In this randomized controlled single-center clinical trial on 96 adult patients with parallel experimental groups (n = 48), the effects of washing a dentin/pulp
wound in non-symptomatic teeth with extremely deep caries and pulpal exposure were compared between a 2.5%
sodium hypochlorite (NaOCl)
solution and a chemically-inert physiological saline control
solution. After the allocated
wound lavage, the pulps were capped with a
mineral trioxide aggregate, covered by a
glass-ionomer/resin liner, and the teeth were immediately restored with a resin-bonded-composite. In this first report, the early events were analyzed: postoperative discomfort (on an NRS-11 scale) at day-3 and -7 after intervention, and the occurrence of unbearable
pain causing patients to contact the principal investigator to perform a root canal treatment (
pulpectomy) during the first three months. The NaOCl
solution caused a highly significant reduction in post-operative discomfort (p = 0.0010 day 3; p = 0.0007 day 7) and early painful failures (p = 0.0008) compared with the control. These novel findings highlight the importance of infection control in teeth with extremely deep
carious lesions. Based on these observations, the use of an NaOCl
solution to wash the exposed dentin/pulp
wound in the vital pulp treatment is highly recommended in order to reduce
pain and early failure.