A Randomized Clinical Trial On The Use Of Iroot BP And Calcium Hydroxide In Indirect Pulp Treatment

[Objective] Dental caries is clinically one of the most common disease. With the rapid progress of caries, the cariogenic bacteria invade the pulp tissue, and thus cause inflammation, leading to the loss of pulp vitality, increasing the risk of root fracture. So when clinicians treat with deep caries, one of the most important prerequisite is to save pulp vitality. Clinically two conservative procedures have been suggested in order to prevent pulp exposures and preserve the vitality of the pulp:stepwise excavation and indirect pulp treatment. There are a variety of materials can be used for indirect pulp capping clinically, and calcium hydroxide has been considered the gold standard for pulp capping material, and iRoot BP have been developed in recent years as a bio ceramic material with good performance, which can be used to indirect pulpcapping. However, its efficacy in clinical remains to be determined. Therefore, the purpose of this clinical trial is to compare effects when iRoot BP and calcium hydroxide are used as a capping agent in protecting permanent pulp-dentine complex.[Methods] Patients with this are experiment mainly from Zhejiang University School of Medicine Affiliated Stomatology Hospital, clinical oral examination, pulp vitality tests and X-ray examination, selection of patients meet the criteria to join the experiment. After the patient understands and agrees that the purpose of this experiment and procedures, the use of high-speed mobile open carious lesion site, use a slow phone or hand-dug a spoon to remove the outer peripheral wall and bounded on the enamel dentine caries. Carefully remove necrotic dentin demineralization central area, and avoid wearing pith, washing and drying, the bottom of the cavity inspection dentin hardness. The patients were randomly divided into two groups, one group using calcium hydroxide indirect pulp capping, another group using iRoot BP, with a temporary filling material to repair teeth. After checking the teeth again after March, and the determination of pulp vitality, reopen the cavity, the cavity at the bottom to remove residual infection dentin, check the hardness of the filling to make a final repair.[Results]ln this experiment,59teeth through the indirect pulp capping treatment, eight patients were lost after three months. The remaining52patients after indirect pulp capping treatment, the success rate was84.3%, of which calcium hydroxide treatment success rate was73.1%, while the indirect pulp capping iRoot BP’s success rate was96%, significantly higher than that of calcium hydroxide (P<0.05). After indirect pulp capping treatment, the remaining dentin cavity bottom appear darker, drier, harder, and the effect is more pronounced iRoot BP.[Conclusion] The results of this randomized clinical trial to confirm the use of stepwise caries and indirect pulp capping treatment of deep caries, can effectively prevent accidental Pithing and maintain pulp vitality while promoting mineralized dentin and dental hard tissues formation. iRoot BP as a new biological biocompatible ceramic materials, when applied to indirect pulp capping, can play a very good effect, should be promoted in the clinical application.