Partial Pulpotomy Not Superior to Direct Pulp Capping in Primary Molars, Thai Trial Reports

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Posted: May 20, 2026

Partial Pulpotomy Not Superior to Direct Pulp Capping in Primary Molars, Thai Trial Reports

Edited by Dentaltown staff

A randomized superiority trial published May 20 in BMC Oral Health found no statistically significant difference in short-term survival between direct pulp capping and partial pulpotomy using RetroMTA in deeply carious primary molars with normal pulp or reversible pulpitis.

Researchers at Chiang Mai University in Thailand enrolled children aged 3 to 9 with at least one eligible primary molar and randomly assigned 88 molars in a 1:1 ratio to receive either direct pulp capping or partial pulpotomy. All treatments were performed by postgraduate dental students under a single instructor’s supervision, with all molars restored immediately with stainless steel crowns. The trial was university-based, assessor-blinded, and parallel-group in design.

Seventy-eight molars were available for final analysis, with 40 in the direct pulp capping group and 38 in the partial pulpotomy group. Follow-up averaged 13.3 months, with a range of 6 to 23 months. Cumulative survival probabilities were 93.8% for direct pulp capping and 100% for partial pulpotomy, a difference that did not reach statistical significance (p=0.153). Two radiographic failures occurred in the direct pulp capping group: pathological external root resorption at 7 months and furcation radiolucency associated with stainless steel crown dislodgement at 11 months.

The authors concluded that partial pulpotomy was not demonstrated to be superior to direct pulp capping when RetroMTA was used as the capping material, and noted that both treatments showed favorable short-term survival under controlled conditions. They cautioned that the limited follow-up duration and small number of failure events warrant careful interpretation, calling for adequately powered studies with longer follow-up before routine clinical adoption.

The study was led by Nattakan Chaipattanawan of the Division of Pediatric Dentistry at Chiang Mai University Faculty of Dentistry. Funding came from the Research Fund for Postgraduate Students at the same institution. The authors reported no competing interests. The trial was retrospectively registered with the Thai Clinical Trials Registry under TCTR20240508001.

The paper is currently available as an early-access unedited manuscript pending final copyediting.

Sources:
BMC Oral Health, “Direct pulp capping versus partial pulpotomy using RetroMTA® in deeply carious primary molars with normal pulp or reversible pulpitis: a superiority randomized controlled trial,” Intawong C, et al., May 20, 2026: link.springer.com/article/10.1186/s12903-026-08674-z
Thai Clinical Trials Registry, TCTR20240508001
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