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European Journal of Paediatric Dentistry Dec 2021The aim of this systematic review was to evaluate the clinical outcome of partial pulpotomy, pulpotomy and pulpectomy for treating primary teeth with normal or infected...
AIM
The aim of this systematic review was to evaluate the clinical outcome of partial pulpotomy, pulpotomy and pulpectomy for treating primary teeth with normal or infected pulp or with irreversible pulpitis.
METHODS
Two reviewers on Pubmed and ISI Web of Science performed a comprehensive literature review of publications from 1966 until July 2019. Pico outline was used to facilitate literature research. Among abstracts, publications were selected according to the following criteria: prospective clinical study, correct indication for the performed treatment, clear definition of clinical and/or radiographic success criteria and at least 6-month follow-up period. The strict selection criteria under the keywords "pulpotomy", "partial pulpotomy" and "pulpectomy" resulted in a limited amount of randomised controlled trials (RCT) or controlled clinical trials (CT). Qualitative assessment of the selected clinical studies and level of evidence was included according to the criteria described by the Oxford Centre for Evidence-Based Medicine (CEBM).
CONCLUSION
Prerequisites for a successful pulpotomy are symptom-free teeth, sterile removal of coronal pulp and haemostasis. Both MTA and formocresol perform well for partial pulpotomies after caries exposure. Formocresol had been the most popular amputation material for pulpotomies. Due to the potential side effects, other medicaments, such as ferric sulfate, mineral trioxide aggregate (MTA) or NaOCl are suggested. Grey and white MTA yeld the same results. Lasers are not recommended due to their large diversity. Regarding pulpectomy, the conditions, procedures, and evaluation for the treatment were not well defined in the studies. Nevertheless, there is evidence to use calcium hydroxide, zinc oxide eugenol paste or iodoform based pastes as root filling materials for non-vital molars. Pulpectomies showed better success rates than pulpotomies. Stainless steel crowns are recommended as definite restorations after both endodontic treatments. Longer follow-up periods, further clinical studies with comparable conditions and clear definition of evaluation criteria are needed to further confirm the results of endodontic treatment in primary teeth.
Topics: Calcium Compounds; Drug Combinations; Humans; Molar; Oxides; Pulpectomy; Pulpotomy; Silicates; Tooth, Deciduous; Treatment Outcome; Zinc Oxide-Eugenol Cement
PubMed: 35034465
DOI: 10.23804/ejpd.2021.22.04.4 -
Journal of Conservative Dentistry : JCD 2019Vitapex has been a popular obturating material for several decades. In recent times, lesion sterilization and tissue repair (LSTR) has shown promising results. This... (Review)
Review
BACKGROUND
Vitapex has been a popular obturating material for several decades. In recent times, lesion sterilization and tissue repair (LSTR) has shown promising results. This technique uses a mixture of 3 antibiotics for sterilization of the root canals and healing of periradicular tissues.
OBJECTIVE
The objective of this systematic review was to compile all the literature comparing Vitapex and LSTR for pulpally involved primary teeth and evaluate the success rate in terms of clinical and radiographic outcomes.
MATERIALS AND METHODS
This review is based on PRISMA guidelines. The electronic search on MEDLINE via PubMed database and Google scholar, cross-referencing and hand search of journals was carried out for articles from January 1, 2000 to December 31, 2019. Articles only in the English language were selected. Out of the 17 articles, 3 unique articles were identified for the review, of which 2 were randomized controlled trials and 1 was a retrospective study.
RESULTS
All the three articles were assessed for their quality and all had a low risk of bias. It was found that LSTR and Vitapex had a high clinical success after 12 months. The radiographic success after 6 months was high but decreased after 12 months in both the groups.
CONCLUSION
There is no difference in the success rate of LSTR as compared to Vitapex for the treatment of pulpally involved primary teeth.
PubMed: 33088056
DOI: 10.4103/JCD.JCD_76_20 -
International Journal of Clinical... 2019The purpose of this systematic review was to compare the efficacy of single-visit pulpectomy (SVP) vs multiple-visit pulpectomy (MVP) in infected primary teeth. (Review)
Review
OBJECTIVE
The purpose of this systematic review was to compare the efficacy of single-visit pulpectomy (SVP) vs multiple-visit pulpectomy (MVP) in infected primary teeth.
MATERIALS AND METHODS
An extensive literature search in the English language was conducted in PICO format using MeSH terms using databases (PubMed, EBSCO, Ovid, and Cochrane) and pre-specified inclusion and exclusion criteria were applied to identify relevant studies comparing pulpectomy in single and multiple visits.
RESULTS
Only 4 studies (3- clinical study; 1- microbial study) sustained the final analysis and were included for critical appraisal. Results of the systematic search revealed that there are only a few studies comparing the efficacy of single-visit pulpectomy vs multiple-visit pulpectomy in infected primary teeth.
CONCLUSION
On the basis of the available studies, evidence favors the SVP protocol over the MVP protocol. Whenever possible the single-visit protocol can be preferred over the multiple-visit protocol. The quality of evidence available is low.
HOW TO CITE THIS ARTICLE
Tirupathi SP, Krishna N, Rajasekhar S, Clinical Efficacy of Single-visit Pulpectomy over Multiple-visit Pulpectomy in Primary Teeth: A Systematic Review. Int J Clin Pediatr Dent 2019;12(5):453-459.
PubMed: 32440053
DOI: 10.5005/jp-journals-10005-1654 -
The Saudi Dental Journal Jun 2024To evaluate and compare the effectiveness of Endoflas and Zinc Oxide Eugenol (ZOE) as root canal filling materials (RCFMs) for the pulpectomy of deciduous teeth by... (Review)
Review
OBJECTIVES
To evaluate and compare the effectiveness of Endoflas and Zinc Oxide Eugenol (ZOE) as root canal filling materials (RCFMs) for the pulpectomy of deciduous teeth by analyzing multiple clinical and radiographic success and failure follow-ups in previously published studies.
DATA
All clinical studies that investigated the pulpectomy of the deciduous teeth of children aged 3-9 years.
SOURCES
The databases used for source identification included MEDLINE (via PubMed), Scopus, Web of Science, and the Cochrane Library. No limitations were imposed on the publication year or language. The selection of studies and extraction of relevant study characteristics were conducted from December 26, 2021, to September 7, 2023. Additionally, the risk of bias (RoB) in the included studies was evaluated by using a RoB instrument (RoB 2). Eligible studies were then combined, and a random-effects model was applied by using the maximum likelihood estimations of log risk ratios and their corresponding 95% confidence intervals.
STUDY SELECTION
Of the 3913 records found in the abovementioned databases, nine were eligible for systematic review and eight were eligible for -analysis. The studies included 628 pulpectomies of deciduous molar teeth in children. The overall results showed that compared with Endoflas, ZOE was associated with a higher risk ratio for clinical evaluation (LOG[RR] = 0.06, CI 0.03-0.09, -value 0.001) and radiographic evaluation (LOG[RR] = 0.68, CI 0.35-1.00, -value 0.001). This association was highly significant at 6- and 9-month follow-ups.
CONCLUSION
Compared with ZOE, Endoflas was associated with a lower risk of the clinical and radiographic failure of deciduous teeth pulpectomy and a 6%-6.8% higher risk ratio, especially at 6- and 9-month follow-ups.
CLINICAL SIGNIFICANCE
This study suggests the superiority of Endoflas over ZOE as an RCFM for deciduous teeth.
PubMed: 38883905
DOI: 10.1016/j.sdentj.2024.03.007 -
Biomaterial Investigations in Dentistry 2022The objective was to review the effectiveness of iodoform-based compared to noniodoform-based filling materials in the root canal treatment of deciduous teeth. (Review)
Review
INTRODUCTION
The objective was to review the effectiveness of iodoform-based compared to noniodoform-based filling materials in the root canal treatment of deciduous teeth.
METHODS
This systematic review and meta-analysis used randomized clinical trials with six months or more follow-up. The risk of bias of individual studies and the certainty of the evidence were evaluated (Cochrane risk of bias tool and GRADE, respectively).
RESULTS
The initial search resulted in 5,127 studies after removal of duplicates. After screening by title and abstract, 34 full-text studies were eligible and 21 remained in the qualitative synthesis and 19 in the meta-analysis. Iodoform-based filling materials resulted in fewer clinical failures when compared to noniodoform-based filling materials at the 6 months (OR = 0.43, 95%CI: 0.19-0.97, = .04) and 9-12 months (OR = 0.46, 95%CI: 0.23-0.93, = .03), but not at the 18-30 months follow-up (OR = 1.08, 95%CI: 0.58-2.03, = .81). When considering radiographic failures, there was no statistical difference between iodoform-based and noniodoform-based filling materials at the 6 months (OR = 0.72, 95%CI: 0.39-1.32, = .29) and 18-30 months follow-ups (OR = 1.06, 95%CI: 0.51-2.21, = .87), but fewer radiographic failures were detected at the 9-12 months follow-up (OR = 0.49, 95%CI: 0.29-0.80, = .005).
CONCLUSION
Iodoform-based filling materials showed better clinical and radiographic performance when compared to non-iodoform-based filling materials in the short term, and similar performance in the long term. However, most of the studies exhibited unclear or high risk of bias and the overall certainty of the evidence ranged from low to very low. Therefore, new randomized clinical trials must be accomplished to corroborate this conclusion.
PubMed: 35615468
DOI: 10.1080/26415275.2022.2060232 -
International Journal of Clinical... 2021A systematic review was planned to compare the clinical and radiographic success rate of pulpectomy in primary molars using a rotary system and hand files system. (Review)
Review
AIM AND OBJECTIVE
A systematic review was planned to compare the clinical and radiographic success rate of pulpectomy in primary molars using a rotary system and hand files system.
STUDY DESIGN
The literature search was undertaken in electronic databases from January 2000 to December 2019 using keywords. Four hundred and forty-two studies were identified after applying limits. Three hundred and thirty-one irrelevant articles were eliminated. Among the 111 articles obtained, 90 articles were eliminated after reading the titles and abstracts. After assessing the full text, 18 articles were eliminated. Randomized controlled trials (RCTs) published in the English language on pulpectomy of primary molars, using hand files and rotary files and with a follow-up period of 12 months were included.
RESULTS
Three RCTs comparing the clinical and radiographic pulpectomy success rates using rotary and hand files instrumentation were finally selected. Qualitative assessment with RoB 2.0 showed one study had a low risk of bias and two studies had a high risk of bias.
CONCLUSION
Pulpectomy procedures in primary teeth using rotary and hand files instrumentation techniques were equally effective in terms of success rates.
HOW TO CITE THIS ARTICLE
Natchiyar N, Asokan S, Geetha Priya PR, Comparison of Clinical and Radiographic Success of Rotary with Manual Instrumentation Techniques in Primary Teeth: A Systematic Review. Int J Clin Pediatr Dent 2021;14(1):8-13.
PubMed: 34326578
DOI: 10.5005/jp-journals-10005-1879 -
The Saudi Dental Journal Sep 2023Studies assessing the clinical and radiographic success of LSTR in terms of the presence of pain, mobility, swelling, fistula/sinus tract, interradicular radiolucency,... (Review)
Review
Studies assessing the clinical and radiographic success of LSTR in terms of the presence of pain, mobility, swelling, fistula/sinus tract, interradicular radiolucency, and root resorption have not been performed. We therefore performed a systematic review with the aim of evaluating the effectiveness of lesion sterilization and tissue repair (LSTR), using three antibacterial mixtures (3Mix), in treating primary teeth. Well-defined search strategies developed for four electronic databases, Web of Science, OVID, PubMed, and Scopus, were used in this study. Two independent reviewers selected relevant articles from 3,232 studies by screening titles and abstracts. Based on the inclusion criteria, 25 articles were selected. Eight analyses of clinical and radiographic results were conducted based on 6, 12, 18, and 24-month follow-up intervals. Data extraction and quality appraisal were performed by three independent reviewers. The composition of antibiotic mixtures used for LSTR varied substantially, with inconsistent radiographic and clinical success rates across the included studies. A quantitative grouping of the studies showed no significant differences between 3Mix and the control medicaments regarding radiographical and clinical success (-value > 0.05). The available evidence on different LSTR using 3Mix is scarce, and the study findings were inconsistent. Therefore, additional clinical trials on 3Mix with different compositions are needed.
PubMed: 37823084
DOI: 10.1016/j.sdentj.2023.06.001 -
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 -
Journal of Dental Research, Dental... 2020This study was conducted to investigate root canal overfilling with different material placement techniques in primary teeth. A systematic search was undertaken by...
This study was conducted to investigate root canal overfilling with different material placement techniques in primary teeth. A systematic search was undertaken by searching PubMed/MEDLINE and Scopus for English language peer-reviewed articles published until February 2018 that reported primary tooth pulpectomy overfilling. Two reviewers independently screened and identified studies in terms of the selection criteria and independently collected the data using a specially designed data extraction form. The overfilling rate was the primary summary measure. The weighted pooled overfilling rates were estimated by random-effects meta-analysis. Twenty clinical and four in vitro studies met the eligibility criteria. In the clinical studies, the pooled overfilling rate for zinc oxide-eugenol (ZOE) was 23.3% with a lentulo spiral mounted on a handpiece, 22.7% with a hand-held lentulo spiral, and 17% with a plugger. The pooled overfilling rate for calcium hydroxide-based materials was 16.7% with a lentulo spiral mounted on a handpiece, 14.7% with a hand-held lentulo spiral, 19.6% with a syringe, and 25.7% with a plugger. In the in vitro studies, neither individual overfilling rates nor two-by-two comparisons were subjected to meta-analysis because of an inadequate number of studies. The lowest overfilling rate in the clinical studies was related to plugger and handheld lentulo spiral techniques for ZOE and calcium hydroxide-based materials, respectively.
PubMed: 33575016
DOI: 10.34172/joddd.2020.043 -
Diagnostics (Basel, Switzerland) Nov 2022The need to perform fast, effective and efficient pulpectomies has led to the development of numerous valid rotary systems. Its technical features allow the clinician to... (Review)
Review
The need to perform fast, effective and efficient pulpectomies has led to the development of numerous valid rotary systems. Its technical features allow the clinician to obtain good results in less working time. The objective of this study is to compare the characteristics of the different current rotary systems to favor a correct diagnosis and subsequent treatment. A systematic review of the literature has been carried out in accordance with the PRISMA recommendations. A search was carried out in PubMed, Embase Scopus, Cochrane and Web of Science databases, and was completed with a manual search. The following variables were extracted from the selected studies: author, year, sample, rotary systems used (length, diameter, taper, speed), obturation material and irrigant. From the initial electronic search of the five databases, 315 articles were identified. Once the duplicate articles were eliminated, a total of 233 remained. After reading both title and abstract, 200 articles were eliminated, leaving 33. On account of reading the full text, 22 were eliminated for not answering the research question or the inclusion criteria, leaving a total of 11 articles for the systematic review. Rotary systems which are able to adapt to the root anatomy of primary teeth and allow rapid and simple instrumentation, without producing excessive extrusion of debris at the root apex, will be the ones that provide the best results to the pediatric dentist during the performance of pulp treatment in primary teeth. Clinical success will only be achieved through proper prior diagnosis.
PubMed: 36428835
DOI: 10.3390/diagnostics12112775