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International Journal of Clinical... 2022This study aims to evaluate, over 12 months of clinical and radiographic follow-ups, the performance and outcomes of Biodentine™ pulpotomy in stage I primary molars.
AIM
This study aims to evaluate, over 12 months of clinical and radiographic follow-ups, the performance and outcomes of Biodentine™ pulpotomy in stage I primary molars.
MATERIALS AND METHODS
A total number of 20 stage I primary molars requiring pulpotomy were selected from eight healthy patients aged between 34 and 45 months. Patients presenting a negative attitude toward dental treatment on the dental chair were scheduled for dental treatments under general anesthesia.Pulpotomy with Biodentine™ as a pulp-dressing material was performed on all selected molars. The patients were called back at 1 and 3 months for clinical follow-ups, then at 6 and 12 months for clinical and radiographic follow-ups. Data were tabulated according to follow-up intervals and occurrence of any changes in root maturation, pulp canal obliteration (PCO), periodontal ligament space (PLS), and bone or root lesion.
RESULTS
No statistically significant differences were recorded at 1, 3, 6, and 12 months. There was a statistically significant increase in number of roots with closed apices from six roots at 6 months to 50 roots at 12 months ( < 0.0005) and the PCO was present in all 50 roots at 12 months, after it was present in 36 roots only at 6 months ( = 0.0001).
CONCLUSION
This is the first randomized clinical trial that evaluates the performance of Biodentine™ as a pulp-dressing agent in stage I primary molar pulpotomy over 12 months of follow-up. Contrary to previous studies, the present work highlights the continued root formation and apical closure (AC) in pulpotomized immature primary molars.
HOW TO CITE THIS ARTICLE
Nasrallah H, Noueiri BE. Biodentine™ Pulpotomy in Stage I primary Molars: A 12-month Follow-up. Int J Clin Pediatr Dent 2022;15(6):660-666.
PubMed: 36866133
DOI: 10.5005/jp-journals-10005-2400 -
International Journal of Clinical... 2023Preservation of healthy pulp tissue is detrimental for the function and vitality of carious primary teeth. Several hemostatic agents used for pulpotomy in primary teeth...
INTRODUCTION
Preservation of healthy pulp tissue is detrimental for the function and vitality of carious primary teeth. Several hemostatic agents used for pulpotomy in primary teeth showed adverse effects on viable surrounding structures.
AIMS
To assess the clinical and radiographic success of chitosan (CH) pulpotomy in primary molars and to compare it with ferric sulphate (FS).
MATERIALS AND METHODS
A total of 40 carious lower primary second molars in 5-9 years children are selected for conventional pulpotomy technique. Over radicular stumps, FS is placed for 15 seconds in the control group, and CH for 4-5 minutes in the study group, followed by intermediate restoration (IRM). Intraoral periapical radiographs were taken immediately after 1 week and after 3rd and 6th months. The clinical and radiographic success rate is assessed and statistically analyzed.
RESULTS
Chitosan (CH) showed a 65% radiographical and 100% clinical success rate, and FS showed 55 and 95%, respectively.
CONCLUSION
Chitosan (CH) showed better results than FS as a pulpotomy agent in primary teeth.
HOW TO CITE THIS ARTICLE
Guguloth S, Jamnapalli SR, Patloth T, Evaluation of Chitosan and Ferric Sulphate as Pulpotomy Agents in Primary Teeth: A Randomized Controlled Trial. Int J Clin Pediatr Dent 2023;16(2):223-226.
PubMed: 37519981
DOI: 10.5005/jp-journals-10005-2514 -
The Journal of Clinical Pediatric... Nov 2023The aim was to investigate the relationship between time to hemostasis and pulpotomy outcomes with the use of iRoot BP Plus (Innovative Bioceramics, Vancouver, Canada)...
The aim was to investigate the relationship between time to hemostasis and pulpotomy outcomes with the use of iRoot BP Plus (Innovative Bioceramics, Vancouver, Canada) for young permanent teeth of patients aged from 7 to 12 with symptomatic irreversible pulpitis and evaluate the outcomes of pulpotomy. The present study was a prospective cohort study. Two hundred and six young permanent teeth with symptomatic irreversible pulpitis underwent pulpotomy with the use of iRoot BP Plus. All patients underwent pulpotomy in accordance with a standardized protocol. Patients were postoperatively re-called after 3, 6, 12 months. Successful cases were defined according to clinical and radiographic evaluations. Main outcome measures included tooth position, cave shape, previous restoration, preoperative symptoms, time to hemostasis and outcomes. On the basis of univariate linear regression model, the relationships between time to hemostasis was evaluated, and < 0.05 indicated a difference that achieved statistical significance. One hundred and ninety-three teeth can be evaluated after a follow-up for 6 to 36 months. The mean age of subjects was 9.43 ± 1.51 years. The overall clinical and radiographic success rate of pulpotomy reached 71.5% (138/193). After adjusting potential confounders (age, sex, previous restoration), non-linear relationship was detected between time to hemostasis and pulpotomy outcomes whose point was 4 minutes. The relationship between time to hemostasis and pulpotomy outcomes is non-linear. Pulpotomy outcomes was negatively related with time to hemostasis when time to hemostasis is more than 4 minutes.
Topics: Humans; Child; Pulpotomy; Calcium Compounds; Prospective Studies; Pulpitis; Silicates; Hemostasis; Treatment Outcome; Oxides
PubMed: 37997245
DOI: 10.22514/jocpd.2023.088 -
Cureus Jan 2020Vital pulp therapies have been used in primary teeth and immature permanent teeth. However, with the advent of new bioactive material, the paradigm is shifting toward... (Review)
Review
Vital pulp therapies have been used in primary teeth and immature permanent teeth. However, with the advent of new bioactive material, the paradigm is shifting toward permanent teeth with mature apices of roots. There are many prospective and retrospective studies, randomized controlled trials, and systematic reviews that report coronal pulpotomy with bioactive material in permanent teeth with pulpal pathosis proved to be as successful as root canal therapy (RCT). Coronal pulpotomy is cost-effective, not very technical demanding like root canal therapy and less time consuming for both the dentists and patients. This treatment can be offered to the patient as an alternative to endodontic therapy. The objective of this study is to review the literature related to the clinical outcome of coronal pulpotomy in permanent teeth with mature apex and having pulpal pathosis. This evidence-based review will facilitate clinical decision making in situations to choose coronal pulpotomy over root canal therapy in mature permanent teeth with irreversible pulpitis.
PubMed: 32133269
DOI: 10.7759/cureus.6747 -
Nigerian Journal of Clinical Practice Jul 2023To histologically assess and compare formocresol (FC), platelet-rich fibrin (PRF), and hesperidin (HPN) as pulpotomy agents in dogs.
AIMS
To histologically assess and compare formocresol (FC), platelet-rich fibrin (PRF), and hesperidin (HPN) as pulpotomy agents in dogs.
MATERIALS AND METHODS
Pulpotomy was attempted from the buccal surface (class V) of 48 teeth in three mongrel dogs (Canis Lupus). Cavities were randomly allocated for three groups (n = 16) according to the pulpotomy agent used; (group I: FC (control), group II: PRF, and group III: HPN). All cavities were then sealed with zinc oxide eugenol followed by resin-modified glass ionomer restoration. Two months later, dogs were euthanized; the specimens were obtained and prepared for histological assessment followed by statistical analysis.
RESULTS
HPN specimens showed the best dentin bridge formation and the least inflammatory signs and pulp disorganization. Followed without statistically significant difference by PRF (P ≥ 0.05). Both of HPN and PRF, however, showed a significant difference statistically (P ≤ 0.05) to FC that showed no dentin bridging with more pronounced inflammation, necrosis, and pulp disorganization.
CONCLUSIONS
For pulpotomy, HPN and PRF seemed histologically to be good substitutes for FC in the dog model.
Topics: Animals; Dogs; Formocresols; Hesperidin; Platelet-Rich Fibrin; Pulpotomy
PubMed: 37635567
DOI: 10.4103/njcp.njcp_1731_21 -
International Journal of Clinical... 2018A different concept of formocresol pulpotomy procedure has been proposed where the formocresol pulpotomy is done with smaller access to the pulp chamber. In our study...
UNLABELLED
A different concept of formocresol pulpotomy procedure has been proposed where the formocresol pulpotomy is done with smaller access to the pulp chamber. In our study formocresol pulpotomy was carried out in 128 primary molar teeth with a limited amount of access opening, saving a bit of more tooth structure, which excludes the requirement of placement of a stainless steel crown (SSC). In 2 years follow-up period, no crown fracture was reported. One hundred fifteen teeth remain vital at the end of 2 years period of observation with the periodic clinical and radiographic review. The result shows 89.4% clinical and radiographic success of this nonconventional pulpotomy procedure that corroborates with several studies of the conventional formocresol pulpotomy procedure.
HOW TO CITE THIS ARTICLE
Chakraborty A, Dey B, Jana S. A Nonconventional Approach to Formocresol Pulpotomy. Int J Clin Pediatr Dent, 2018;11(6):490-495.
PubMed: 31303736
DOI: 10.5005/jp-journals-10005-1563 -
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 -
Australian Dental Journal Mar 2016Endodontic management of the permanent immature tooth continues to be a challenge for both clinicians and researchers. Clinical concerns are primarily related to... (Review)
Review
Endodontic management of the permanent immature tooth continues to be a challenge for both clinicians and researchers. Clinical concerns are primarily related to achieving adequate levels of disinfection as 'aggressive' instrumentation is contraindicated and hence there exists a much greater reliance on endodontic irrigants and medicaments. The open apex has also presented obturation difficulties, notably in controlling length. Long-term apexification procedures with calcium hydroxide have proven to be successful in retaining many of these immature infected teeth but due to their thin dentinal walls and perceived problems associated with long-term placement of calcium hydroxide, they have been found to be prone to cervical fracture and subsequent tooth loss. In recent years there has developed an increasing interest in the possibility of 'regenerating' pulp tissue in an infected immature tooth. It is apparent that although the philosophy and hope of 'regeneration' is commendable, recent histologic studies appear to suggest that the calcified material deposited on the canal wall is bone/cementum rather than dentine, hence the absence of pulp tissue with or without an odontoblast layer.
Topics: Aluminum Compounds; Apexification; Calcium Compounds; Calcium Hydroxide; Drug Combinations; Humans; Odontogenesis; Oxides; Pulpotomy; Regeneration; Root Canal Irrigants; Silicates; Tooth Apex; Tooth Injuries
PubMed: 26923451
DOI: 10.1111/adj.12401 -
BMC Oral Health Jun 2024The aim of this retrospective study was to determine the long-term clinical and radiographic success of our previous randomized clinical trial and to compare the success... (Comparative Study)
Comparative Study
BACKGROUND
The aim of this retrospective study was to determine the long-term clinical and radiographic success of our previous randomized clinical trial and to compare the success of hyaluronic acid, with the widely used formocresol and ferric sulphate agents.
METHODS
This retrospective study is the extension of the 1-year survey of our randomized clinical trial that had compared the effectiveness of a hyaluronic acid pulpotomy over formocresol and ferric sulphate pulpotomies and included clinical and radiographic evaluations with a follow-up period of over 24 months for 44 children who applied to our clinic between May 2019 and September 2019. Long-term clinical and radiographic data were obtained from the periodic files of our department, wherein each tooth's file was examined to identify any clinical and radiographic findings. Descriptive statistics and Pearson's chi-square tests were used to evaluate the data. Statistical significance was considered as p < 0.05.
RESULTS
The clinical and radiographic success rates of the hyaluronic acid, formocresol, and ferric sulphate groups were not statistically different at > 24 months. None of the teeth in the hyaluronic acid group showed any clinical findings at > 24 months.
CONCLUSIONS
Hyaluronic acid pulpotomies exhibited comparable success rates to formocresol and ferric sulphate materials spanning over 24 months examinations. Because of convenient accessibility and applicability of hyaluronic acid, it may be recommended as a promising alternative medicament for pulpotomy treatments of primary molars. However, further long-term follow-up human studies are needed to better understand the effect of hyaluronic acid on the dental pulp of human primary molars.
Topics: Humans; Hyaluronic Acid; Pulpotomy; Retrospective Studies; Tooth, Deciduous; Molar; Formocresols; Ferric Compounds; Female; Male; Child; Child, Preschool; Treatment Outcome; Follow-Up Studies
PubMed: 38867194
DOI: 10.1186/s12903-024-04405-4 -
Translational Pediatrics Apr 2022This study aimed to evaluate the effect of mineral trioxide aggregate (MTA) pulp capping for caries-exposed permanent teeth. However, the efficacy of MTA in the...
BACKGROUND
This study aimed to evaluate the effect of mineral trioxide aggregate (MTA) pulp capping for caries-exposed permanent teeth. However, the efficacy of MTA in the treatment of children's gums is still controversial, and different studies have shown different efficacy. Therefore, it is necessary to systematically review the efficacy and safety of MTA pulp incision in the treatment of pediatric caries using meta methods.
METHODS
We used meta-analysis to compare differences in the efficacy of MTA and calcium hydroxide (CH) for treating caries in permanent teeth. The mean treatment success rate of MTA for reversible and irreversible pulpitis groups was calculated, and the effect of apical opening condition and surgical type on success rate were investigated.
RESULTS
A total of 15 studies were included, and meta-analysis showed that there was a significant statistical difference between the MTA group and CH group in efficacy [odds ratio (OR) =1.87, 95% confidence interval (CI): 1.28, 2.73, P=0.001, I=63%, Z=3.25], success rate (OR =3.20, 95% CI: 1.93, 5.30, P<0.00001, I=0%, Z=4.52), influence of apical foramen condition on success rate (OR =1.77, 95% CI: 1.14, 2.73, P=0.01, I=15%, Z=2.56), and surgical procedure on success rate (OR =2.64, 95% CI: 1.65, 4.23, P<0.0001, I=45%, Z=4.05).
DISCUSSION
Our results showed that MTA pulpotomy was superior to CH. Nonclosure of apical openings and complete coronal pulpotomy may be more beneficial than partial pulpotomy.
PubMed: 35558967
DOI: 10.21037/tp-22-68