Inflammatory Status of Excavated Pulp Tissue and Internal Root Resorption in Pulpotomized Primary Molars

Statement of the Problem:

 Internal root resorption after pulpotomy is a pathological phenomenon and can lead to early root resorption and subsequent loss of the tooth.

To assess the relationship between initial inflammatory coronal pulp status in decayed primary molars treated by pulpotomy and internal root resorption after one-year follow-up.

In this clinical in vivo and in vitro experiment, vital pulpotomies were performed on 50 primary molars from 50 patients aged 5 to 10 years. Coronal pulp was carefully removed followed by hemostasis and placement of a reinforced zinc oxide eugenol over the vital radicular pulp. Enzyme-linked immunosorbent assay (ELISA) assay was done on coronal pulp samples and the level of tumor necrosis factor-alpha (TNF- α) and interlukin-6 (IL-6) was measured. After a 12-month follow-up, periapical radiographs were taken from pulpotomized teeth. Kolmogorov-Smirnov, Chi-square, Kruskal–Wallis, and Mann-Whitney tests were implemented.

11 treated teeth (22%) showed an internal root resorption as diagnosed on X-rays. No significant association was found between TNF- α, IL-6 levels, and pathological root resorption respectively (p= 0.953) and (p= 0.944). A significant association between age and pathological root resorption was observed (p= 0.031). No significant association between remaining dentin thickness and pathological root resorption was established (p= 0.346).

There was no association between pro-inflammatory cytokines levels/ TNF- α, IL-6 and internal root resorption following pulpotomy in pediatric patients.