Date of Graduation

2014

Document Type

Thesis

Degree Type

MS

College

School of Dentistry

Department

Orthodontics

Committee Chair

Michael D Bagby

Committee Co-Chair

Anthony T Borgia

Committee Member

Richard Jurevic

Abstract

The aim of this study was to evaluate success rates of vital pulp therapy cases completed exclusively by endodontic residents at West Virginia University School of Dentistry with 3 different bioactive calcium silicate cements. The materials used were ProRootRTM Mineral Trioxide Aggregate (MTA) white, EndosequenceRTM Root Repair Material (ERRM), and BiodentineRTM. Failures were also examined to observe trends toward failure associated with multiple factors.;All follow-up examinations included a clinical and radiographic evaluation, which included multiple examiners that read each radiograph. Associations between procedure failure rates and the factors of interest were examined through non-parametric tests due to the small number of failures relative to the overall sample size. Fisher's exact tests were used to investigate associations between failure rate and each categorical factor. Wilcoxon rank sum tests were employed to assess associations between procedure failure rates and the continuous factors of patient age and follow-up time.;A total of 130 cases were completed by endodontic residents. Fifty cases were successfully recalled, and 41 cases met the inclusion criteria after a retrospective chart review. All cases were completed between 2010 and 2013. The age of patients ranged from 7-58 years with an average age of 14.3 years. The follow-up time for successful cases ranged from 160 to 1000 days with an average of 730 days. Failure follow-up ranged from 7-38 days with an average of 24 days. The overall success rate of the 41 cases was 87.8%. Those patients receiving ERRM materials had over twice the odds of failure compared to those patients receiving ProRootRTM MTA. (OR: 2.29 (0.32,16.51)). ERRM materials included both ERRM putty (8 patients) and ERRM syringeable (1 patient). Those patients with trauma-related procedures had over three times the odds of failure compared to those patients with caries/decay-related procedures. (OR: 3.22 (0.44, 23.65)). Also, one out of the four patients who received cotton and TriageRTM instead of immediate restoration were reported as failed cases. Nearly every patient with a failed procedure was older than the median age of patients that had a successful case. None of the factors examined were statistically significant.;Vital pulp therapy in this study had a success rate of 87.8% with an average of 730 days follow-up. While each of our conservative statistical tests did not indicate statistical significance, they are potentially clinically relevant. The factors of age, cases completed with ERRM, trauma vs. caries, and immediate restoration vs. temporizing should be examined in future studies.

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