Clinical and radiographic success of vital pulp therapy using marginal regression model

Root canal therapy (RCT) is the gold standard and commonly used treatment for pulpitis. However, regarding the importance of tooth survival, pulpotomy has become of great concern. The aim of this study was to compare the RCT and vital pulp therapy treatment in teeth with irreversible pulpitis. This was a clinical trial carried out in 4 provinces of Iran including Khorasan Razavi, Tehran, Yazd, and Fars in 2008. Patients were randomly allocated into three arms: The RCT, pulpotomy with CEM, and pulpotomy with MTA. Periapical lesion and percussion test were evaluated at baseline, 6th and 12th month follow ups. Data were analyzed using marginal regression and generalized estimating equations by SAS software version 9.1. The odds ratio of periapical lesion in RCT group was 5.07 times higher than that of pulpotomy with MTA and 3.25 times higher than CEM cement group (P<.001). The difference between MTA and CEM cement groups was insignificant, statistically. Also, the odds ratio of percussion test failed to show any statistically significant difference in treatment group. In addition, neither the age nor the gender influenced the percussion test and periapical lesion responses, statistically. Regarding the data found in our study, Pulpotomy can be considered as an alternative treatment for RCT.