Evaluation of Postoperative Pain Following Adult Pulpotomy in Symptomatic Irreversible Pulpitis using MTA, Bioceramic Material, and Nanohydroxyapetite
Keywords:
vital pulp therapy, adult pulpotomy, postoperative pain, nanohydroxyapatite, bioceramic, MTA, diabetic patients.Abstract
Introduction: Adult pulpotomy is a novel approach for the management of symptomatic irreversible pulpitis in mature permanent teeth. The type of pulp-capping agent significantly influences postoperative pain and pulpal healing. This study evaluated postoperative pain following adult pulpotomy in diabetic patients using three different pulp capping materials: mineral tri-oxide aggregate (MTA), bioceramic putty, and a newly introduced nanohydroxyapatite (nHA) material.
Methods: Thirty diabetic patients diagnosed with symptomatic irreversible pulpitis in vital teeth were randomly allocated into three equal groups (n = 10) according to the pulp capping material used: Group I – MTA (ProRoot, Dentsply, USA); Group II – Bioceramic putty (NeoPutty, Avalon Biomed, USA); and Group III – Nanohydroxyapatite (Sigma-Aldrich, USA). Standardized pulpotomy procedures were performed under local anesthesia and rubber dam isolation. Postoperative pain was recorded using a Visual Analogue Scale (VAS) at 24, then 48, and 72 hours. Data were analyzed using Friedman, Wilcoxon, Kruskal–Wallis, and Mann–Whitney tests at a significance level of p ≤ 0.05.
Results: All groups showed a statistically significant reduction in pain intensity over time (p = 0.002). At each time interval, significant differences were found among materials (p ≤ 0.005). while, Nanohydroxyapatite exhibited the lowest mean VAS scores at all intervals, followed by bioceramic and MTA. After 72 hours, the mean VAS scores were 2.00 ± 0.00 (MTA), 1.00 ± 0.89 (bioceramic), and 0.33 ± 0.52 (nHA).
Conclusion: Under the conditions of this study, all tested materials effectively reduced postoperative pain following adult pulpotomy in diabetic patients with symptomatic irreversible pulpitis. Nanohydroxyapatite demonstrated the lowest pain levels and may represent a promising bioactive alternative for vital pulp therapy in medically compromised patients.
