Agents In Primary Molars Research Articles

Clinical and Radiographic Efficacy of Low-level Laser Therapy and Formocresol as Pulpotomy Agents in Primary Molars: A Systematic Review and Meta-analysis

Clinical and Radiographic Efficacy of Low-level Laser Therapy and Formocresol as Pulpotomy Agents in Primary Molars: A Systematic Review and Meta-analysis

Assessment of MMP levels in reversible and irreversible pulpitis and a randomized controlled trial comparing clinical success of two different calcium-silicate cements in pulpotomy treatment of primary molars with an 18-month follow-up

BackgroundMatrix metalloproteinases (MMPs) are critical enzymes involved in the remodeling and defense mechanisms of dental pulp tissue. While their role in permanent teeth has been extensively studied, research focusing on MMPs in primary teeth remains limited. This gap highlights the need for further investigations to understand the specific contributions of MMPs to pulpal defense in primary teeth. Moreover, the clinical efficacy of Biodentine as a pulpotomy material in primary teeth warrants further exploration through well-designed studies to establish its success and long-term outcomes in pediatric dentistry.AimThis study aims to compare the expression levels of MMP-2, MMP-8, and MMP-9 in cases of reversible and irreversible pulpitis. Additionally, it seeks to evaluate the clinical success of Mineral Trioxide Aggregate (MTA) and Biodentine when used as pulpotomy agents in primary molars. By analyzing the differential expression of these MMPs, the study will contribute to a better understanding of their role in pulpal inflammation and the potential therapeutic outcomes of MTA and Biodentine in primary molars.DesignIn this parallel randomized controlled trial, 63 mandibular primary second molars were assigned to two main groups: Group 1, consisting of 42 teeth diagnosed with reversible pulpitis, and Group 2, consisting of 21 teeth diagnosed with irreversible pulpitis. Group 1 was further divided into two randomized subgroups, each containing 21 teeth. The expression levels of MMP-2, MMP-8, and MMP-9 were evaluated in all samples. Pulpotomy treatments were performed using MTA and Biodentine in Group 1. Clinical and radiographic evaluations were conducted over an 18-month follow-up period. Statistical analyses were carried out using The Kolmogorov-Smirnov test, t-test and Fisher’s exact test (p < 0.05).ResultsThe study revealed that MMP-2 and MMP-9 expression levels were significantly elevated in specimens with irreversible pulpitis (p = 0.01), indicating a potential correlation between these matrix metalloproteinases and the severity of pulpal inflammation. However, no significant difference was observed in the clinical success rates of pulpotomies performed with MTA and Biodentine, suggesting that both materials are equally effective in the treatment of primary molars with reversible pulpitis.ConclusionsThe expression of MMP-2 and MMP-9 in pulpal blood presents a promising biomarker for assessing the degree of pulpal inflammation in primary teeth, offering a potentially valuable diagnostic tool. Additionally, the clinical success of Biodentine in pulpotomy procedures supports its viability as an effective alternative to MTA, providing a reliable option.Clinical Trial Registration IDThe study protocol has been registered with an ID: NCT05145686. Registration Date: 9th November 2021.

To Evaluate and Compare Platelet-rich Fibrin and Mineral Trioxide Aggregate as Direct Pulp Capping Agents in Primary Molars: A Randomized Prospective Clinical Study.

This study aimed to evaluate and compare the clinical and radiographic success of platelet-rich fibrin (PRF) and mineral trioxide aggregate (MTA) as direct pulp capping (DPC) agents in primary molars. In this study, 50 primary first and second molars from healthy children aged 5-9 years requiring pulp therapy were randomly allocated into two groups. In the PRF group, after coronal pulp removal and hemostasis, the remaining pulp tissue was covered with PRF preparation. In the MTA group, after coronal pulp removal and hemostasis, MTA was placed, followed by a zinc oxide eugenol (ZOE) base and glass ionomer cement (GIC) in both groups. Clinical and radiographic evaluations were undertaken at 1-, 3-, 6-, 9-, and 12-month intervals. By the end of the 12th month, the overall success rate was 82.6% in the PRF group, whereas it was 61.9% in the MTA group. Platelet-rich fibrin can be used successfully as an appropriate alternative material in DPC of primary teeth when compared with MTA. Tiwari T, Tyagi P, Tiwari S, et al. To Evaluate and Compare Platelet-rich Fibrin and Mineral Trioxide Aggregate as Direct Pulp Capping Agents in Primary Molars: A Randomized Prospective Clinical Study. Int J Clin Pediatr Dent 2024;17(S-1):S25-S29.

Efficacy of two different pulpotomy agents in primary molars in a tertiary care hospital, Multan: A randomized control trial.

Objective: Multifactorial chronic dental infection and degenerative condition, the dental caries is a major health issue. Initially formocresol was the gold standard treatment for the primary teeth pulpotomy but now multiple sealing agents are used. Study Design: Prospective Interventional study. Setting: Multan Medical and Dental College/Ibn-e-Sina Hospital. Period: 15th February to 15th August 2022 and follow up 15th August to 15th November 2022. Material &amp; Methods: After informed consent, cavities in two primary teeth of equal size after clinical and radiological examination requiring pulpotomies were selected and a total of 40 pulpotomies were done. Results: Among 15 pairs of contralateral teeth, 9 pairs were clinically as well as radiographically successful for both MTA and CH pulpotomy during the follow up appointments at 0, 1 and 3 months appointment. One pair showed failure for both MTA and CH pulpotomy. Five pairs showed success with MTA pulpotomy but failure in CH pulpotomy cases. Conclusion: It can be concluded from the study that MTA is superior and more effective than CH in primary teeth pulpotomies.

Efficacy of orthoMTA, retroMTA and ferric sulphate as pulpotomy agents in primary molars: A randomized clinical trial

Efficacy of orthoMTA, retroMTA and ferric sulphate as pulpotomy agents in primary molars: A randomized clinical trial

A comparative evaluation of light cure calcium silicate and resin-modified glass ionomer as indirect pulp capping agent in primary molars: A randomized clinical trial.

Minimally invasive techniques should be employed to maintain pulp vitality without affecting physiological tooth resorption for pediatric patients. This study aims to evaluate clinical and radiographic success of light cure calcium silicate and resin-modified glass ionomer (RMGI) as indirect pulp-capping agent in primary molars in children between 5 and 9 years. In this randomized clinical trial study, 40 primary molars with the International Caries Detection and Assessment System criteria 4-6 score were divided randomly into two groups after computerized randomization method. After caries excavation by minimally invasive dentistry principle, affected dentin was lined by either light cure calcium silicate (Group I) or RMGI (Group II) liner followed by composite restoration. Clinical success was determined with the absence of symptoms and bitewing radiographs were taken at baseline, 3, and 6 months' interval to measure increase in dentin increment using ImageJ software. Statistical analysis for intergroup comparison was done using Paired t-test, and Independent t-test was used for intragroup comparison. The level of statistical significance was set at P < 0.05. Change in dentin increment seen from baseline to 6 months in Group I was 0.19 mm and in Group II was 0.20 mm (P = 0.924). Intragroup increment was statistically significant during all follow-up intervals for both the groups (Group I - P ≤ 0.001, Group II - P = 0.009). For baseline remaining dentin thickness >1.5 mm, statistically significant increase was observed in the dentin increment at 3 months' interval between both the groups. Both TheraCal LC and Vitrebond show acceptable clinical and radiographic results when used in primary molars as indirect pulp treatment agents. Both the liners are equivalent to each other in terms of feasibility and cost-effectiveness but TheraCal LC can be preferred due to better handling and avoiding the manipulation step thereby reducing treatment time.

Silver Diamine Fluoride as Indirect Pulp Capping Agent in Primary Molars: A Case Series

According to the current recommendations of the American Academy of Pediatric Dentistry (AAPD), Indirect Pulp Capping or Indirect Pulp Treatment (IPT) is defined as a procedure that preserves the deepest cavities adjacent to the pulp to prevent pulp exposure. Preserving and protecting the vital pulp through remineralisation of hypomineralised carious dentin poses a significant challenge in restorative dentistry. Traditionally, managing deep caries often led to pulp exposure and subsequent root canal treatment. Selective or stepwise caries removal is based on the concept of halting the progression of carious destruction, allowing for biological repair of the pulp-dentin complex by promoting the formation of tertiary dentin between temporary and definitive restorations. Silver Diamine Fluoride (SDF) has gained popularity due to its unique combination of silver and fluoride, which provides antimicrobial and remineralising properties. In this case series of three cases, three-year-old preschool boy, five year old girl and five year old girl, in whom, deep carious lesions in primary molars were treated using selective caries removal techniques with SDF as an IPT agent, resulting in successful minimally invasive restorative procedures. This case series underscores the importance of employing selective caries removal techniques and the potential use of SDF as an IPT agent in such scenarios to preserve tooth vitality in a less invasive therapeutic approach suitable for the pediatric population.

Clinical and Microbiological Evaluation of the Chemomechanical Caries Removal Agents in Primary Molars.

Chemomechanical caries removal (CMCR) is a noninvasive procedure that uses a chemical substance to remove the diseased dentin. The natural dental architecture is also preserved using this technique, preventing patient discomfort and pulp irritation. This method of eliminating caries is based on disintegration. This method removes soft carious dentin using chemical agents and non-traumatic mechanical force. This study was carried out to evaluate the clinical and microbiological evaluation of the chemomechanical caries removal agents in primary molars. For the elimination of caries, teeth in category I (polymer bur category) were treated with Smartburs II® (SS White Dental, Lakewood, New Jersey, United States) (n = 40). Teeth treated with the new Carisolv® technology (Mediteam, Sweden) to remove caries (n = 40). Teeth were treated for removal cavities in category III (conventional group) using excavators and carbon steel low-speed round burs from Dentsply Maillefer in Switzerland (n = 40). There was an evaluation of the efficacy of caries removal, the time required for caries removal, patient satisfaction, and microbial culture assessment. In comparison to the other two categories, the conventional category median caries detector dye values were considerably lower (p value<0.05). There was no substantial difference observed between study participants belonging to category I and category II with a p-value greater than 0.05. Time taken during the removal of caries was substantially greater in category I (455.46±73.7) as compared to category II (129.21±44.18) and the traditional category (113.26±37.7). The value of significance was less than 0.05. Contrarily, no discernible difference was observed between category I and category III (the p-value was greater than 0.05). In comparison to the other two categories, the conventional group's median facial expression scale scores were substantially higher (p = 0.02). In comparison, there was no discernible difference between categories I and II (p = 0.65). It was observed that there was no substantial variation in three categories regarding the number of colonies of bacteria prior to the eradication of caries (p-value greater than 0.05). After caries had been removed, the number of living bacterial colonies in category I was noticeably greater than those in the other two categories. However, there was no discernible variation between category II and category 1 (p-value greater than 0.05). The mechanical approach has the highest clinical efficacy for removing caries. Carisolv required the most time to remove cavities. Patient satisfaction levels were greater with Carisolv than with the mechanical approach. It was also observed that Carisolv as well as the mechanical technique had greater antibacterial effectiveness.

Comparative Evaluation of Ozonoid Olive Oil and Calcium Hydroxide as an Indirect Pulp Capping Agent in Primary Mandibular Second Molar: A Randomized Controlled Trial

The aim of this study was to evaluate clinical and radiographical success of ozonoid olive oil as an indirect pulp capping (IPC) agent in primary mandibular second molar when compared to calcium hydroxide and to evaluate the antimicrobial efficacy of ozonoid olive oil on Streptococcus mutans and Lactobacilli. A split-mouth randomized controlled trial was conducted on 30 primary mandibular second molars in 15 children of age 5-9 years with deep dentinal carious lesion. Teeth were randomly allocated to two groups of 15 each. After achieving local anesthesia and rubber dam isolation, an IPC procedure was performed using ozonoid olive oil in group I and calcium hydroxide in group II. Teeth were evaluated clinically and radiographically at 6 and 12 months of follow-up for success or failure of IPC. The bacterial counts of S. mutans and Lactobacilli were measured before and after application of ozonoid olive oil for 60 seconds on dentinal tissue in group I and recorded as colony-forming units per mL (CFU/mL). There were no statistically significant differences found between the materials used for IPC (p >0.05). About 93.33% and 100% clinical and radiographical success rates were seen in group I and group II, respectively. Statistically significant differences were observed for bacterial reduction after the application of ozonoid olive oil (p <0.05) for both the microorganisms. The results of this study showed that the success of IPC is independent of capping material. Ozonoid olive oil, an antimicrobial agent, can also be used for IPC. The success of the IPC procedure depends on a reduction in the bacterial count and sealing of the tooth with hermetic restoration. More clinical studies with a larger sample size and longer follow-up duration are required for understanding the efficacy of this material. Ozonoid olive oil can be used as an IPC agent in primary molars and also for a bacterial reduction in dentinal caries.

Dilute Silver Diamine Fluoride (1:10) Versus Light Cure Calcium Hydroxide as Indirect Pulp Capping Agents in Primary Molars - A Randomized Clinical Trial.

To evaluate the clinical and radiographic outcomes of diluted silver diamine fluoride (1:10) and light cure calcium hydroxide as indirect pulp capping agents in primary molars. Fifty-six primary molars requiring indirect pulp treatment were randomly allocated to two groups: Dilute SDF (one drop of SDF mixed with 9 drops of distilled water giving a 1:10 dilution) and light cure calcium hydroxide. The indirect pulp treatment was followed by glass ionomer cement restoration and all primary molars received stainless steel crown as full coverage restoration. The teeth were followed up both clinically and radiographically at 1,6- and 12-months' time interval using a pre-determined criterion. The results were statistically analyzed using Chi square analysis. The significance level was set at p ≤0.05. Overall clinical and radiographic success rate of indirect pulp treatment with SDF was 96% and with light cure calcium hydroxide was 91.6% respectively at the end of 12 months but the difference was not statistically significant (p>0.05). Dilute silver diamine fluoride (1:10) can be advocated as potential indirect pulp capping agent in primary molars with deep carious lesions.

Comparative Evaluation of the Success Rate of Pulpotomy in Primary Molars Using Ferric Sulphate (FS) and Mineral Trioxide Aggregate (MTA): A Clinical and Radiographic Study

Purpose: The aim of this present study was to observe clinical, radiographic response of pulp to Ferric Sulphate and Mineral Trioxide Aggregate when used as pulpotomy agent in primary molars.&#x0D; Materials and Methods: Sixty restorable primary molars were selected for the study. The children were chosen who require minimum two pulpotomies in either arch preferably each on the opposite side (i.e. right and left). Primary molars on the right side of the patient were assigned to Ferric Sulphate (FS) (Group A) and left side was assigned for the Mineral Trioxide Aggregate (MTA) (Group B). Statistical analysis was done for pain, swelling, sinus, and fistula and for internal resorption, furcation radiolucency and periapical pathology using the chi-square test.&#x0D; Results: outcome of the present study was observed at 3 month interval and after 6 months. The clinical success rate for MTA (AQUA) and ferric sulphate during 3 and 6 month follow up was 100%. The radiographic follow up of MTA was 100% during 3 and 6 month, whereas it was 96.6% for 3 and 6 month follow up with respect to ferric sulphate. There were no significant differences in the clinical (p&gt;0.1) and radiographic (p&gt;0.98) success rates among both the groups.&#x0D; Conclusion: ferric sulphate was found to be equally effective when compared with MTA. Radiographic success rate was lower for Ferric sulphate (Group A) than that of MTA (Group B) with occurrence of one internal resorption seen with first primary molar.

Comparative Evaluation of Fresh Aloe Barbadensis Plant Extract and Mineral Trioxide Aggregate as Pulpotomy Agents in Primary Molars

Comparative Evaluation of Fresh Aloe Barbadensis Plant Extract and Mineral Trioxide Aggregate as Pulpotomy Agents in Primary Molars

Clinical and Radiographic Evaluation of Mineral Trioxide Aggregate, Laser and Antioxidant Mix as Pulpotomy Agents in Primary Molars

Clinical and Radiographic Evaluation of Mineral Trioxide Aggregate, Laser and Antioxidant Mix as Pulpotomy Agents in Primary Molars

Histological Analysis of Human Pulp by Comparing Propolis, Mineral Trioxide Aggregate and Calcium Enriched Mixture as a Direct Pulp Capping Agent in Primary Molars

Aim: To evaluate the histological pulp response to three direct pulp capping agents (Propolis, Mineral Trioxide Aggregate and Calcium Enriched Mixture) in primary molars. Study design: Comparative study Place and duration of study: Pediatric Dentistry department and Oral Pathology department at de’Montmorency College of Dentistry, Lahore from 1st May 2016 to 31st December 2016. Methodology: Fifty-seven human vital primary first molars were selected from patients aged 8 years. They were divided into three groups of nineteen each. Propolis, mineral trioxide aggregate (MTA) and calcium enriched mixture (CEM) were used as direct pulp capping (DPC) agents in primary molars. After pinpoint exposure, the teeth were directly pulp capped with above mentioned materials. Teeth were extracted after fifteen days for histological examination of inflammatory pulpal cell response. Results: In Propolis group (15 days duration), 15 teeth (78.9%) were in grade 1inflammation, 1 tooth (5%) was in grade 2 inflammation and 3 teeth (15.7%) were in grade 3 inflammation. In Mineral Trioxide Aggregate group 14 teeth (73.7%) were in grade 1 inflammation, 3 teeth (15.7%) were in grade 2 inflammation and 2 teeth (10.5%) were in grade 3 inflammation. In Calcium Enriched Mixture group 15 teeth (78.9%) were in grade 1 inflammation, 3 teeth (15.7%) were in grade 2 inflammation and 1 tooth (5.3%) were in grade 3 inflammation. Conclusion: The effects of Propolis, Mineral Trioxide Aggregate (MTA) and Calcium Enriched Mixture (CEM) on pulpal tissue are comparable to each other. Propolis is a cheaper material as compared to other direct pulp capping agents and easily available. Therefore, it may be used as an alternative pulp capping agent however, further investigation is required to analyze human pulpal response. Keywords: Direct pulp capping. Propolis, Mineral trioxide aggregate, Calcium enriched mixture, Primary molars

Evaluation of bioactive glass and hydroxyapatite crystals as pulpotomy agents in primary molars: A clinical study

Aim: To clinically and radiographically evaluate the potential of bioactive glass and hydroxyapatite crystals as pulpotomy agents in primary molars. Methods: A total of fifty teeth were selected from 25 children (14 boys and 11 girls) aged 4 to 9 years, who had no medical condition that would contraindicate pulp therapy. Each child had at least two primary molars (first and/or second primary molar) requiring pulpotomy. A conventional pulpotomy procedure was performed on the selected teeth using bioactive glass and hydroxyapatite crystals. All molars were evaluated clinically and radiographically at regular intervals over 12 months. The results were subjected to statistical analysis using Fischer exact test. Results: One hundred percent clinical success and 84% radiographic success was observed in both the groups at the end of the study period. Conclusions: The study concluded that both bioactive glass and hydroxyapatite crystals can be used as pulpotomy agents in primary molars.

Biodentine Versus MTA as Pulpotomy Agents in Primary Molars: Clinical and Radiographic Study.

ABSTRACT Objective: to compare the clinical and radiographic success rate of” Biodentine” to that of “mineral trioxide aggregates” (MTA) when used as “pulpotomy agents” in primary molars of children. Study design: This split-mouth controlled randomized clinical study was performed on 10 healthy children age ranged from 2-6 years indicated for complete oral rehabilitation under general anaesthesia, with at least two carious primary molar indicated for pulpotomy. A total of thirty primary molars were treated, teeth were randomly assigned into two groups: Group A “Biodentine” group and Group B “MTA” group. All teeth were restored with “stainless steel crowns”. Follow up was done after 6 and 12 months for clinical and radiographic assessment. Results: clinical success rate was 100% in both group after12 months follow up period. Both groups showed internal root resorption (IRR) either at 6 or 12 months follow up. In the “Biodentine” group four teeth out of 15 showed internal root resorption (IRR) in the whole period of the study. In the “MTA” group two teeth showed IRR in the whole period of study. The radiographic success rate of Biodentine to MTA was 73.3% and 86.6% respectively, with no statistically significant difference between the two groups (P=0.65). Conclusion: Using “Biodentine” and “MTA” as pulpotomy agent in primary teeth showed excellent clinical results. Radiographically, IRR was a finding in both groups. “Biodentine” showed more number of teeth with IRR but the difference was not statistically significant.

Evaluation of Modified Portland Cement versus Mineral Trioxide Aggregate as a pulpotomy agent in Primary Molars: Histological Study

Evaluation of Modified Portland Cement versus Mineral Trioxide Aggregate as a pulpotomy agent in Primary Molars: Histological Study

The efficacy of Portland cement as a pulpotomy agent in deciduous teeth

PurposeThe objective of this study was to compare the efficacy of Portland cement (Pc) in comparison with Mineral Trioxide Aggregate (MTA) as a pulpotomy agent in primary molars. Materials and methods64 Deciduous Mandibular Second Molar of children aged between 6 and 8 years were randomly distributed to either PC or MTA groups which was treated by a conventional pulpotomy technique. The teeth were restored with resin modified glass ionomer cement and stainless-steel crowns. All teeth were assessed clinically and radiographically for success and followed at 3, 6 and 12 months. ResultsAt 12 months follow-up, the Clinical success rates of MTA and PC were 100% and 93.3% respectively. The radiographic success rate of MTA after 12 months was 96.7% while PC was 93.3% respectively. However, the results showed no significant difference between the two groups. ConclusionThis study finding showed that PC can be used a as pulpotomy agent with high clinical and radiographic success rates similar to MTA. PC may serve as a good alternative to MTA for pulpotomies of primary teeth.

Comparative study of the clinical and radiographic effects of pulpotec and mineral trioxide aggregate on the pulp of the primary molars

Objective The aim was to evaluate clinically and radiographically the effectiveness of pulpotec and mineral trioxide aggregate (MTA) on the radicular pulp tissue of the primary molars after pulpotomy procedure and compare the results of the tested materials with that of formocresol (FC). Materials and methods Pulpotomy was performed on 90 lower primary molars in 30 children aged 4–8 years then were randomly divided into three treatment groups of 30 molars for each group. Group I: the pulp was treated with Pulpotec. Group II: the pulp was treated with MTA. Group III: the pulp was treated with FC. All treated molars were covered with stainless steel crowns. Clinical evaluation and standardized periapical radiographs were done after 3, 6, and 9 months. Results The three groups were clinically successful as Pulpotec showed (100%) success rate, MTA showed (100%) and FC showed (92.9%) success rate. There was no statistically significant difference (P > 0.05) between the three groups regarding to their clinical performance. While the radiographic examinations showed that Pulpotec had the highest radiographic success rate (100%) in comparison to MTA and FC (92.9, 78.6%, respectively) with statistically significant difference between the three tested materials (P > 0.05). Conclusion Pulpotec and MTA may be promising materials as pulpotomy agents in primary molars.

Clinical Comparison of Eggshell Derived Calcium Hydroxyapatite with Dycal® as Indirect Pulp Capping Agents in Primary Molars

Objective: To evaluate and compare the efficacy of eggshell derived calcium hydroxyapatite with Dycal ® as indirect pulp capping material in primary molars. Material and Methods: A total of 32 carious primary molars from 22 children (6-10-years) were screened, of which 26 primary molars meeting inclusion criteria were selected and equally divided into two groups. At the first appointment, the infected dentin was excavated using a spoon excavator after treating the carious part with Carie-Care™ chemomechanical caries removal agent. After this, eggshell derived calcium hydroxyapatite in Group 1 and Dycal ® in Group 2 were used as liners followed by restoration of the cavity with type IX glass ionomer cement. Clinical assessment for pain and radiographic assessment for measurement of the amount of reparative dentin thickness formation was performed at baseline, 8 weeks and 3 months. The data were subjected to statistical analysis by one-way ANOVA and Kruskal-Wallis tests . Results: Higher mean reparative dentin formation was found in eggshell derived calcium hydroxyapatite group than Dycal ® group at the end of 8 weeks and 3 months and the difference was significant statistically (p<0.001) . Conclusion: Eggshell derived calcium hydroxyapatite seems to be a suitable alternative to Dycal ® (calcium hydroxide) that can be used as a liner for indirect pulp capping in primary molars.