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. 2018 May 31;2018(5):CD003220. doi: 10.1002/14651858.CD003220.pub3

Khorakian 2014.

Methods RCT, split‐mouth
Teeth randomly assigned
Conducted in the paediatric department of Mashhad Dental School, Iran. Operator was a postgraduate student of paediatric dentistry, who was supervised by two academic staff
Participants 51 children, 102 teeth, age range 4 to 6 years
Interventions Group 1:Pulpotomy (CEM); n = 51 (1 visit)
  • Rubber dam

  • Caries removal prior to pulpal access

  • Pulp access with a high speed bur

  • Pulpotomy amputation with slow speed bur

  • For haemostasis, cotton pellets wet by sterile saline

  • Irrigation not mentioned

  • a 2 mm layer of CEM cement (BioniqueDent, Tehran, Iran) was applied directly over the radicular pulp. CEM was prepared using a 3 to 1 powder to liquid ratio, before being restored with stainless steel crown


Group 2:Pulpotomy (ES/ZOE); n = 51 (1 visit)
  • Rubber dam

  • Caries removal prior to pulpal access

  • Pulp access with a high speed bur

  • Pulpotomy amputation with slow speed bur

  • For haemostasis, cotton pellets wet by sterile saline

  • Irrigation not mentioned

  • ES ball‐shaped electrode was immediately used for tissue coagulation. The unit was set at 55 W, 3.69 MHz, 600 ohm, and COAG mode. The electrode was placed 1 to 2 mm above the pulp orifices and then electrical arc allowed to bridge for 1 s. This procedure was repeated up to three times on each pulpal orifice with 5 to 10 s cool‐down intervals, until a dark brown appearance was observed in the tissues. After copious irrigation, zinc oxide eugenol was placed directly on the radicular pulp stump, before being restored with stainless steel crown

Outcomes Clinical success (lack of pain, mobility, swelling, sinus tract, tenderness to percussion and bone swelling), radiographic success (PDL and periapical regions with normal width and trabeculation minimal internal resorption), pulp canal obliteration: evaluation at 6, 12 and 24 months
Notes  
Risk of bias
Bias Authors' judgement Support for judgement
Random sequence generation (selection bias) Low risk Computerised random‐number
Allocation concealment (selection bias) Unclear risk Insufficient information to make a clear judgement
Blinding of participants and personnel (performance bias) 
 All outcomes Low risk Quote: "...both the patients and outcome assessors were blinded to the type of treatment"
Blinding of clinical outcomes assessment Low risk Quote: "...both the patients and outcome assessors were blinded to the type of treatment"
Blinding of radiological outcomes assessment Low risk Quote: "...both the patients and outcome assessors were blinded to the type of treatment"
Incomplete outcome data (attrition bias) 
 All outcomes High risk Proportion of missing outcomes > 10% children randomly assigned
Selective reporting (reporting bias) Unclear risk Insufficient information to make a clear judgement