Postoperative Pain following Pulpotomy of Primary Molars with Two Biomaterials: A Randomized Split Mouth Clinical Trial

Introduction: The aim of this randomized clinical trial split-mouth study was to compare the postoperative pain following use of mineral trioxide aggregate (MTA) and calcium-enriched mixture (CEM) cement as pulpotomy agents in carious primary molars. Methods and Materials: Forty-seven children aged between 6-10 years old were enrolled in this study. Each child had two cariously involved primary molar in need of pulpotomy. After caries removal and preparing access cavity in one of the carious teeth, either MTA or CEM cement was randomly used as the pulpotomy agent, while the other cariously involved primary molar tooth was capped with the other material in a separate visit. After covering the radicular pulp with one of the capping materials the teeth were permanently restored with stainless steel crown (SSC). Postoperative pain was recorded by using Wong-Baker faces pain rating scale (Wong- Baker FPRS) up to seven days following the treatment. Data was analyzed using the Wilcoxon, McNemar, and chi square tests. Results: Forty-five patients fulfilled the treatment procedure and returned the Wong-Baker FPRS forms. Overall 65.6% of the patients reported pain irrespective of the pulpotomy agents used. There was no significant difference in postoperative pain between the teeth that received either MTA or CEM cement as pulpotomy agents in the first, second and the third day (P=0.805, P=0.942, P=0.705, respectively) following the procedure. The trend of the pain scores showed decreasing manner during the study period for the teeth in either groups of MTA or CEM cement. There was no significant difference between the two groups in the number of analgesics used following the treatment (P>0.05). Conclusion: The findings of the present study showed that a majority of the children felt pain following pulpotomy and SSC placement; however, there was no significant difference in pain reported when either MTA or CEM cement was used as pulpotomy agents.