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European Journal of Paediatric Dentistry Jun 2019Indirect pulp capping (IPC) is a treatment that preserves pulp vitality. Several materials have been used for this procedure. The aim of this study is to evaluate the...
AIM
Indirect pulp capping (IPC) is a treatment that preserves pulp vitality. Several materials have been used for this procedure. The aim of this study is to evaluate the radiographic and clinical outcomes of TheraCal LC (Bisco Inc., Schaumburg, IL, USA) and to compare it with mineral trioxide aggregate (MTA) (Pro Root MTA, Dentsply Tulsa, Johnson City, TN, USA) and calcium hydroxide [Ca(OH)2] (Dycal, Dentsply De Trey Konstanz, Germany) biomaterials in IPC treatment.
MATERIALS AND METHODS
A total of 295 teeth, including second primary molars and first permanent molars with IPC indications from healthy and cooperative children aged between 4-15 years, were included in this study. Teeth were divided into three groups according to the materials used for pulp capping. Indirect pulp treatment was applied using Dycal for 91 teeth, ProRoot MTA for 89 teeth and TheraCal LC for 115 teeth. Primary molars were restored with the compomer material, and permanent molars were restored with the resin composite material. Restorations were evaluated with the Modified United States Public Health Service (modified USPHS) criteria. Clinical and radiographic findings were evaluated for 24 months at follow-up.
STATISTICS
Statistical analysis was performed using the IBM SPSS Statistics 22 (IBM SPSS, Turkey) program, with descriptive statistical methods (means, standard deviations) and Chi-square, Fisher's exact test, and Yates's continuity correction (p<0.05 significance level) to evaluate the data.
RESULTS
There were no statistically significant differences between the materials (p>0.05). The respective success rates of ProRoot MTA, Theracal LC, and Dycal were 94.4%, 87.8%, and 84.6%. There was no statistically significant difference between primary and permanent teeth according to the modified USPHS criteria (p>0.05).
CONCLUSION
These results support the idea that the success of IPC is independent from the capping material. Recently produced calcium-silicate based materials can also be used for IPC. The most important factors are to apply the indirect pulp treatment carefully, avoiding bacterial contamination, and to seal the teeth with hermetic restoration. More clinical studies with longer follow-up periods are required for understanding the clinical efficiency of these materials.
Topics: Adolescent; Aluminum Compounds; Calcium Compounds; Child; Child, Preschool; Dental Pulp; Dental Pulp Capping; Drug Combinations; Follow-Up Studies; Humans; Oxides; Pulp Capping and Pulpectomy Agents; Silicates; Turkey
PubMed: 31246084
DOI: 10.23804/ejpd.2019.20.02.04 -
The Journal of Clinical Pediatric... Jul 2021In a tooth with deep dentinal caries; judicious removal of infected dentin and isolating affected dentin from oral fluids with suitable biocompatible material is called... (Randomized Controlled Trial)
Randomized Controlled Trial
OBJECTIVE
In a tooth with deep dentinal caries; judicious removal of infected dentin and isolating affected dentin from oral fluids with suitable biocompatible material is called indirect pulp therapy (IPT). This randomized clinical trial was done to evaluate and compare the efficacy of Biodentine, Theracal LC and. Dycal as an indirect pulp capping agent in young permanent teeth.
STUDY DESIGN
IPT was performed in 60 young permanent molars with caries approaching pulp in 55 healthy children using Biodentine, Theracal and Dycal. A 2-3mm layer of GIC was placed over the intervening material followed by restoration of cavity with composite. Clinical and radiographic examinations were conducted at 3 weeks, 3 months, 6 months,12 months, 18 months and 24 months. The data was compared using chi-square test at a significance level of 0.05.
RESULTS
By end of 24 months ,54 teeth presented for follow up with overall success rate of 100% in Theracal, 94.44% in Biodentine, and 77.78% in Dycal. Overall success of Theracal was statistically significant in comparison to Biodentine and Dycal at 24 months follow up (p= 0.03) Conclusions: Radiographic and clinical outcomes of Theracal and Biodentine suggest their use as an alternative material for IPT in young permanent molars with higher success.
Topics: Calcium Compounds; Child; Dental Pulp Capping; Humans; Oxides; Pulp Capping and Pulpectomy Agents; Silicates
PubMed: 34192759
DOI: 10.17796/1053-4625-45.3.3 -
BMJ Case Reports Apr 2013Taurodontism leads to constriction of the cementoenamel junction, which results in vertically elongated pulp chambers, apical displacement of the pulpal floor, and...
Taurodontism leads to constriction of the cementoenamel junction, which results in vertically elongated pulp chambers, apical displacement of the pulpal floor, and bifurcation or trifurcation of the root. This trait can be seen in permanent and primary teeth, in a single tooth or in several molars in the same quadrant, and can be unilateral or bilateral. We report a rare case of a 26-year-old male patient presening with taurodontism involving all the developed molars of all four quadrants, which was not associated with any other anomalies or syndromes.
Topics: Adult; Dental Pulp Cavity; Diagnosis, Differential; Humans; Male; Pulpectomy; Radiography, Panoramic; Tooth Abnormalities
PubMed: 23598931
DOI: 10.1136/bcr-2012-008490 -
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 -
Clinical and Experimental Dental... Dec 2021To evaluate the survival rates of pulpectomized primary teeth treated under general anesthesia (GA) or local anesthesia (LA), and to determine which factors affected...
OBJECTIVES
To evaluate the survival rates of pulpectomized primary teeth treated under general anesthesia (GA) or local anesthesia (LA), and to determine which factors affected tooth survival following pulpectomy.
MATERIALS AND METHODS
This retrospective study collected data from dental records. Patients under 5 years of age received dental treatment under GA or LA during 2007-2016, with at least one anterior or posterior tooth receiving a pulpectomy, were recruited. Pulpectomy was considered a failure if the tooth required extraction or retreatment due to pulp treatment failure. Survival analysis was used to assess the outcome. The cumulative survival probability was analyzed with the Kaplan-Meier estimator. Cox regression analysis was used to evaluate the associations between tooth survival and possible prognosis factors; sex, age, dental arch (upper/lower), tooth type (anterior/posterior), molar type (first/second molar), molar location (upper/lower molar), root filling material type, restoration type, preoperative radiographic findings and presence of pathologic root resorption.
RESULTS
Two hundred and twenty-seven primary teeth were included. At the 5-year follow-up, the survival rates of the pulpectomized teeth treated under GA and LA were 81.4% and 87.4%, respectively, which were not significantly different (p ≥ 0.05). A radiolucency on the preoperative radiograph was the only factor associated with tooth extraction or retreatment following pulpectomy, with a hazard ratio of 3.88 (95% CI = 1.29-11.65).
CONCLUSIONS
Pulpectomized primary teeth treated under GA and LA demonstrated high survival rates. Preoperative radiolucency is a possible associated factor that decreases tooth survival following pulpectomy. Why this paper is important Pulpectomy treatment under GA and LA provided high 5-year cumulative survival rates, which were not significantly different. Pulpectomy treatment in teeth with a preoperative radiolucency were 3.9-fold as likely to fail as teeth without pathology. Based on our findings, practitioners could apply these findings and discuss with caregivers about the treatment options, outcomes, and prognosis of pulpectomized teeth.
Topics: Humans; Pulpectomy; Retrospective Studies; Survival Rate; Tooth, Deciduous; Treatment Outcome
PubMed: 34272835
DOI: 10.1002/cre2.473 -
The Saudi Dental Journal Jan 2016Endodontic treatment in primary teeth can be challenging and time consuming, especially during canal preparation, which is considered one of the most important steps in... (Review)
Review
Endodontic treatment in primary teeth can be challenging and time consuming, especially during canal preparation, which is considered one of the most important steps in root canal therapy. The conventional instrumentation technique for primary teeth remains the "gold-standard" over hand instrumentation, which makes procedures much more time consuming and adversely affects both clinicians and patients. Recently nickel-titanium (Ni-Ti) rotary files have been developed for use in pediatric endodontics. Using rotary instruments for primary tooth pulpectomies is cost effective and results in fills that are consistently uniform and predictable. This article reviews the use of nickel-titanium rotary files as root canal instrumentation in primary teeth. The pulpectomy technique is described here according to different authors and the advantages and disadvantages of using rotary files are discussed.
PubMed: 26792964
DOI: 10.1016/j.sdentj.2015.08.004 -
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 -
International Journal of Clinical... Sep 2023To assess the clinical and radiographic success of conventional pulpectomy and pulpectomy done under an endodontic microscope over a period of 12 months.
AIM
To assess the clinical and radiographic success of conventional pulpectomy and pulpectomy done under an endodontic microscope over a period of 12 months.
MATERIALS AND METHODS
The study was conducted as a single-blinded, parallel-group prospective, randomized, and controlled clinical trial. The enrollment of the study involved the assessment of 258 deciduous molars for eligibility as per the inclusion criteria. A total of 104 teeth were allocated to each group, that is, group I (conventional pulpectomy) and group II (pulpectomy under microscope). However, due to unavoidable circumstances during the coronavirus disease 2019 (COVID-19) pandemic, 98 and 90 teeth were treated in each group, respectively. Pulpectomy in both groups was done using standard protocol except for the use of an endodontic microscope in group II. The clinical and radiographic outcomes were assessed by an independent blinded observer and analyzed using appropriate statistical tests.
RESULTS
The clinical success at 6 months is 95.7 and 96.5%, and at 12 months is 96.6 and 97.7% in groups I and II, respectively. The radiographic success at 6 months is 93.5 and 95.4%, and at 12 months is 95.5 and 98.8% in groups I and II, respectively. The overall success rates of both groups with statistically no significant differences.
CONCLUSION
The present study concludes comparable results are achieved using an endodontic microscope to conventional pulpectomy without magnification.
HOW TO CITE THIS ARTICLE
Kumar G, Rehman F. Comparative Evaluation of Clinical and Radiographic Success of Pulpectomy Done with and without Dental Operating Microscope in Pediatric Patients: An Study. Int J Clin Pediatr Dent 2023;16(S-2):S155-S160.
PubMed: 38078029
DOI: 10.5005/jp-journals-10005-2641 -
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 -
Pakistan Journal of Medical Sciences 2017To evaluate the therapeutic effects of pulpotomy and pulpectomy on deciduous molars with deep caries.
OBJECTIVE
To evaluate the therapeutic effects of pulpotomy and pulpectomy on deciduous molars with deep caries.
METHODS
A total of 124 children (192 molars) with deep caries treated from February 2014 to February 2015 were selected. They each had at least one molar with deep caries. MTA pulpotomy (101 molars) and Vitapex pulpectomy (91 molars) as well as prefabricated metal crown repair were conducted. The patients were followed up for 18 months after surgery, and the therapeutic effects were evaluated through clinical and X-ray examinations.
RESULTS
The proportion of molars without lesions was 80.20% in pulpotomy group, which significantly exceeded that of pulpectomy group (72.53%). The pulpotomy group with good clinical manifestations underwent spontaneous pain in four molars during follow-up, and five molars gradually underwent pain and gingival redness and swelling. The pulpectomy group suffered from occlusion discomfort in nine molars and gingival fistula in seven molars during follow-up. The postoperative morbidity of pulpectomy group was significantly higher than that of pulpotomy group (χ=4.50, P=0.04). The 18-month tooth survival rates of pulpotomy and pulpectomy groups were 90% and 79% respectively, which were significantly different (χ=4.645, P=0.031).
CONCLUSION
The postoperative outcomes of pulpotomy are superior to those of pulpectomy.
PubMed: 29492080
DOI: 10.12669/pjms.336.13488