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Journal of Endodontics May 2011This systematic review aims to illustrate the outcome of vital pulp therapy, namely direct pulp capping, partial pulpotomy, and full pulpotomy, in vital permanent teeth... (Review)
Review
INTRODUCTION
This systematic review aims to illustrate the outcome of vital pulp therapy, namely direct pulp capping, partial pulpotomy, and full pulpotomy, in vital permanent teeth with cariously exposed pulp.
METHODS
Electronic database MEDLINE via Ovid, PubMed, and Cochrane databases were searched. Hand searching was performed through reference lists of endodontic textbooks, endodontic-related journals, and relevant articles from electronic searching. The random effect method of weighted pooled success rate of each treatment and the 95% confidence interval were calculated by the DerSimonian-Laird method. The weighted pooled success rate of each treatment was estimated in 4 groups: >6 months-1 year, >1-2 years, >2-3 years, and >3 years. All statistics were performed by STATA version 10. The indirect comparison of success rates for 4 follow-up periods and the indirect comparison of clinical factors influencing the success rate of each treatment were performed by z test for proportion (P < .05).
RESULTS
Overall, the success rate was in the range of 72.9%-99.4%. The fluctuation of the success rate of direct pulp capping was observed (>6 months-1 year, 87.5%; >1-2 years, 95.4%; >2-3 years, 87.7%; and >3 years, 72.9%). Partial pulpotomy and full pulpotomy sustained a high success rate up to more than 3 years (partial pulpotomy: >6 months-1 year, 97.6%; >1-2 years, 97.5%; >2-3 years, 97.6%; and >3 years, 99.4%; full pulpotomy: >6 months-1 year, 94%; >1-2 years, 94.9%; >2-3 years, 96.9%; and >3 years, 99.3%).
CONCLUSIONS
Vital permanent teeth with cariously exposed pulp can be treated successfully with vital pulp therapy. Current best evidence provides inconclusive information regarding factors influencing treatment outcome, and this emphasizes the need for further observational studies of high quality.
Topics: Dental Caries; Dental Pulp Capping; Dental Pulp Exposure; Follow-Up Studies; Humans; Pulp Capping and Pulpectomy Agents; Pulpotomy; Treatment Outcome
PubMed: 21496652
DOI: 10.1016/j.joen.2010.12.004 -
Dentistry Today Dec 1996
Review
Topics: Adult; Child; Dental Caries; Dental Pulp Capping; Dental Pulp Exposure; Humans; Patient Selection; Pulpectomy; Pulpotomy
PubMed: 9567885
DOI: No ID Found -
British Dental Journal Apr 2022Background According to the Children's Dental Health Survey 2013, around one in ten children in Wales, Northern Ireland and England will have sustained dental trauma to... (Review)
Review
Background According to the Children's Dental Health Survey 2013, around one in ten children in Wales, Northern Ireland and England will have sustained dental trauma to a permanent incisor by the of age 15. Management of an exposed pulp in an immature permanent incisor is often urgent and has an impact on the long-term outcome of the tooth; therefore, it is essential that general dental practitioners feel confident in managing such a scenario to achieve an optimal outcome. This paper discusses the indications, technique, materials and outcomes.Aims This article aims to review the literature, which discusses various treatment modalities and materials for pulpal therapy and root canal treatment in the immature permanent tooth.Method Electronic searches were limited to English language, human studies, published within the past five years and the medical subject heading terms used were: direct pulp capping, apexogenesis, Cvek pulpotomy, full pulpotomy/pulpectomy, partial pulpotomy, apexification, non-vital pulp therapy and mineral trioxide aggregate apexification. Older, seminal articles identified through the references sections have also been included.Conclusion A number of options are available for the management of immature permanent teeth that have suffered an insult such as caries or trauma. This paper reviews the various methods of pulpal treatment, preservation therapy and root canal treatment options depending on the extent of the damage.
Topics: Adolescent; Calcium Compounds; Child; Dental Pulp Cavity; Dentists; Dentition, Permanent; Drug Combinations; Humans; Oxides; Professional Role; Pulpotomy; Silicates; Treatment Outcome
PubMed: 35459824
DOI: 10.1038/s41415-022-4139-4 -
Revue Belge de Medecine Dentaire 2004Rather easy to perform, pulpotomy of the deciduous teeth is the most frequent endodontic treatment performed on children, but also the most controversial. Based on the... (Review)
Review
Rather easy to perform, pulpotomy of the deciduous teeth is the most frequent endodontic treatment performed on children, but also the most controversial. Based on the amputation of the pulp chamber and the conservation of the inflammation-free root canals, the clinical results can be good, depending on the materials used. In this, calcium hydroxide (Ca(OH)2) as well as zinc-oxide-eugenol (ZOE) have been proven very inflammatory whereas Formocresol (FC) remains the reference even if its clinical toxicity is still reported in literature on a very controversial way. Nevertheless, this was sufficient to trigger and stimulate a search for alternatives, and led to the proposition to use ferric sulfate and even more recently MTA as new bases for the treatment of the pulp stumps after pulp chamber amputation.
Topics: Child; Dental Pulp; Dental Pulp Cavity; Humans; Pulpotomy; Root Canal Filling Materials; Tooth, Deciduous
PubMed: 15526642
DOI: No ID Found -
Quintessence International, Dental... Apr 1973
Topics: Pulpotomy
PubMed: 4514096
DOI: No ID Found -
BMC Oral Health Apr 2024Pulpotomy procedures aiming to preserve and regenerate the dentin-pulp complex have recently increased exponentially due to developments in the field of biomaterials and... (Review)
Review
BACKGROUND
Pulpotomy procedures aiming to preserve and regenerate the dentin-pulp complex have recently increased exponentially due to developments in the field of biomaterials and tissue engineering in primary and permanent teeth. Although the number of studies in this domain has increased, there is still scarcity of evidence in the current literature.
OBJECTIVES
(1) Report the methods of outcome assessment of pulpotomy clinical trials in both primary and permanent teeth; (2) Identify the various bioactive agents and biodegradable scaffolds used in pulpotomy clinical trials in both primary and permanent teeth.
MATERIALS AND METHODS
A scoping review of the literature was performed, including a search of primary studies on PubMed, Scopus, Web of Science, ProQuest and Clinicaltrials.gov. A search for controlled trials or randomized controlled trials published between 2012 and 2023 involving primary or permanent teeth receiving partial or full pulpotomy procedures using bioactive/regenerative capping materials was performed.
RESULTS
127 studies out of 1038 articles fulfilled all the inclusion criteria and were included in the current scoping review. More than 90% of the studies assessed clinical and radiographic outcomes. Histological, microbiological, or inflammatory outcomes were measured in only 9.4% of all included studies. Majority of the studies (67.7%) involved primary teeth. 119 studies used non-degradable bioactive cements, while biodegradable scaffolds were used by 32 studies, natural derivates and plant extracts studies were used in only 7 studies. Between 2012 (4 studies) and 2023 (11 studies), there was a general increase in the number of articles published. India, Egypt, Turkey, and Iran were found to have the highest total number of articles published (28, 28,16 and 10 respectively).
CONCLUSIONS
Pulpotomy studies in both primary and permanent teeth relied mainly on subjective clinical and radiographic outcome assessment methods and seldom analyzed pulpal inflammatory status objectively. The use of biodegradable scaffolds for pulpotomy treatments has been increasing with an apparent global distribution of most of these studies in low- to middle-income countries. However, the development of a set of predictable outcome measures as well as long-term evidence from well conducted clinical trials for novel pulpotomy dressing materials are still required.
Topics: Humans; Pulpotomy; Tooth, Deciduous; Biocompatible Materials; Dentition, Permanent; Outcome Assessment, Health Care; Pulp Capping and Pulpectomy Agents; Tissue Scaffolds
PubMed: 38678210
DOI: 10.1186/s12903-024-04221-w -
Pediatric Dentistry May 2023The purpose of this randomized clinical trial was to evaluate the clinical and radiographic success of the premixed bioceramic (NeoPUTTY®) as pulpotomy medicament in... (Randomized Controlled Trial)
Randomized Controlled Trial
PURPOSE
The purpose of this randomized clinical trial was to evaluate the clinical and radiographic success of the premixed bioceramic (NeoPUTTY®) as pulpotomy medicament in primary molars in comparison to NeoMTA® 2.
METHODS
Seventy primary molars indicated for pulpotomy in 42 children were randomly allocated into two groups: (1) a mineral trioxide aggregate (MTA) group (NeoMTA® 2); and (2) a premixed bioceramic group (NeoPUTTY®). Clinical and radiographic examinations of the molars following pulpotomy were conducted by two independent evaluators at six and 12 months. The data were analyzed using Fishe`s exact tests.
RESULTS
At 12 months, the clinical and radiographic success for the MTA group were 100 percent (34 out of 34) and 94.1 percent (32 out of 34), respectively. For the NeoPUTTY® group, the clinical and radiographic success were 97.1 percent (34 out of 35) and 92.8 percent (32 out of 35), respectively. No significant differences were found between the two materials.
CONCLUSIONS
NeoPUTTY® showed a comparable success to mineral trioxide aggregate in primary molar pulpotomies over 12 months. Further clinical trials with larger sample sizes and longer follow-up periods are recommended.
Topics: Child; Humans; Pulpotomy; Molar
PubMed: 37381123
DOI: No ID Found -
Journal of Endodontics Jul 2008Formocresol pulpotomy (FP) in the United States is most frequently used to treat asymptomatic caries near the pulp in primary teeth. Indirect pulp therapy (IPT) is also... (Review)
Review
Formocresol pulpotomy (FP) in the United States is most frequently used to treat asymptomatic caries near the pulp in primary teeth. Indirect pulp therapy (IPT) is also indicated and has a significantly higher long-term success. Pulpotomy is thought to be indicated for primary teeth with carious pulp exposures, but research shows the majority of such teeth are nonvital or questionable for treatment with vital pulp therapy. IPT has a significantly higher success in treating all primary first molars, but especially those with reversible pulpitis compared with FP. The purpose of this article was to review the dental literature and new research in vital pulp therapy to determine the following: (1) Is a pulpotomy indicated for a true carious pulp exposure? (2) Is there a diagnostic method to reliably identify teeth that are candidates for vital pulp therapy? (3) Is primary tooth pulpotomy out of date, and should indirect pulp therapy replace pulpotomy?
Topics: Dental Caries; Dental Cavity Preparation; Dental Pulp Capping; Dental Restoration, Temporary; Glass Ionomer Cements; Humans; Pulpotomy; Tooth, Deciduous
PubMed: 18565370
DOI: 10.1016/j.joen.2008.02.033 -
Pediatric Dentistry 2008Formocresol pulpotomy (FP) in the United States is most frequently used to treat asymptomatic caries near the pulp in primary teeth. Indirect pulp therapy (IPT) is also... (Review)
Review
Formocresol pulpotomy (FP) in the United States is most frequently used to treat asymptomatic caries near the pulp in primary teeth. Indirect pulp therapy (IPT) is also indicated and has a significantly higher long-term success. Pulpotomy is thought to be indicated for primary teeth with carious pulp exposures, but research shows the majority of such teeth are nonvital or questionable for treatment with vital pulp therapy. IPT has a significantly higher success in treating all primary first molars, but especially those with reversible pulpitis compared with FP. The purpose of this article was to review the dental literature and new research in vital pulp therapy to determine the following: (1) Is a pulpotomy indicated for a true carious pulp exposure? (2) Is there a diagnostic method to reliably identify teeth that are candidates for vital pulp therapy? (3) Is primary tooth pulpotomy out of date, and should indirect pulp therapy replace pulpotomy? )
Topics: Dental Caries; Dental Cavity Preparation; Dental Pulp Capping; Dental Restoration, Temporary; Glass Ionomer Cements; Humans; Pulpotomy; Tooth, Deciduous
PubMed: 18615989
DOI: No ID Found -
European Archives of Paediatric... Jun 2008The principles of evidence-based dentistry were used to compare mineral trioxide aggregate (MTA), formocresol (FC), ferric sulphate (FS) and calcium hydroxide (CH) as... (Comparative Study)
Comparative Study Meta-Analysis Review
AIM
The principles of evidence-based dentistry were used to compare mineral trioxide aggregate (MTA), formocresol (FC), ferric sulphate (FS) and calcium hydroxide (CH) as primary molar pulpotomy medicaments.
METHODS
Electronic databases were searched and sieved for relevant papers by examining titles, abstracts and finally full texts. Included were randomized clinical trials (RCTs) and clinical trials (CTs) comparing the clinical and radiographic successes of MTA, FC, FS and CH pulpotomies. Data were extracted and common odds ratios (CORs) were derived by fixed effects meta-analysis (direct or indirect MA). Mean clinical and radiographic success rates from relevant study arms were examined.
RESULTS
Eighteen RCTs and 10 CTs (total 1,260 molars) were identified to compare MTA and FC. Direct MAs found MTA was significantly more successful clinically (COR=3.11; 95%CI=1.09-8.85) and radiographically (COR=4.50; CI=1.78-11.42) than FC, and clinical and radiographic data confirmed this. Fourteen RCTs and 4 CTs (total 959 molars) were identified to compare MTA and FS. Indirect MAs found no statistically significant difference in clinical successes, but a statistically significant difference in the radiographic successes of MTA and FS (COR=4.69; CI=1.70-12.95). Clinical and radiographic data showed MTA was significantly more successful than FS. Nine RCTs and 7 CTs (total 531 molars) were identified to compare MTA and CH. Indirect MAs found statistically significant differences in the clinical (COR=6.48; CI=1.75-24.0) and radiographic (COR=10.47; CI=3.35-32.76) successes of MTA and CH. Clinical and radiographic data confirmed MTA was significantly more successful than CH.
CONCLUSION
Currently available evidence suggests MTA compared with FC, FS and CH as a pulpotomy medicament resulted in significantly higher clinical and radiographic successes in all time periods up to exfoliation.
Topics: Aluminum Compounds; Calcium Compounds; Calcium Hydroxide; Clinical Trials as Topic; Drug Combinations; Evidence-Based Medicine; Ferric Compounds; Formocresols; Humans; Oxides; Pulpotomy; Randomized Controlled Trials as Topic; Root Canal Irrigants; Silicates; Tooth, Deciduous; Treatment Outcome
PubMed: 18534173
DOI: 10.1007/BF03262612