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Bioinformation 2023The motor impairments of cerebral palsy (CP) are typically accompanied by subsequent musculoskeletal issues, seizures, and abnormalities of sensation, intelligence,...
The motor impairments of cerebral palsy (CP) are typically accompanied by subsequent musculoskeletal issues, seizures, and abnormalities of sensation, intelligence, communication, and behaviour. These kids have a lower capacity for regulating oral health because of their poor voluntary movements. Poor oral hygiene brought on by insufficient brushing and flossing, increased use of sugary foods, and orally administered drugs puts people at risk for periodontal disorders and dental caries. Poor dental health and rising therapy demands establish a sadistic cycle that affects patient overall health and wellbeing. The purpose of this investigation was comparing kids with CP against healthy kids of comparable age group and demographic situation in order to evaluate status of oral heath, current caries behavior using measurement of concentrations in saliva, and treatment required. 204 study participants were divided into two categories: Category A and category B. Both categories consisted of 102 study participants. Category A consisted of study participants having CP while category B consisted of healthy normal controls with same age of same demographic features. Malocclusion, trauma, DMFS/defs, gingival index, and Oral hygiene score (OHI), and were recorded for oral examinations of al study participants However, no radiological assistance was utilized since minimal patient compliance existed in CP patients. When compared with the control category, the CP category had a higher detection of the DMFS index in the permanent teeth. The estimated defs for the CP category did not differ noticeably from the control category. In the CP category, status of hygiene of oral cavity was discovered to be substantially subpar. In comparison to the control category, the gingival condition of the CP category was noticeably worse. Treatment requirements were seen to require greater preventative care in the control category while, stainless steel crowns, pulpectomy and extractions were needed in the CP category. was found in high concentrations in the salivary specimens of the CP category compared to the control category, indicating active dental caries and greater probability of further development.
PubMed: 37814684
DOI: 10.6026/97320630019215 -
Current Stem Cell Research & Therapy 2021The concept of regenerative endodontics wherein one can replace damaged pulp structures and recuperate the functionality in erstwhile necrotic and infected root canal... (Review)
Review
The concept of regenerative endodontics wherein one can replace damaged pulp structures and recuperate the functionality in erstwhile necrotic and infected root canal systems has been a cutting-edge technology. Though the notion started as early as the 1960s, even before the discovery of stem cells and regenerative medicine, it was in the 2000s that this procedure gained momentum. Ever since then, researchers continue to discover its essential benefit to immature teeth and its ability to overcome the caveats of endodontic therapy, which is commonly known as root canal treatment. Further, through this therapy, one can redevelop root even in immature teeth with necrotic pulps, which overall helps in maintaining skeletal and dental development. Past literature indicates that regenerative endodontic procedures seem to be successful, especially when compared with other conventional techniques such as Mineral Trioxide Aggregate apexification. Besides, many clinicians have begun to apply regenerative endodontic procedures to mature teeth in adult patients, with several clinical case reports that have shown complete resolution of signs and symptoms of pulp necrosis. Generally, the three most desirable outcomes anticipated by clinicians from this procedure include resolution of clinical signs and symptoms, root maturation and redevelopment of the neurogenesis process. Despite this, whether these objectives and true regeneration of the pulp/dentin complex are achieved is still a question mark. Following the discovery that regenerative endodontics indeed is a stem cell-based treatment, addressing the fundamental issue surrounding stem cells might assist in achieving all identified clinical outcomes while favoring tissue formation that closely resembles the pulp-dentin complex.
Topics: Apexification; Dental Pulp; Humans; Regenerative Endodontics; Regenerative Medicine; Root Canal Therapy; Stem Cell Transplantation
PubMed: 33198618
DOI: 10.2174/1574888X15999201116162256 -
Journal of Functional Biomaterials Oct 2022In this study, some physicochemical and antibacterial properties of three root canal filling materials for primary teeth, Calplus “CP” (Prevest DenPro, Lewes, DE,...
In this study, some physicochemical and antibacterial properties of three root canal filling materials for primary teeth, Calplus “CP” (Prevest DenPro, Lewes, DE, USA), Bio-C Pulpecto “Bio-CP” (Angelus, Basil, Londrina, Paraná, Brazil), and Zinc Oxide and Eugenol “ZOE” (Prevest DenPro, Lewes, DE, USA) were compared. For each material, the pH, solubility, contact angle, and crystalline microstructure under SEM were evaluated. Their antibacterial activity against Enterococcus faecalis was determined through direct tests. The Kruskal−Wallis test was used to analyze the results using a one-way analysis of variance on ranks. All the materials had an alkaline pH at 3, 24, and 72 h, with CalPlus having the highest (p < 0.05). Bio-CP was more soluble during the evaluation period (24 h) than ZOE and CalPlus (p < 0.05). Bio-CP and ZOE demonstrated the creation of crystallite structures on their surfaces after immersion in PBS at 37 °C, whereas CalPlus showed none. The lowest contact angle was observed for Bio-CP (53 ± 1.5°); contact angles of (86 ± 4°) and (96 ± 1°), respectively, were observed after 10 s of the deposition of the water drop for CalPlus and ZOE. In conclusion, according to this study, there is still a need to develop new filling materials for primary teeth. ZOE, CalPlus and Bio-CP demonstrated different physicochemical and antibacterial properties, but none of the materials had optimal properties and could be considered the most suitable filling material for primary teeth pulpectomy. Bioceramics in their current state are not an alternative. The physicochemical and antibacterial properties still need improvement to fit the intricate anatomy of primary teeth.
PubMed: 36278646
DOI: 10.3390/jfb13040177 -
International Journal of Clinical... Jan 2024To establish lesion sterilization and tissue repair (LSTR) therapy as an alternate treatment option in managing infected primary molars with poor prognosis that were...
BACKGROUND AND AIM
To establish lesion sterilization and tissue repair (LSTR) therapy as an alternate treatment option in managing infected primary molars with poor prognosis that were indicated for extraction, thereby fulfilling the objective of retaining the primary tooth till its normal exfoliation in the dental arch.
MATERIALS AND METHODS
A total of 84 children who met the inclusion criteria requiring extraction in 142 teeth involving primary molars were included in the study. The selected patients were allocated to two groups, that is, group I-LSTR therapy with 3Mix-MP paste and group II-pulpectomy with metapex. All the treated teeth were then clinically and radiographically evaluated after 1, 3, 6, 9, and 12 months, respectively, to determine the success between groups I and II. Pearson's Chi-squared test along with the z-test was used to compare the clinical and radiographic success of the two groups ( < 0.05).
RESULTS
Pain and tenderness were completely resolved within one month of follow-up in both groups. Abscesses were resolved completely at 1 month in the pulpectomy group and mobility was resolved at 6 months follow-up in both groups. Interradicular and periradicular radiolucency persisted even at 12 months of the follow-up period in both groups. The intergroup comparison revealed no statistical differences between LSTR and pulpectomy procedure and both were equally effective at all time intervals ( > 0.05).
CONCLUSION
Both LSTR therapy with 3Mix-MP and pulpectomy with metapex showed 100% clinical success rates. Radiographically no changes were observed even at the 12-month follow-up period in both groups. LSTR therapy can be an alternative treatment option for pulpally involved primary teeth with poor prognosis and in cases where mechanical instrumentation could not be achieved due to physiologic root resorption.
HOW TO CITE THIS ARTICLE
Sefa I, Garg N, Pathivada L, Success of Lesion Sterilization and Tissue Repair Therapy and Pulpectomy in the Management of Infected Primary Molars with Poor Prognosis. Int J Clin Pediatr Dent 2024;17(1):41-47.
PubMed: 38559868
DOI: 10.5005/jp-journals-10005-2750 -
International Journal of Clinical... 2019To evaluate the clinical and radiographic success rates of 3Mix and Vitapex in the treatment of necrosed primary teeth.
OBJECTIVE
To evaluate the clinical and radiographic success rates of 3Mix and Vitapex in the treatment of necrosed primary teeth.
MATERIALS AND METHODS
Seventy teeth of healthy children aged 4-9 years with necrotic primary molar (nonvital) were treated with 3Mix (lesion sterilization tissue repair therapy) and Vitapex before restoration with stainless steel crowns. The participants were followed up clinically and radiographically for 3 months and 6 months, respectively. The outcome was compared using Fisher exact test with a significance level of < 0.05.
RESULTS
Clinical success rate of 3Mix group at 3 months and 6 month follow-up was 100% and 97.14% and that of Vitapex group was 100% and 100%, respectively. The radiographic success rate of 3Mix group at 3 months and 6 months was 74.29% and 77.14% and of Vitapex group was 97.14% and 97.14%, respectively. Considering the clinical success, no statistical difference was found between the two groups at the end of 6 month ( = 1.000). But radiographically statistical significant difference was found between the two groups ( = 0.028).
CONCLUSION
Non-instrumentation endodontic treatment using 3Mix has shown a good clinical success of 97.14% but the radiographic success rate at 6 months was lower (77.14%). So it can be suggested that the use of 3Mix antibiotic treatment cannot replace conventional root canal treatment over the long term.
HOW TO CITE THIS ARTICLE
Rai R, Shashibhusan KK, Babaji P, Clinical and Radiographic Evaluation of 3Mix and Vitapex as Pulpectomy Medicament in Primary Molars: An Study. Int J Clin Pediatr Dent 2019;12(6):532-537.
PubMed: 32440070
DOI: 10.5005/jp-journals-10005-1686 -
BMC Oral Health Sep 2023The success of primary teeth pulpectomy is strongly reliant on instrumentation techniques and their impact on obturation quality & postoperative pain. Recently,... (Randomized Controlled Trial)
Randomized Controlled Trial
INTRODUCTION
The success of primary teeth pulpectomy is strongly reliant on instrumentation techniques and their impact on obturation quality & postoperative pain. Recently, pediatric rotary file systems have been implemented.
AIM
to compare two pediatric rotary file systems (Kedo-S-Square & Fanta AF™ Baby) with manual K-files concerning obturation quality, instrumentation time, and postoperative pain in root canal preparation of primary molars using cone beam computed tomography (CBCT).
METHODS
A randomized clinical trial was conducted with the trial registration number (TRN: NCT05619796 and date of registration: (17/11/2022) on sixty primary lower 2nd molars in healthy children aged 4-7 years. Molars were assigned randomly to three groups (n = 20). Group-I and -II were prepared with Kedo-S-Square & Fanta AF™Baby rotary systems respectively while group-III was prepared with a manual K-file. Instrumentation time was recorded using a stopwatch. CBCT was used to assess obturation quality immediately & recorded as optimal, underfilled, or overfilled. Postoperative pain was evaluated at 6, 12, 24, 48 h-time intervals using a four-point pain intensity scale. Statistical analysis was performed for the collected data.
RESULTS
Among the three groups, group-I revealed a greater number of optimally filled teeth (85%) & less instrumentation time (74.75 s) followed by group-II & manual-K file group (p < 0.05). The hand K-file group had significantly more postoperative pain than the two rotary groups (p < 0.05).
CONCLUSION
the tested rotary file systems resulted in better obturation quality, less instrumentation time, and less postoperative pain compared to manual-K files during primary teeth pulpectomy.
Topics: Child; Humans; Root Canal Preparation; Tooth, Deciduous; Pulpectomy; Molar; Pain, Postoperative
PubMed: 37742023
DOI: 10.1186/s12903-023-03393-1 -
Frontiers in Oral Health 2023Symptomatic irreversible pulpitis (SIP) or symptomatic apical periodontitis (SAP) are two painful conditions often warranting emergency treatment. The most common... (Review)
Review
Pain after emergency treatments of symptomatic irreversible pulpitis and symptomatic apical periodontitis in the permanent dentition: a systematic review of randomized clinical trials.
BACKGROUND
Symptomatic irreversible pulpitis (SIP) or symptomatic apical periodontitis (SAP) are two painful conditions often warranting emergency treatment. The most common emergency treatments supported by evidence are pulpotomy and pulpectomy and are normally performed under time-constrained circumstances. However, there is no strong evidence of which treatment suggested in literature a clinician can use to reduce endodontic pain effectively. Therefore, the aim of this systematic review is to investigate the present knowledge on postoperative pain related to the two types of emergency treatments available for treating SIP and SAP.
METHODS
Randomized controlled trials investigating postoperative pain after emergency treatments (pulpotomy and/or pulpectomy) on permanent dentition with signs and symptoms of SIP and/or SAP were searched in three major databases from 1978 until 2022. Risk of bias was assessed with Cochrane's tool.
RESULTS
Only five studies fulfilled the inclusion criteria. The included studies indicated that pulpotomy and pulpectomy are both suitable treatment options for SAP and SIP, as they provide sufficient alleviation of pain in permanent dentition. However, inconsistent results were found between the included trials on which emergency treatment is more effective in reducing pain. Cochrane's tool revealed that the studies had a low risk of bias. Limitations found in the design of the included randomized control trials decreased the level of evidence. None of the included studies accounted for essential confounding variables, such as factors affecting pain (including the psychological aspects). Moreover, possible non-odontogenic pain was not assessed, and therefore, it was not excluded; hence, affecting the internal validity of the studies.
CONCLUSION
There are controversies within the available randomized control trials on which treatment is most effective in reducing emergency pain. This could be due to some weaknesses in the design of the clinical trials. Thus, further well-designed studies are warranted to draw conclusions on which emergency treatment is more effective in reducing pain.
SYSTEMATIC REVIEW REGISTRATION
PROSPERO (CRD42023422282).
PubMed: 37920592
DOI: 10.3389/froh.2023.1147884 -
Pediatric Dentistry Sep 2020To present an evidence-based guideline for non-vital pulp therapies due to deep caries or trauma in primary teeth. The authors, working with the American Academy of... (Meta-Analysis)
Meta-Analysis
To present an evidence-based guideline for non-vital pulp therapies due to deep caries or trauma in primary teeth. The authors, working with the American Academy of Pediatric Dentistry, conducted a systematic review/meta-analysis for studies on non-vital primary teeth resulting from trauma or caries and used the GRADE approach to assess level of certainty of evidence for clinical recommendations. GRADE was assessed from high to very low. Comparing teeth with/without root resorption, pulpectomy success was better (P<0.001) in those without preoperative root resorption. Zinc oxide plus iodoform plus calcium hydroxide ([ZO/iodoform/CH]; Endoflas TM ) and zinc oxide and eugenol (ZOE) pulpectomy success did not differ from iodoform (iodoform plus calcium hydroxide; Vitapex, Metapex) (P=0.55) after 18-months; however, ZO/iodoform/CH and ZOE success rates remained near 90 percent while iodoform was 71 percent or less. Network analysis ratings showed ZO/iodoform/CH and ZOE better than iodoform. Lesion sterilization tissue repair (LSTR) was better (P<0.001) than pulpectomy in teeth with preoperative root resorption, but pulpectomy results were better (P=0.09) if roots were intact. Rotary instrumentation of root canals was significantly faster (P<0.001) than manual, but the quality of fill did not differ (P=0.09) and both had comparable success. Network analysis ranked ZO/iodoform/CH the best, ZOE second, and iodoform lowest at 18 months. Success rates were not impacted by method of obturation or root length determination, type of tooth, number of visits, irrigants, smear layer removal, or timing/type of final restoration. Pulpectomy 18-month success rates supported ZO/iodoform/CH and ZOE pulpectomy over iodoform. LSTR had limited indication for teeth with resorbed roots and requires close monitoring.
Topics: Child; Humans; Pulpectomy; Root Resorption; Tooth, Deciduous; Zinc Oxide-Eugenol Cement
PubMed: 33087217
DOI: No ID Found -
International Endodontic Journal Oct 2021To evaluate the dental pulp response to a novel mineral trioxide aggregate containing phosphorylated pullulan (MTAPPL) in rats after direct pulp capping.
AIM
To evaluate the dental pulp response to a novel mineral trioxide aggregate containing phosphorylated pullulan (MTAPPL) in rats after direct pulp capping.
METHODS
Ninety-six cavities were prepared in the maxillary first molars of 56 male Wistar rats. The dental pulps were intentionally exposed and randomly divided into four groups according to the application of pulp capping materials: MTAPPL; phosphorylated pullulan (PPL); a conventional MTA (Nex-Cem MTA, NCMTA; positive control); and Super-Bond (SB; negative control). All cavities were restored with SB and observed for pulpal responses at 1-, 3-, 7- and 28-day intervals using a histological scoring system. Statistical analysis was performed using Kruskal-Wallis and Mann-Whitney U-test with Bonferroni's correction, and the level of significance was set at 0.05. DMP1 and CD34 antigen were used to evaluate odontoblast differentiation and pulpal vascularization, respectively.
RESULTS
On day 1, mild inflammatory cells were present in MTAPPL and NCMTA groups; fewer inflammatory cells were present in the PPL, whereas SB was associated with a mild-to-moderate inflammatory response. A significant difference was observed between PPL and SB (p < .05). No mineralized tissue deposition was observed. On day 3, moderate-to-severe inflammatory cells were present in PPL and SB, whereas MTAPPL and NCMTA had a mild inflammatory response. Initial mineralized tissue deposition was observed in the NCMTA, MTAPPL and SB. A significant difference was observed between MTAPPL and PPL (p < .05). On day 7, a thin layer of mineralized tissue was observed in all tested groups with no or mild inflammatory response. On day 28, no inflammatory response was observed in MTAPPL, whereas NCMTA, PPL and SB had mild inflammatory responses. A significant difference was observed between MTAPPL and SB (p < .05). Complete mineralized tissue barrier formation was observed in MTAPPL, NCMTA and PPL with no significant difference (p > .05). SB exhibited incomplete mineralized tissue barriers, significantly different from NCMTA, MTAPPL and PPL (p < .05). The staining with CD34 was positive in all the groups on all observation days.
CONCLUSION
The favourable pulpal responses and induction of mineralized tissue formation associated with MTAPPL indicate its potential application as a direct pulp capping material.
Topics: Aluminum Compounds; Animals; Calcium Compounds; Dental Pulp; Dental Pulp Capping; Drug Combinations; Glucans; Male; Molar; Oxides; Pulp Capping and Pulpectomy Agents; Rats; Rats, Wistar; Silicates
PubMed: 34096634
DOI: 10.1111/iej.13587 -
International Journal of Environmental... Jan 2023This study aims to retrospectively evaluate the survival rate of pulpectomy performed under dental general anesthesia (DGA) through long-term follow-up and to explore...
OBJECTIVES
This study aims to retrospectively evaluate the survival rate of pulpectomy performed under dental general anesthesia (DGA) through long-term follow-up and to explore the risk factors associated with treatment failure.
METHODS
The medical records of the children who were diagnosed with S-ECC and received pulpectomy treatment under general anesthesia (GA) from 1 August 2014 to 1 December 2019, in the Stomatological Hospital of Xi'an Jiaotong University, were collected. Two dentistry postgraduates extracted the necessary information and filled in a predesigned excel form. Survival analysis was performed using the Kaplan-Meier method. The shared frailty model was used to explore possible factors affecting the success rate of pulpectomy in primary teeth.
RESULTS
A total of 381 children (mean age 3.49 ± 0.90) with S-ECC and 1220 teeth were included in the study, including 590 primary anterior teeth and 630 primary molars. The overall 35-month survival rate was 38.5%, which was 52.9% for anterior teeth and 31.1% for molars. The overall median survival time was 31 months, in which anterior teeth were 35 months and molars were 26 months. The older the children were, the greater the risk of treatment failure (HR 1.56, 95% CI 1.09, 2.24). The risk of pulpectomy failure of primary molars was 1.9 times that of primary anterior teeth (95% CI 1.36, 2.65) and the teeth with abnormal radiological findings before treatment was 1.41 times higher than that of teeth without imaging abnormalities (95% CI 1.74, 3.36).
CONCLUSION
The survival rate of primary tooth pulpectomy is acceptable but decreased gradually with time. The failure rate of pulpectomy in primary molars is higher than that of primary anterior teeth. When the primary caries has extended to the pulp and resulted in a nonvital lesion, pulpectomy could be an option for maximum retention of the primary tooth.
Topics: Humans; Child; Child, Preschool; Pulpectomy; Retrospective Studies; Dental Caries Susceptibility; Tooth, Deciduous; Anesthesia, General; Risk Factors; Survival Analysis; Dental Caries
PubMed: 36673947
DOI: 10.3390/ijerph20021191