Purpose: Parents increasingly request esthetic restorations for their children's teeth. This split mouth, randomized controlled trial compared primary molars treated with white MTA pulpotomies and restored with either multi-surface composites (MSC) or stainless steel crowns (SSC).
Methods: Forty matched, contra-lateral pairs of molars received MTA pulpotomies and were randomly assigned to MSC or SSC restorations and evaluated clinically and radiographically at 6 and 12 months. Two calibrated, blinded examiners evaluated and scored radiographs.
Results: Thirty-seven matched pairs were evaluated at 6 months, and 31 were available at 12 months. All teeth in both groups were radiographically and clinically successful at 6 and 12 months. Dentin bridge formation was noted in 20% of the primary molars by 12 months. Although not significant, the composite group exhibited fewer intact clinical margins than the SSC group. The vast majority (94%) of teeth restored with composite displayed gray discoloration at follow-up exams, which did not appear to affect the quality of the restoration and is believed to be associated with the white MTA.
Conclusions: The white MTA pulpotomies succeeded over 12 months regardless of the restoration; however, the teeth restored with composite were not as durable nor considered an esthetic alternative to the SSC.