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International Journal of Clinical... 2019Pulpectomy is one of the most important procedures in maintaining the necrotic primary teeth until physiologic exfoliation. In clinical practice, time efficacy is... (Review)
Review
UNLABELLED
Pulpectomy is one of the most important procedures in maintaining the necrotic primary teeth until physiologic exfoliation. In clinical practice, time efficacy is invaluable, especially in pediatric endodontics, where unpredictability and difficulty of root canal morphology adds to a clinician's challenge. The success of a pulpectomy procedure mainly depends upon the biomechanical preparation of the root canal systems. With the advent of NiTi rotary files, adult endodontic procedures have been rendered easy, but its popularity in pedodontic practice is limited. Therefore, the purpose of this article is to review the use of NiTi rotary files for root canal instrumentation in primary teeth.
HOW TO CITE THIS ARTICLE
Chauhan A, Saini S, Dua P, Rotary Endodontics in Pediatric Dentistry: Embracing the New Alternative. Int J Clin Pediatr Dent 2019;12(5):460-463.
PubMed: 32440054
DOI: 10.5005/jp-journals-10005-1679 -
Journal of Dental Sciences Apr 2022Pulpectomy is the last means to preserve primary teeth with pulpitis or pulp necrosis. The aim of the study was to investigate the survival rate of primary teeth after...
BACKGROUND/PURPOSE
Pulpectomy is the last means to preserve primary teeth with pulpitis or pulp necrosis. The aim of the study was to investigate the survival rate of primary teeth after pulpectomies and to explore the factors influencing the prognosis of pulpectomy.
MATERIALS AND METHODS
This retrospective study was performed on patients who received primary tooth pulpectomy in the Department of Pediatric Dentistry at Peking University Hospital of Stomatology between January 2014 and February 2019. The demographic characteristics of children and the information of teeth treated were collected, and the clinical and radiographic examination after treatment were evaluated. Survival analysis was performed to determine the influencing factor of pulpectomy failure.
RESULTS
A total of 592 primary anterior teeth and 583 primary molars were included. The 30-month survival rate of primary anterior teeth was 58.5% and that of primary molars was 37.0%. The survival rate of postoperative primary molars was lower than that of primary anterior teeth ( < 0.05). Primary anterior tooth interventions with preoperative periapical lesions, Vitapex® filling, or nongeneral anesthesia treatment had a higher failure risk ( < 0.05). Treatment at an older age and glass ionomer cement filling indicated a higher failure risk for primary molar pulpectomies.
CONCLUSION
Primary anterior teeth after pulpectomies had a higher survival rate than primary molars. Periapical lesions, treatment methods, and root filling materials had significant impacts on the prognosis of primary anterior pulpectomies, and children's age significantly affected the prognosis of primary molar pulpectomies, which has not been reported before.
PubMed: 35756771
DOI: 10.1016/j.jds.2021.10.007 -
Pediatric Dentistry Nov 2022The purpose of this study was to evaluate the clinical and radiographic outcomes of direct pulp capping (DPC) using calcium hydroxide (CH), mineral trioxide aggregate... (Randomized Controlled Trial)
Randomized Controlled Trial
The purpose of this study was to evaluate the clinical and radiographic outcomes of direct pulp capping (DPC) using calcium hydroxide (CH), mineral trioxide aggregate (MTA), and premedicated DPC with formocresol (FC) in primary teeth. Sixty primary mandibular second molars with pulp exposures in children aged four to eight years old were treated using DPC. The molars were randomly divided into three groups (n equals 20 per group). Pulp exposures in the CH and MTA groups were capped directly using CH and MTA pastes, respectively, while those in the FC group were premedicated with FC and then capped with zinc oxide eugenol (ZOE) cement. All teeth were finally restored with stainless steel crowns, and clinical and radiographic evaluations were carried out at baseline and three, six, and 12 months after restoration. Fisher's exact test was performed to define the significance between the groups and follow-up periods. The clinical and radiographic findings showed no significant difference between the three groups. The overall success in the CH, MTA, and FC groups were 88.2 percent, 100 percent, and 73.3 percent, respectively. However, these differences were not statistically significant (P>0.05). All three materials examined in this study exhibited clinical and radiographical efficacy when used as direct pulp capping materials.
Topics: Child; Humans; Child, Preschool; Calcium Hydroxide; Pulp Capping and Pulpectomy Agents; Formocresols; Pulpotomy; Dental Caries; Calcium Compounds; Oxides; Aluminum Compounds; Silicates; Drug Combinations; Zinc Oxide-Eugenol Cement; Molar; Dental Pulp Capping
PubMed: 36947754
DOI: No ID Found -
World Journal of Clinical Cases Jul 2020Lumbar disc herniation is a common disease. Endoscopic treatment may have more advantages than traditional surgery.
BACKGROUND
Lumbar disc herniation is a common disease. Endoscopic treatment may have more advantages than traditional surgery.
AIM
To compare the clinical efficacy and safety of microendoscopic discectomy (MED) and open discectomy with lamina nucleus enucleation in the treatment of single-segment lumbar intervertebral disc herniation.
METHODS
Ninety-six patients who were operated at our hospital were selected for this study. Patients with single-segment lumbar disc herniation were admitted to the hospital from March 2018 to March 2019 and were randomly divided into the observation group and the control group with 48 cases in each group. The former group underwent lumbar discectomy and the latter underwent laparotomy and nucleus pulpectomy. Surgical effects were compared between the two groups.
RESULTS
In terms of surgical indicators, the observation group had a longer operation time, shorter postoperative bedtime and hospital stay, less intraoperative blood loss, and smaller incision length than the control group ( < 0.05). The excellent recovery rate did not differ significantly between the observation group (93.75%) and the control group (91.67%). Visual analogue scale pain scores were significantly lower in the observation group than in the control group at 1 d, 3 d, 1 mo, and 6 mo after surgery ( < 0.05). The incidence of complications was significantly lower in the observation group than in the control group (6.25% 22.92%, < 0.05).
CONCLUSION
Both MED and open discectomy can effectively improve single-segment lumbar disc herniation, but MED is associated with less trauma, less bleeding, and a lower incidence of complications.
PubMed: 32775376
DOI: 10.12998/wjcc.v8.i14.2942 -
BMC Oral Health Mar 2024Pulpotomy as a minimally invasive pulp therapy technique is the treatment of choice for carious pulp exposures, however many pediatric dentists perform pulpectomies in... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
Pulpotomy as a minimally invasive pulp therapy technique is the treatment of choice for carious pulp exposures, however many pediatric dentists perform pulpectomies in vital primary incisors. The aim of this split mouth randomized controlled study was to compare formocresol pulpotomy and zinc-oxide and eugenol pulpectomy in the treatment of vital pulp exposure in primary incisors.
METHODS
Contralateral pairs of incisors were randomly assigned to receive pulpotomy or pulpectomy in children aging from 18 to 66 months old and were followed up for 12 months.
RESULTS
39 pairs of incisors were included. Clinical and radiographical success rates showed no statistical significant difference (p = 1, p = 0.8 respectively). Relative risk measures for clinical success rates (RR = 1.03, 95%CI 0.87 to 1.23) and for radiographic success rates (RR = 1.03, 95%CI 0.83 to 1.29) with CIs including number one showing no difference between the two groups. The Survival rate using Kaplan-Meier survival analysis score showed 82% for pulpotomy and 74% for pulpectomy at 12 months (P = 0.2).
CONCLUSIONS
Both pulpotomy and pulpectomy techniques can be used successfully in the treatment of carious vital pulp exposure in primary incisors.
TRIAL REGISTRATION
The trial was retrospectively registered in Clinicaltrials .gov with this identifier NCT05589025 on 21/10/2022.
Topics: Child; Humans; Infant; Child, Preschool; Pulpotomy; Pulpectomy; Incisor; Zinc Oxide; Pulp Capping and Pulpectomy Agents; Tooth, Deciduous; Silicates; Treatment Outcome; Calcium Compounds
PubMed: 38504243
DOI: 10.1186/s12903-024-04116-w -
International Journal of Clinical... 2019Dental treatment is known to trigger anxiety and fear even in fully grown adults, especially if administration of local anesthesia with a syringe is indicated. This...
INTRODUCTION
Dental treatment is known to trigger anxiety and fear even in fully grown adults, especially if administration of local anesthesia with a syringe is indicated. This study is aimed to evaluate whether procedures like an extraction and pulpectomy could trigger fear and anxiety in a pediatric patient and also the response of pediatric patients to other treatment modalities. Their perception toward receiving dental treatment as a whole is also evaluated. The effect of conditioning of the environment and the dentist (extractions done in second or third appointments) and its effect in decreasing the anxiety is also evaluated. The aim of the study is to evaluate the behavior of pediatric patients aged 7-17 years in response to various treatment procedures at Saveetha Dental College.
MATERIALS AND METHODS
The behavior of 50 children reporting to Saveetha Dental College, categorized according to the Frankl's behavior rating scale, was recorded before, during, and posttreatment.
RESULTS
Children undergoing extractions and pulpectomies showed the most uncooperative behavior. Sixty percent of patients undergoing extraction and 45% of patients undergoing the pulp therapy showed negative behavior (rating 2) during treatment.
CONCLUSION
Invasive procedures like extractions and pulpectomies were procedures that brought out negative behavior in pediatric patients, especially during treatment.
HOW TO CITE THIS ARTICLE
Sivakumar P, Gurunathan D. Behavior of Children toward Various Dental Procedures. Int J Clin Pediatr Dent 2019;12(5):379-384.
PubMed: 32440041
DOI: 10.5005/jp-journals-10005-1670 -
European Journal of Dentistry Oct 2023Our aims were to evaluate the Vitapex pulpectomy (PE) success rate, Vitapex resorption rate, and their associated factors in primary teeth.
OBJECTIVES
Our aims were to evaluate the Vitapex pulpectomy (PE) success rate, Vitapex resorption rate, and their associated factors in primary teeth.
MATERIAL AND METHODS
This retrospective study evaluated the clinical records of Vitapex PE-treated patients at the Pediatric Dental Clinic, Faculty of Dentistry, Mahidol University, from 2013 to 2019. The patient's and pulpectomized tooth's characteristics, procedure, materials used, and type of operator were recorded. A dentist evaluated and compared the periapical lesion, root status, obturation quality, and Vitapex resorption on preoperative, immediate, and follow-up digital radiographs. PE failure was defined as radiographic lesion progression.
STATISTICAL ANALYSIS
The Kaplan-Meier method was used to estimate the Vitapex PE success rate and Vitapex resorption rate. Multivariate Cox regression was used to determine the related factors.
RESULTS
In total, 647 Vitapex PE teeth from 448 patients (19-121-month-old) were analyzed. The follow-up periods ranged from 6 to 60 months. The success rate was 88.9 and 68.1% at the 12- and 24-month follow-up, respectively, and remained stable at 53.8% at the 36 to 60-month follow-ups. The factors related to Vitapex PE failure were age and a preoperative pathologic lesion. More than 50% of the pulpectomized teeth presented Vitapex resorption faster than physiologic root resorption at the 12-month follow-up. The patients' age at treatment and the obturation quality were significantly related to the Vitapex resorption rate.
CONCLUSIONS
The success rate of Vitapex PE decreased time dependently and was related to the patient's age at treatment and a preoperative lesion. The Vitapex resorption was faster than root resorption and was associated with the patient's age at treatment and the root filling extravasation.
PubMed: 37276881
DOI: 10.1055/s-0042-1758792 -
Journal of the American Dental... Dec 2022The purpose of this study was to identify differences in usage trends for 2 specific pulpal therapy treatments in pediatric patients during an 11-year period from...
BACKGROUND
The purpose of this study was to identify differences in usage trends for 2 specific pulpal therapy treatments in pediatric patients during an 11-year period from January 1, 2010, through December 31, 2020.
METHODS
Insurance data claims for children aged 2 through 12 years undergoing a pulpotomy or a pulpectomy performed by a general dentist (GD) or pediatric dentist (PD) from 2010 through 2020 were extracted from a dental data warehouse. The state where the provider was located was included in the extracted claim.
RESULTS
Rates of undergoing a pulpotomy or pulpectomy declined from 2010 through 2020 (odds ratio [OR], 0.978 or 0.946, respectively; P < .001). PDs were more likely to perform pulpotomies than GDs (OR, 1.393; P < .001), but PDs were less likely to perform pulpectomies than GDs (OR, 0.225; P < .001). Younger patient age was a significant predictor for undergoing pulpotomy treatment for both GDs and PDs (ORs, 0.850 and 0.892, respectively; P < .001). With increasing patient age, PDs had increased odds of performing a pulpectomy (OR, 1.030; P < .001) and GDs had decreased odds of performing a pulpectomy (OR, 0.995; P = .04). When examining effects according to American Academy of Pediatric Dentistry national membership districts, the trends remained consistent with those above.
CONCLUSIONS
The percentage of children undergoing pulpotomy and pulpectomy therapy declined from 2010 through 2020 among both GDs and PDs.
PRACTICAL IMPLICATIONS
These changes in pulpal therapy practice might indicate a teaching change in pulpal therapy guidelines, suggesting that less invasive pulpal therapy can be used rather than pulpotomies or pulpectomies.
Topics: Child; Humans; Dental Care; Dentists; Insurance; Odds Ratio; Pediatric Dentistry; Insurance Claim Review; Pulpotomy
PubMed: 36441087
DOI: 10.1016/j.adaj.2022.09.009 -
The Journal of Evidence-based Dental... Dec 2023Pulpotomy is the most commonly performed treatment for asymptomatic primary molars with exposed dental pulp. This study aimed to assess the clinical /radiographic... (Randomized Controlled Trial)
Randomized Controlled Trial
OBJECTIVES
Pulpotomy is the most commonly performed treatment for asymptomatic primary molars with exposed dental pulp. This study aimed to assess the clinical /radiographic success of diode laser pulpotomy with mineral trioxide aggregate (MTA), calcium hydroxide (CH), and calcium-enriched mixture (CEM) cement as pulp capping agents.
METHODS
This split-mouth randomized clinical trial was conducted initially on 34 children aged 3-8 years but 4 patients left the study before the first follow-up visit and the study was accomplished and analyzed with 30 cases. The patients had at least 3 first/second molars with deep caries that in radiographic evaluation revealed that they required pulpotomy. Following pulpotomy, the pulp stump was irradiated with diode laser (noncontact mode, 632 nm, 30 mW power) as photobiomodulation mode. Pulp tissue was then capped with MTA, CH, or CEM cement (n = 30 in each group). Reinforced zinc oxide eugenol was applied over the capping agent, and the teeth were restored with stainless steel crowns. Teeth were clinically/radiographically assessed at 6, 12, 18, and 36 months, after treatment. Data were analyzed by Cochran and McNemar tests.
RESULTS
All 30 patients showed up for clinical/radiographic follow-ups for up to 36 months. Regarding clinical outcomes, the 6-, 12-, 18-, and 36-month success rates of all experimental groups were nearly similar with no significant difference (p > .05). Regarding radiographic outcomes, the 6-month success rates were similar among the groups (p > .05); however, the 12-, 18-, and 36-month outcomes of CEM and MTA groups were similar but significantly superior to that of CH group (p < .05).
CONCLUSION
Diode laser irradiation and subsequent capping of pulp tissue with MTA or CEM cement can be employed for pulpotomy of primary molars.
Topics: Child; Humans; Calcium Hydroxide; Dental Caries; Lasers, Semiconductor; Molar; Mouth; Pulp Capping and Pulpectomy Agents; Pulpotomy; Treatment Outcome; Child, Preschool
PubMed: 38035897
DOI: 10.1016/j.jebdp.2023.101920 -
Maedica Dec 2023Since pain control in dental treatments, including root canal treatment, is challenging, and no study has measured the appropriate pattern of Anaheal Plus drug...
Since pain control in dental treatments, including root canal treatment, is challenging, and no study has measured the appropriate pattern of Anaheal Plus drug consumption in reducing pain after root canal treatment, in this study the appropriate pattern of taking Anaheal Plus drug in reducing pain after root canal treatment was evaluated. The present study examined maxillary and mandibular molar teeth with irreversible pulpitis. Patients were divided into three groups: A) Anaheal Plus capsule; B) control; and C) ibuprofen. Teeth were treated in two sessions, pulpectomy treatment was performed and drugs were used between sessions. A visual analog scale questionnaire was used to assess pain. Patients were asked to record the pain score before the root canal treatment as well as eight hours, 48 hours and five days after root canal treatment. All procedures were done in Amol's private clinic, where root canal treatment was administered by a dentist, and the teeth were obturated after a week. This study examined 90 patients with an average age of 33.94 years. Rescue doses were reported only in the control group, and there was a significant difference between groups (p-value < 0.001). In all groups, pain had decreased significantly (p-value<0.001), but the average pain in groups A and C was lower than that of group B at all times, and there was no difference between them. Anaheal Plus significantly reduced pain after root canal treatment compared to the control group.
PubMed: 38348069
DOI: 10.26574/maedica.2023.18.4.651