, VPT/CEM is highly recommended for universal clinical practice.

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Acknowledgments

This work was supported by the Iranian Ministry of Health and Medical Education (Health Deputy, Oral Health Office) and Shahid Beheshti University of Medical Sciences (grant number p/25/17/1/tm/103). The authors thank the study participants and dentists (Dr. S. Niknam, Dr. H. Abdolmaleki, Dr. M. Shahriari, Dr. B. Sepehri, Dr. M. Zarei, Dr. H. Mohadesi, Dr. L. Kochmeshki, Dr. N. Shirzaei, Dr. S.H. Hoseini, Dr. M.R. Naderi, Dr. A.R. Torkamanzadeh, Dr. N. Sahranavard, Dr. J. Mohebi, Dr. A. Naseri, Dr. M. Forozanfar, Dr. A. Razavi, Dr. A. Izadi, Dr. H. Fadaei, Dr. K. Khorshidian, Dr. H.A. Taheri, Dr. M.H. Bagheri-Atabak, Dr. M. Zareshahi, and Dr. M. Pahlevan-Shamsi) for their enthusiastic contributions as well as Dr. K. Bagheri-Lankarani, Dr. S.H. Emami-Razavi, Dr. S.M. Alavian, Dr. A.R. Mesdaghinia, Dr. M.M. Goya, Dr. M.H. Khoshnevisan, Dr. S.M. Tabatabaei, Dr. K. Etemad, Dr. M.M. Vardi, Dr. M. Sourosh, and Dr. H. Hesary who provided the national supervision and support for this trial; Dr. S.M.R. Safavi for critical review; Dr. A.R. Zali, Dr. S. Mohamad-Sadeghi, Dr. M. Piriaei, and Dr. S. Kheirieh for administrative help; and Dr. R.A. Taheri, Dr. F. Rahnama, Dr. A. Heravi, Dr. G.A. Dehghani, and Dr. H. Fotohi who monitored the trial in different states.

Conflict of interest

The authors report no conflict of interest.

Author information

Authors and Affiliations

  1. Iranian Center for Endodontic Research, Research Institute of Dental Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran

    Saeed Asgary, Mahta Fazlyab & Alireza Akbarzadeh Baghban

  2. Dental Research Center, Research Institute of Dental Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran

    Mohammad Jafar Eghbal

  3. Department of Basic Sciences, School of Rehabilitation Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran

    Alireza Akbarzadeh Baghban

  4. Endodontic Department, Dental School, Mashad University of Medical Sciences, Mashad, Iran

    Jamileh Ghoddusi

  5. Iranian Center for Endodontic Research, Shahid Beheshti Dental School, Evin, Tehran, 1983963113, Iran

    Saeed Asgary

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  1. Saeed Asgary
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  2. Mohammad Jafar Eghbal
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  3. Mahta Fazlyab
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Correspondence to Saeed Asgary.

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Asgary, S., Eghbal, M.J., Fazlyab, M. et al. Five-year results of vital pulp therapy in permanent molars with irreversible pulpitis: a non-inferiority multicenter randomized clinical trial. Clin Oral Invest 19, 335–341 (2015). https://doi.org/10.1007/s00784-014-1244-z

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  • DOI: https://doi.org/10.1007/s00784-014-1244-z

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