BC RRM-F Promising Alternative to Gold Standard MTA for primary molar pulpotomy, reveals Pediatric Dentistry Study

In a groundbreaking development for pediatric dentistry, researchers have explored an alternative to the long-established gold standard material, Mineral Trioxide Aggregate (MTA), for vital pulpotomy procedures in primary molars. The study concludes that TotalFill® BC RRM™ Fast Set Putty can be considered a viable alternative to MTA for primary molar pulpotomy.

The study results were published in the Journal of Dentistry. 
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Mineral Trioxide Aggregate (MTA) has long been hailed as the gold standard material for pulpotomy procedures in pediatric dentistry. However, challenges related to poor handling and extended setting times have prompted a quest for alternatives. Hence, researchers conducted a recent double-blinded, randomized controlled trial, to compare the radiographic and clinical performance of a premixed, fast-setting bioceramic root repair material (BC RRM-F) with MTA in vital pulpotomy procedures for primary molars in children. The study also explored the impact of different restorative materials, namely stainless-steel crowns (SSC) and glass ionomer (GI), on the success of these procedures.
Conducted as a double-blinded, four-arm, parallel group randomized controlled trial, the study involved 64 primary molars. These were strategically allocated to four treatment groups: MTA with a stainless steel crown (SSC), MTA with glass ionomer (GI), BC RRM-F with GI, and BC RRM-F with SSC. The primary objective was to compare the radiographic and clinical performance of BC RRM-F with MTA, providing valuable insights into the efficacy of these materials in pulpotomy procedures for children.Methods:
Clinical and radiographic evaluations were conducted at intervals of 1, 3, 6, and 12 months, employing the modified Zurn and Seale criteria. Multivariate Cox regression models and Kaplan-Meier curves were utilized for survival analysis, offering a comprehensive understanding of the long-term impact of the tested materials.
Results:
  • Contrary to the longstanding belief in MTA as the gold standard, the study revealed that TotalFill® BC RRM™ Fast Set Putty can serve as a credible alternative in primary molar pulpotomy procedures.
  • The research found no statistically significant difference in the success rates of pulpotomy procedures between MTA and BC RRM-F.
  • Moreover, the choice of final restorative material proved to be a crucial factor.
  • Survival analysis indicated that using glass ionomer (GI) instead of stainless-steel crowns (SSC) was associated with an increased risk of failure, emphasizing the significance of the overall treatment approach.
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The study’s findings pave the way for a paradigm shift in pediatric dentistry, suggesting that BC RRM-F holds promise as an effective substitute for MTA in vital pulpotomy procedures. Notably, the research underscores the importance of considering both clinician preferences and cost-effectiveness when choosing between these materials. Clinicians are urged to take a holistic approach, weighing factors such as preference, cost, and parental expectations when deciding between MTA and BC RRM-F for primary molar pulpotomy. The study also highlights the nuanced considerations related to parental preferences for tooth-colored restorations, providing valuable insights for enhancing patient care and satisfaction in pediatric dentistry. This research opens up new possibilities for optimizing treatment approaches, ensuring that children receive the most effective and well-suited interventions based on individual needs and preferences.

Further reading: One-year Radiographic and Clinical Performance of Bioactive Materials in Primary Molar Pulpotomy: A Randomized Controlled Trial. Doi: https://doi.org/10.1016/j.jdent.2024.104864

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