The Influence of different Disinfection and Hemostatic Procedures on Post-Operative Pain In Adult Pulpotomy: Clinical Study

Abstract

Aim: This clinical study aimed to assess the effectiveness of the use of sodium hypochlorite and Diode laser as hemostatic agents, in relieving postoperative pain in pulpotomy procedures for treatment of permanent teeth with symptomatic irreversible pulpitis.

Materials and Methods: Sixty patients, each with a lower first permanent molar diagnosed with symptomatic irreversible pulpitis, were enrolled in this study. The access cavity was prepared followed by coronal pulp tissue extraction. The initial hemorrhage was controlled with a saline-moistened cotton pellet. Patients were divided into 3 groups, (where n=20). Hemostasis and cavity disinfection was attained by the application of either a 2.5% NaOCl solution (Group 1) or a 5% NaOCl solution (Group 2) or diode laser (Group 3). This was followed by the gentle application of Neoputty on the floor of the pulp chamber, followed by the applications of layers of (Fuji Equia) Glass Ionomer Cement. Final permanent restoration using composite Tetric N-Ceram resin was done during the same visit. The patients documented their levels of postoperative pain at the sixth hour, first day, and eighth day. Pain was scored on a Visual Analog Scale (VAS), with scores spanning from 0 mm (no pain-free) to 100 mm (highest level of pain).

Results: At all intervals, NaOCl 2.5% recorded the highest mean score value, while the least mean value was recorded in (Diode laser), with no statistically significant difference between (NaOCl 2.5%) and (NaOCl 5%).

Conclusions: Within the limitation of this study, modern disinfection modalities like Diode laser device, when used as hemostatic agent in pulpotomy of mature molar teeth with IP, exhibits promising results in terms of postoperative pain.