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Pain Research & Management 2020This equivalence, randomized, clinical trial aimed to compare the postoperative pain of root canal therapy (RCT) with pulpotomy with mineral trioxide aggregate (PMTA) or... (Randomized Controlled Trial)
Randomized Controlled Trial
This equivalence, randomized, clinical trial aimed to compare the postoperative pain of root canal therapy (RCT) with pulpotomy with mineral trioxide aggregate (PMTA) or calcium-enriched mixture (PCEM) in permanent mature teeth. In seven academic centers, 550 cariously exposed pulps were included and randomly allocated into PMTA ( = 188), PCEM ( = 194), or RCT ( = 168) arms. Preoperative "Pain Intensity" (PI) on Numerical Rating Scale and postoperative PIs until day 7 were recorded. Patients' demographic and pre-/intra-/postoperative factors/conditions were recorded/analysed. The arms were homogeneous in terms of demographics. The mean preoperative PIs were similar (=0.998), the mean sum PIs recorded during 10 postoperative intervals were comparable (=0.939), and the trend/changes in pain relief were parallel (=0.821) in all study arms. The incidences of preoperative moderate-severe pain in RCT, PMTA, and PCEM arms were 56.5%, 55.7%, and 56.7%, which after 24 hours considerably decreased to 13.1%, 10.6%, and 12.9%, respectively (=0.578). The time span of endodontic procedures was statistically different; RCT = 69.73, PMTA = 35.37, and PCEM = 33.62 minutes ( < 0.001). Patients with greater preoperative pain, symptomatic apical periodontitis, or presence of PDL widening suffered more pain (=0.002, 0.035, and 0.023, resp.); however, other pre-/intra-/postoperative factors/conditions were comparable. Pulpotomy with MTA/CEM and RCT demonstrate comparable and effective postoperative pain relief.
Topics: Adult; Aluminum Compounds; Calcium Compounds; Dental Cements; Drug Combinations; Female; Humans; Male; Molar; Oxides; Pain, Postoperative; Prevalence; Pulpotomy; Root Canal Filling Materials; Root Canal Therapy; Silicates; Treatment Outcome
PubMed: 32676136
DOI: 10.1155/2020/5853412 -
The Journal of the Michigan Dental... Apr 2018Mineral Trioxide Aggregate (MTA) has been used in many endodontic procedures with success. We hypothesized that MTA as a pulpotomy medicament elicits outcomes no...
UNLABELLED
Mineral Trioxide Aggregate (MTA) has been used in many endodontic procedures with success. We hypothesized that MTA as a pulpotomy medicament elicits outcomes no different than that of the diluted formocresol (DFC).
PURPOSE
The purpose of this study was to compare the outcomes of grey MTA and DFC in primary molar pulpotomies at a teaching institution and a pediatric dental practice.
METHODS
At the teaching institution, 206 primary molars of 122 children were enrolled. At 48-months, 20 teeth treated with MTA and 25 teeth treated with DFC, were available for evaluation. At the private practice, dental records of 245 primary molars of 68 patients were available for evaluation.
RESULTS
At 48 months, the results from both sites showed a radiographic success rate of 80 percent for DFC and 95 percent for MTA. The odds of radiographic failure were not affected by study sites. The Cox-regression analysis revealed that patient's age at the time of pulpotomy impacted the "hazard of exfoliation." Each year following the completion of DFC or MTA pulpotomy, there is a 4.6-times-more-likely chance for early exfoliation of the pulpotomized tooth.
CONCLUSION
Grey MTA is an acceptable alternative for primary molar pulpotomies.
Topics: Aluminum Compounds; Calcium Compounds; Child, Preschool; Drug Combinations; Follow-Up Studies; Humans; Molar; Oxides; Prospective Studies; Pulpotomy; Retrospective Studies; Silicates; Tooth, Deciduous
PubMed: 30636813
DOI: No ID Found -
Zhonghua Kou Qiang Yi Xue Za Zhi =... Aug 2016Since laser was introduced in the field of medicine in 1970's, its application range has continuously expanded. The application of laser in endodontics also increased... (Review)
Review
Since laser was introduced in the field of medicine in 1970's, its application range has continuously expanded. The application of laser in endodontics also increased due to its safety and effectiveness in dental treatments. The majority of the laser application researches in dentistry focused on dentin hypersensitivity, removal of carious tissues, tooth preparations, pulp capping or pulpotomy, and root canal treatment. In this article, we reviewed literature on the effects of laser in the treatments of dental and pulp diseases.
Topics: Dental Care; Dental Pulp Capping; Dental Pulp Diseases; Dentin Sensitivity; Endodontics; Humans; Laser Therapy; Pulpotomy; Root Canal Therapy; Tooth Diseases
PubMed: 27511037
DOI: 10.3760/cma.j.issn.1002-0098.2016.08.007 -
Endodontics & Dental Traumatology Dec 1993The material comprised 37 young posterior teeth with deep carious lesions and exposed pulps, treated with partial pulpotomy and dressed with calcium hydroxide. The teeth...
The material comprised 37 young posterior teeth with deep carious lesions and exposed pulps, treated with partial pulpotomy and dressed with calcium hydroxide. The teeth were divided into two groups. Group 1 consisted of 31 teeth with no clinical or radiographic symptoms before treatment, Group 2 of 6 teeth with temporary pain, widened periodontal space periapically and/or productive osteitis, i.e. increased density of the surrounding alveolar bone. After an observation time of 24 to 140 months (mean = 56 months), healing had occurred in 29 of 31 teeth in Group 1 (93.5%) and in 4 of 6 teeth in Group 2. It was concluded that the present, as well as previously reported results indicate that partial pulpotomy may be an adequate treatment for young permanent molars with a carious exposure, although more studies are needed before the treatment can be recommended for routine clinical use.
Topics: Adolescent; Child; Dental Caries; Dental Pulp Exposure; Humans; Molar; Pulpotomy; Treatment Outcome
PubMed: 8143574
DOI: 10.1111/j.1600-9657.1993.tb00279.x -
Lasers in Medical Science Oct 2008The purpose of this study was to histologically investigate whether pulpotomy with Er,Cr:YSGG laser is an acceptable alternative for formocresol. Pulpotomy of 48 dog's...
The purpose of this study was to histologically investigate whether pulpotomy with Er,Cr:YSGG laser is an acceptable alternative for formocresol. Pulpotomy of 48 dog's primary canine teeth was performed with formocresol or Er,Cr:YSGG laser. Histological evaluations on hematoxylin and eosin-stained pulp tissues were made by an optical microscope 7 or 60 days later. Statistical analysis was performed with Fisher's exact test, Mann-Whitney U test, and Student's t test. Seven days after pulpotomy, samples treated with laser had significantly favorable histological features in the following measures: continuity of odontoblastic layer (P<0.001), presence of hemorrhage (P<0.008), amount of inflammation (P<0.002), tissue necrosis (P<0.001), internal resorption (P<0.002), level of vascularization (P<0.002), and size of abscess (P<0.041). Similar results were observed 60 days after pulpotomy, except that the differences were not mostly significant due to natural exfoliation of 16 teeth. In conclusion, Er,Cr:YSGG laser system is an acceptable alternative for formocresol in pulpotomy of deciduous teeth.
Topics: Animals; Dental Pulp; Dogs; Formocresols; Hematoxylin; Laser Therapy; Lasers, Solid-State; Male; Models, Animal; Odontoblasts; Pilot Projects; Pulpotomy; Tooth, Deciduous; Zinc Oxide
PubMed: 17957333
DOI: 10.1007/s10103-007-0505-3 -
Intentional Partial Pulpotomy for Treatment of Immature Permanent Maxillary Incisor with Talon Cusp.The Bulletin of Tokyo Dental College 2017We report the successful morphological correction of a maxillary lateral incisor with a talon cusp and the preservation of vital pulp by employing an intentional partial...
We report the successful morphological correction of a maxillary lateral incisor with a talon cusp and the preservation of vital pulp by employing an intentional partial pulpotomy. A talon cusp is a comparatively rare morphological tooth anomaly that may cause multiple clinical problems. An 11-year-old girl was referred to our department for morphological correction of a maxillary lateral incisor with a talon cusp prior to orthodontic treatment. Following a detailed CT examination of the interior morphology, the abnormal cusp was resected and an intentional partial pulpotomy performed. Five years postoperatively, the tooth showed no abnormalities. These results indicate that an intentional partial pulpotomy following a detailed CT examination is effective in correcting complicated morphological anomalies such as a talon cusp containing extended dental pulp.
Topics: Child; Female; Humans; Incisor; Maxilla; Pulpotomy
PubMed: 29269719
DOI: 10.2209/tdcpublication.2016-0045 -
Pediatric Dentistry Sep 2017This study compared the outcome of partial pulpotomies with mineral trioxide aggregate (MTA) or calcium hydroxide (CH) following hemorrhage control with 2.5 percent... (Comparative Study)
Comparative Study Randomized Controlled Trial
PURPOSE
This study compared the outcome of partial pulpotomies with mineral trioxide aggregate (MTA) or calcium hydroxide (CH) following hemorrhage control with 2.5 percent sodium hypochlorite (SH) or 0.9 percent sterile saline (SS) solutions in cariously exposed immature permanent molars.
METHODS
Following removal of two to three mm of the pulp at the exposure site, 80 Class I cavities were randomly allocated to four groups according to the hemorrhage control agent and pulp-capping material used: (1) group one-SH plus MTA; (2) group two-SS plus MTA; (3) group three-SH plus CH; (4) group four-SS plus CH. Glass ionomer cement was applied over the pulp-capping material, and the teeth were later restored with composite resin. The patients were recalled at six, 12, 18, and 24 months.
RESULTS
After 24 months, simultaneous radiographic and clinical success rates were 94.4 percent, 100 percent, 95 percent, and 100 percent for groups one to four, respectively (P>.05). No significant correlation was found between marginal integrity scores of restorations and partial pulpotomy failure (P>.05).
CONCLUSIONS
Partial pulpotomy, performed with MTA or CH used as the pulp-capping material following hemostasis with SH or SS solutions, provided comparable and favorable outcomes in carious pulp exposures of immature permanent teeth.
Topics: Adolescent; Aluminum Compounds; Calcium Compounds; Calcium Hydroxide; Child; Dental Caries; Drug Combinations; Female; Hemorrhage; Humans; Male; Materials Testing; Molar; Oxides; Prospective Studies; Pulpotomy; Silicates
PubMed: 29070158
DOI: No ID Found -
Nigerian Journal of Clinical Practice Jun 2023This study aimed to evaluate postoperative pain scores after sodium hypochlorite (NaOCl) and KTP laser pulpotomies in the permanent teeth with symptomatic irreversible...
AIM
This study aimed to evaluate postoperative pain scores after sodium hypochlorite (NaOCl) and KTP laser pulpotomies in the permanent teeth with symptomatic irreversible pulpitis retrospectively. Materials and Methods: This study is based on the records of patients treated with pulpotomy using sodium hypochlorite or KTP laser for disinfection and hemostasis at the Department of Endodontics. Sixty patients' molar teeth were treated with either NaOCl or KTP laser. Sodium hypochlorite was used on 31 teeth, and KTP laser was used on another 29 teeth, for disinfection and hemostasis. Initial bleeding control was obtained with saline. 2.5% NaOCl or KTP laser was applied to complete hemostasis. Calcium hydroxide was then placed on the chamber floor to cover the canal orifices. The permanent restoration was completed with composite resin. Pre and postoperative pain scores were recorded with a visual analog scale. The evaluation was performed on the 6, 24, 48, 72 hours, and 7 days depending on the severity of the pain. Results: There was no significant difference between the groups in terms of demographic data and preoperative pain scores (P > 0.05). The postoperative pain score in the KTP laser group was significantly lower at the 24 hour than in the NaOCl group (P < 0.05). No significant difference was found between the groups at other evaluated time intervals (P > 0.05). The greatest pain score was recorded at the 6 hour in both groups.
CONCLUSION
Although the level of pain decreased significantly in both groups in the postoperative period, KTP laser-assisted pulpotomy provided better pain control, especially at the 24 hour.
Topics: Humans; Pulpotomy; Pulpitis; Sodium Hypochlorite; Disinfection; Retrospective Studies; Pain, Postoperative; Hemostasis
PubMed: 37470658
DOI: 10.4103/njcp.njcp_923_22 -
Medical Hypotheses Feb 2012Dental pulp exposure is a common incident during dental treatment. If there are clinical signs of pulp vitality, it is recommended to carry out direct pulp capping (DPC)...
Dental pulp exposure is a common incident during dental treatment. If there are clinical signs of pulp vitality, it is recommended to carry out direct pulp capping (DPC) using appropriate pulp covering agents (PCA). The main objectives are maintenance of pulp vitality/healing along with the formation of a calcified bridge beneath the PCA. Our proposed hypothesis is based on consideration of biologic principles in order to achieve improved treatment outcomes of DPC for cariously exposed pulp using miniature pulpotomy procedure (MPP). MPP will result in improved treatment outcomes of DPC by improved maintenance of a clean surgical pulp wound; removal of infected dentin chips/damaged pulp tissue specially injured odontoblast cells; improved proximity/interaction of PCA to undifferentiated mesenchymal/stem cells; better control of bleeding; and creating an improved seal using PCA.
Topics: Anti-Infective Agents; Biocompatible Materials; Calcinosis; Dental Pulp; Dental Pulp Capping; Dental Pulp Exposure; Humans; Odontoblasts; Pulpotomy; Treatment Outcome
PubMed: 22137499
DOI: 10.1016/j.mehy.2011.11.002 -
Journal of Dental Research Dec 2005Pulpotomy is the accepted therapy for the management of cariously exposed pulps in symptom-free primary molars; however, evidence is lacking about the most appropriate... (Comparative Study)
Comparative Study Randomized Controlled Trial
Pulpotomy is the accepted therapy for the management of cariously exposed pulps in symptom-free primary molars; however, evidence is lacking about the most appropriate technique. The aim of this study was to compare the relative effectiveness of the Er:YAG laser, calcium hydroxide, and ferric sulfate techniques with that of dilute formocresol in retaining such molars symptom-free. Two hundred primary molars in 107 healthy children were included and randomly allocated to one of the techniques. The treated teeth were blindly re-evaluated after 6, 12, 18, and 24 months. Descriptive data analysis and logistic regression analysis, accounting for each patient's effect by a generalized estimating equation (GEE), were used. After 24 months, the following total and clinical success rates were determined (%): formocresol 85 (96), laser 78 (93), calcium hydroxide 53 (87), and ferric sulfate 86 (100). Only calcium hydroxide performed significantly worse than formocresol (p = 0.001, odds ratio = 5.6, 95% confidence interval 2.0-15.5). In conclusion, calcium hydroxide is less appropriate for pulpotomies than is formocresol.
Topics: Calcium Hydroxide; Child; Child, Preschool; Crowns; Dental Pulp Capping; Dental Pulp Exposure; Dental Restoration, Permanent; Female; Ferric Compounds; Follow-Up Studies; Formocresols; Glass Ionomer Cements; Hemostatics; Humans; Laser Therapy; Male; Pulpotomy; Single-Blind Method; Tooth, Deciduous; Treatment Outcome; Zinc Oxide-Eugenol Cement
PubMed: 16304444
DOI: 10.1177/154405910508401210