Endodontic Treatment Of Primary Teeth Research Articles

Evaluation of Mechanical Versus Manual Root Canal Preparation in Primary Molars-A Comparative In Vitro Study.

The endodontic treatment of primary teeth is to maintain the function of the tooth free of symptoms until its physiological exfoliation. A critical factor for success is how quickly and effectively the root canal preparation can be performed. Therefore, the aim of this comparative in vitro study was to analyze the efficiency of two mechanical root canal preparation systems FM (FlexMaster) and HF (HyFlex EDM) to manual KF (K-file) on extracted primary molars. A total of 45 teeth were divided into three groups (n = 15): KF (#15-35), FM (04#30) and HF (25/~ OneFile). Root canal preparation was performed, and the preparation time was measured. All root canals were non-destructively analyzed by micro-computed tomography in the cervical, middle and apical thirds before and after preparation with regard to the parameters of canal transport (in μm) and centering ratio (0-1). Statistical analysis was performed at a 5% significance level using non-parametric tests. HF caused the lowest canal transport in the apical third (p = 0.008). The centering ratio value of HF was significantly higher in the middle third of the root canals than in the other two groups (p < 0.01). The mean instrumentation time was significantly higher for KF (6.67 min) than for FM (4.69 min) and HF (4.03 min, p < 0.01). HF can be recommended for primary molar root canal treatment.

Is clindamycin-modified triple antibiotic paste better than iodoform-based medicament for the treatment of non-vital primary molars using LSTR technique – A randomised clinical trial

Objectives: The objectives of this study were to evaluate and compare the success rate of local application of iodoform-based obturating material (Pulpotec – [Produits Dentaires S.A., Switzerland]) and clindamycin-modified triple antibiotic paste (ClinM-TAP) in pulp chamber using minimally invasive endodontic treatment of carious primary molars indicated for pulpectomy, for 12 months, using clinical and radiographic parameters. Materials and Methods: A randomised clinical trial was conducted in 60 children in the age group of 3–8 years reporting carious primary molars with symptoms of irreversible pulpitis and pulpal involvement clinically, allocated into Group 1 (30) and Group 2 (30). In Group 1, Lesion sterilisation and tissue repair (LSTR) was done using Pulpotec (Produits Dentaires S.A., Switzerland) as medicament and in Group 2, ClinM-TAP (Clindamycin-modified triple antibiotic paste) was used as medicament. Clinical follow-up was done at 3, 6 and 12 months; radiographic follow-up was done at 6 and 12 months. Clinical parameters compared were tenderness on percussion, spontaneous pain, intraoral swelling and sinus/fistula. Radiographic comparison was done based on furcation radiolucency, root resorption and bone regeneration. Both intergroup and intragroup statistical analysis was done using Chi-square test or Fisher exact test, Cochran’s Q Test and Mann–Whitney U-Test for the test of significance. All the statistical tests were performed at 5% significance level. Results: The mean age of patients in the study was 5.25 ± 1.3years with 45% males and 55% females. Both groups showed significant improvement in terms of clinical symptoms from baseline to 12 months. On intergroup comparison clinical parameters, TOP was present in 11.2% and 44% of cases at the end of 12 months in Groups 1 and 2, respectively (P &lt; 0 0.05). On intergroup comparison of radiographic parameters, at the end of 12 months, furcation radiolucency was seen in 32% and 73% (P &lt; 0.05) and root resorption was seen in 16% and 30% cases in Group 1 and 2, respectively (P &gt; 0.05). Overall clinical success rate of Group 1 and Group 2 was 88% and 50%, respectively (P &lt; 0.05) and radiographic success rate was 60% and 27%, respectively (P &lt; 0.05). Conclusion: LSTR using Pulpotec as a medicament has shown promising results in the present study. It could be a better alternative to conventional endodontic treatment in primary teeth. In the present study, ClinM-TAP has shown poor radiographic success; hence, it should be used with caution.

Effectiveness of dental care automation implementation in endodontic treatment of primary teeth

Relevance. The development of medical care quality control systems and implementation of medical information systems in dental services have recently been very relevant. Thus, research to increase the level of pediatric dental care through the implementation of modern medical information systems is paramount. Aim. The study aimed to improve the dental service quality control systems for primary teeth pulpitis treatment in children under seven years by implementing a medical information system. Material and Methods. According to the Protocols of management of children with dental diseases and clinical recommendations project „Pulpitis in children”, we comparatively assessed patient record documentation quality of 236 children under seven years who presented with diagnosis К04.03 „chronic pulpitis” to the pediatric dental clinic of the Clinical Centre for Maxillofacial, Plastic Surgery and Dentistry of the MSUMD in 2016 and 2018. Results. The study confirmed that medical information system ensures a higher quality of dental record documentation. Conclusion. A medical information system implementation significantly contributes to the improvement of the dental care quality control system.

Photodynamic therapy for endodontic treatment of primary teeth

Background: Tooth decay and traumatic dental injuries are the main causes of pulp inflammation in primary teeth. The present study was conducted on photodynamic therapy for endodontic treatment of primary teeth. Materials &amp; Methods: 40 primary anterior teeth with pulp necrosis were divided into 2 groups: Group I, conventional root canal therapy and group II, conventional root canal therapy combined with antimicrobial PDT. Each group with 20 patients. Microbiological samples of the intra-canal content were taken using paper cones. Results: Group I &amp; II had 19 boys and 9 girls and 8 boys and 12 girls respectively. Colony-forming units (CFU/mL) before and after treatment in group I at sample 1, 2, 3, 4, 5, 6, 7, 8, 9&amp; 10 were 94000 and 0, 87040 and 2433, 14530 and 0,154231 and 4500, 123145 and 3200, 28453 and 550, 110232 and 1250,112456 and 3100, 43294 and 0 and 142945 and 1955 respectively. CFU before and after treatment in group II at sample 1,2,3,4,5,6,7,8,9 &amp;10 were 194000 and 248,187040 and 2450,24530 and 0, 254231 and 4200,23140 and 300,38453 and 430,120232 and 1280, 212438 and 3600,143294 and 0 and 242940 and 1924 respectively. Conclusion: Conventional treatment combined with antimicrobial PDT found to be equally

Clinical and radiographic success of (partial) pulpotomy and pulpectomy in primary teeth: A systematic review.

The aim of this systematic review was to evaluate the clinical outcome of partial pulpotomy, pulpotomy and pulpectomy for treating primary teeth with normal or infected pulp or with irreversible pulpitis. Two reviewers on Pubmed and ISI Web of Science performed a comprehensive literature review of publications from 1966 until July 2019. Pico outline was used to facilitate literature research. Among abstracts, publications were selected according to the following criteria: prospective clinical study, correct indication for the performed treatment, clear definition of clinical and/or radiographic success criteria and at least 6-month follow-up period. The strict selection criteria under the keywords "pulpotomy", "partial pulpotomy" and "pulpectomy" resulted in a limited amount of randomised controlled trials (RCT) or controlled clinical trials (CT). Qualitative assessment of the selected clinical studies and level of evidence was included according to the criteria described by the Oxford Centre for Evidence-Based Medicine (CEBM). Prerequisites for a successful pulpotomy are symptom-free teeth, sterile removal of coronal pulp and haemostasis. Both MTA and formocresol perform well for partial pulpotomies after caries exposure. Formocresol had been the most popular amputation material for pulpotomies. Due to the potential side effects, other medicaments, such as ferric sulfate, mineral trioxide aggregate (MTA) or NaOCl are suggested. Grey and white MTA yeld the same results. Lasers are not recommended due to their large diversity. Regarding pulpectomy, the conditions, procedures, and evaluation for the treatment were not well defined in the studies. Nevertheless, there is evidence to use calcium hydroxide, zinc oxide eugenol paste or iodoform based pastes as root filling materials for non-vital molars. Pulpectomies showed better success rates than pulpotomies. Stainless steel crowns are recommended as definite restorations after both endodontic treatments. Longer follow-up periods, further clinical studies with comparable conditions and clear definition of evaluation criteria are needed to further confirm the results of endodontic treatment in primary teeth.

Can zirconia crowns be the first restorative choice after endodontic treatment of primary teeth?

Early loss of primary teeth due to caries can cause temporary or permanent problems, such as occlusion disorders, aesthetic problems, nutritional problems, abnormal habits, and speech disorders. Although the development of restorative materials has led to significant improvements, failures are still frequent. The purpose of this study was to evaluate the success rates of zirconia crowns compared to other crowns for the restoration of endodontically treated teeth with excessive loss of material. A total of 45 teeth of patients aged under 10years, including primary molars and anterior teeth, requiring restoration after root canal treatment, were included in this randomized, non-blinded clinical study. Stainless steel (SSC), zirconia (ZC), and strip (SC) crowns were used and compared clinically and radiographically during a six-month follow-up period. Parents were asked to fill out a questionnaire at one week and six months to evaluate the parent and child satisfaction levels. The patients' pain and discomfort levels were assessed using a visual analogue scale. The Mann-Whitney U, Chi-Squared and Friedman and Cochran Q tests were used for statistical comparisons using IBM SPSS Statistics version 23 (IBM, Armonk, NY, USA). The six-month follow-up evaluations revealed no significant differences in clinical outcomes between the SSC, ZC, and SC groups. There were no significant differences between the groups with respect to parent and child satisfaction. The clinical outcomes of ZCs were comparable to those of the other crowns. ZCs could be a choice for aesthetic purposes, with the disadvantage of a higher cost.

Pain assessment following endodontic treatment using two automated systems compared to manual treatment in primary molars.

Root canal treatment in primary teeth is quite difficult and time-consuming, especially canal preparation. Pain is the most common negative outcome following root canal treatment, occurring hours or days after treatment. It is an unpleasant experience for both the patient and the dentist. The objective of this study was to assess the severity and duration of pain following the endodontic treatment of primary molars with the use of rotary and reciprocating preparation systems compared to the traditional manual method. The research sample consisted of 157 asymptomatic primary lower second molars with non-vital pulp that were indicated for root canal treatment. The patients were randomly divided into 3 groups: in the 1st group, the molars (n = 52) were prepared using the manual method; in the 2nd group (n = 53), a reciprocating automated preparation system (WaveOne®) was used; and in the 3rd group (n = 52), a rotary preparation system (ProTaper Next®) was used. Pain assessment was carried out after 6, 12, 24, 48, and 72 h, and after 1 week, using a four-face facial pain scale. The manual method provided a higher pain score through 6, 12 and 24 h (p < 0.05) as compared to the 2 automated preparation systems. The intensity of pain did not vary between the 2 machine preparation systems after 6, 12 , 24, and 48 h (p > 0.05). There were no differences between the 3 methods after 72 h and after 1 week (p > 0.05). The manual method caused more pain than the other 2 preparation systems, but there was no difference between the 2 automated methods. Automated root canal preparation systems could be used to reduce the intensity of postoperative pain after the endodontic treatment of primary teeth.

Biomechanical preparation in primary endodontics- A comprehensive review

A major objective of modern dentistry for children is to maintain the integrity of the primary dentition until normal exfoliation, for the purpose of promoting function, esthetics and phonetics. Endodontic treatment in primary teeth can be challenging and time consuming, especially during canal preparations, which is considered one of the most important steps in root canal therapy. In recent years, new materials, equipments and instruments have evolved to a great extend and simplified the endodontic treatment procedures for the clinicians. Hence, we aim to provide review on some of the important aspects of the biomechanical preparation of the teeth.

Antibiotic Mixtures in Noninstrumental Endodontic Treatment of Primary Teeth with Necrotic Pulps: A Systematic Review.

Objective To compare the effectiveness of topical antibiotic mixtures used in noninstrumental endodontic treatment (NIET) of primary teeth. Methods Electronic databases including MEDLINE, the Cochrane Library, and Scopus database were searched. Randomized clinical trials evaluating the clinical and radiological outcomes of topical antibiotics used in NIET were selected. The revised Cochrane risk-of-bias tool (RoB 2.0) was used to assess the quality of the methodology of the included articles. Results Five articles comparing the outcomes of four different drugs combination were included. Three studies conducted to evaluate the success rate of two combinations of antibacterial drugs consisting of ciprofloxacin-minocycline-metronidazole (3 Mix) in one group and ciprofloxacin-minocycline-ornidazole in the other group showed no statistically significant difference between both groups (P > 0.05). The ciprofloxacin-minocycline-ornidazole group showed better results compared with the 3 Mix group. One study conducted to compare the effectiveness of 3 Mix with ciprofloxacin-tinidazole-minocycline reported no significant difference between both groups, and one study that compared 3 Mix and ciprofloxacin-metronidazole-clindamycin mixture concluded that the overall success rates of both groups were 80.96% and 76.20%, respectively, with no statistically significant difference. Conclusion Based on the overall success rates, the ciprofloxacin-minocycline-ornidazole mixture was considered more effective than the 3 Mix which was more effective than the ciprofloxacin-tinidazole-minocycline and the ciprofloxacin-metronidazole-clindamycin groups. Clinical Relevance. Different antibiotic combinations, showing good clinical and radiographic success in treating necrotic primary teeth, can be used effectively in NIET and this technique can be considered effective for teeth with advanced root resorption and when conventional endodontic treatment is contraindicated.

Cost analysis of endodontic treatment in primary teeth: results from a randomized clinical trial.

This study compared the cost of endodontic treatment in primary teeth involving a technique that does not require root canal instrumentation using antibiotic paste (CTZ) with that of the instrumented technique using iodoform paste (GP). This study is part of a randomized, controlled, parallel arm, noninferiority, 1:1 allocation, blinded (patient) multioperator study of 52 primary incisors of children aged 3 to 6 years with caries lesion and pulp involvement. Each technique was performed according to the creators' descriptions. The cost was assessed by analyzing the costs of capital, dental supplies, and professional labor according to the time taken to perform the procedure and the CHEERS guidelines were used to report the cost assessment. Endodontic treatment with CTZ had a 58.33% lower execution cost than GP (US$6.73 and US$16.15, respectively). The t-test showed significant differences between groups regarding treatment time and total cost (p < 0.0001). The CTZ technique seems to be more economically viable than GP for endodontic treatment of primary teeth, requiring a shorter treatment time and lower costs.

Antibacterial and Solubility Analysis of Experimental Phytotherapeutic Paste for Endodontic Treatment of Primary Teeth

Objective: To evaluate the antibacterial effect and the solubility of experimental root canal filling pastes containing the phytoconstituents terpineol and cinnamaldehyde. Material and Methods: Minimum Inhibitory Concentration (MIC) of each phytoconstituent was determined against Enterococcus faecalis. Five groups of antibiotic pastes based on zinc oxide were obtained by mixing: only terpineol, only cinnamaldehyde, terpineol and cinnamaldehyde combined, chlorhexidine (antibiotic control), and CTZ paste (control paste). Antibacterial activity was analyzed through direct contact test within 24 and 72 hours. Solubility was evaluated by spectrophotometry within 48 and 144 hours. Antibacterial activity data were analyzed descriptively, and solubility data was analyzed using ANOVA and Tukey tests (p<0.05). Results: The MIC obtained for terpineol and cinnamaldehyde were, respectively, 2000 µg/mL and 500 µg/mL. After 24h, only the terpineol paste did not inhibit E. faecalis growth. After 72h, all groups inhibited E. faecalis growth. After 48h, the highest solubility was verified in the terpineol paste (p<0.05), and no differences were detected among other groups (p>0.05). After and 144h, highest solubility was observed in the terpineol paste (p<0.05), followed by the CTZ paste (p<0.05). No differences were detected for cinnamaldehyde, terpineol+cinnamaldehyde and chlorhexidine pastes (p>0.05). Conclusion: Pastes containing cinnamaldehyde or terpineol+cinnamaldehyde showed antibacterial activity against E. faecalis similar to CTZ paste, with lower solubility.

Survival rate of pulpectomy in primary teeth using Feapex® paste: a clinical study in infants

Objective: The aim of this clinical study was to evaluate the survival rate of a new pulpectomy protocol using2% chlorhexidine digluconate gel and Feapex paste for endodontic treatment in primary teeth. Material andMethods: A total of 105 pulpectomies were performed in anterior and posterior teeth of 48 infants (1-3 yearsold) with high caries experience with irreversible pulpitis or pulp necrosis. All treatments were performed bydental surgeons with no specialization in Pediatric Dentistry, under local anesthesia and rubberdam isolation.Manual files were used in conjunction with 2% chlorherixidine gel for root canal instrumentation, and Feapex®paste was used as a obturation material. The clinical and radiographic outcomes were collected by one trainedindependent evaluator with a follow-up period of 24months. Success was determined by the absence of pain,pathological mobility, pathologic bone rarefaction, pathological root resorption and soft tissue pathology aroundthe affected tooth Survival of the endodontic treatment was evaluated by estimating survival rates throughKaplan-Meier curves. Cox Regression analysis with shared fragility were performed to evaluate the associationbetween the independent variables to endodontic treatment failure (alpha=5%). Results: After 24 months, thetreatment survival was 86% (SE=0.03). Root resorption at baseline was associated with a higher risk of failure(HR=2.81; CI=1.12-7.08; p=0.027). The survival rate of the endodontic treated teeth due to dental traumawas 100%, while teeth with dental caries had lower survival rate (85.05%; p&lt;0.001*). Other variables analyzedincluded gender, age of the child, tooth position (incisor/molar), restoration type, obturation quality, andcaries experience were not associated with treatment failure (p&gt;0.05). Conclusion: The new protocol using2% chlorhexidine digluconate and Feapex® presented a high survival rate and can be considered as a suitableprotocol for pulpectomy in primary teeth.Trial Registration: REBEC (RBR-282s2f).KEYWORDSRoot canal treatment; Primary teeth; Infants; Pulpectomy.

Evaluation of a Novel Endodontic Paste for Primary Teeth with Necrotic Pulp

Background: The ideal root canal filling for endodontic treatment of primary teeth with necrotic pulp must have antimicrobial activity, not cause tooth discoloration or interfere with the eruption of permanent successor teeth. This study aimed to evaluate physiochemical properties of a novel paste (CZ Paste) for endodontic treatment of primary teeth with necrotic pulp and compare its antimicrobial activity to Chloramphenicol, Tetracycline, Zinc oxide (CTZ) and Zinc Oxide eugenol (ZOE) pastes. Methods: CZ, CTZ and ZOE pastes were homogenized with eugenol at the time of testing. Fourier Transform Infrared spectroscopy (FTIR) and Differential Scanning Calorimetry (DSC) tests were performed. Antimicrobial activity was assessed using agar diffusion test (ADT), direct contact test (DCT) and bactericidal effect assessment against Staphylococcus aureus, Enterococcus faecalis and Pseudomonas aeruginosa. Results: FTIR showed that CZ paste has a similar profile to chloramphenicol spectrum and in DSC thermograms it demonstrated a slight change in endothermic transition temperature. In the ADT, CTZ paste and CZ paste presented similar inhibition zone diameters and were higher than ZOE paste (P Key words: Primary tooth, Pulpectomy, Root canal filling materials, Antibiotic paste, Bacteria.

Knowledge and attitude of endodontic treatment of primary teeth among various specialists

Knowledge and attitude of endodontic treatment of primary teeth among various specialists

Is there evidence for the use of lesion sterilization and tissue repair therapy in the endodontic treatment of primary teeth? A systematic review and meta-analyses.

To assess whether lesion sterilization and tissue repair (LSTR) technique resulted in similar clinical and radiographic success outcomes as compared with pulpectomy in primary teeth. Randomized clinical trials comparing LSTR with pulpectomy by means of clinical and radiographic parameters were included. Risk of bias was assessed using Cochrane methodology and the certainty of evidence was determined by GRADE. Six articles were included. Conventional pulpectomy was favored with respect to radiographic success frequency in the systematic review. Four studies were included in meta-analyses. Based on the clinical results at 6months (RR = 0.99, 95% CI, 0.94-1.04, p= 0.67; I2= 0%), 12months (RR = 0.97, 95% CI, 0.90-1.04, p= 0.34; I2= 0%), and 18months (RR = 0.89, 95% CI, 0.77-1.04, p= 0.14; I2= 0%) and radiographic findings at 6months (RR = 0.91, 95% CI, 0.78-1.06, p= 0.23; I2= 9%), 12months (RR = 0.87, 95% CI, 0.65-1.18, p= 0.38; I2= 64%), and 18months (RR = 0.84, 95% CI, 0.69-1.02, p= 0.08; I2= 0%), there was no difference observed regarding success between the two treatments. The quality of evidence ranged from moderate to very low. No difference between the LSTR and pulpectomy approaches could be confirmed by meta-analyses. The quality of evidence according to the GRADE scheme ranged from moderate to very low. The present meta-analyses could not demonstrate the superiority of one treatment over the other.

Influence of hand and rotary files for endodontic treatment of primary teeth on immediate outcomes: Secondary analysis of a randomized controlled trial

Endodontic treatment of primary teeth can be time-consuming. To compare hand and rotary files regarding the time for root canal chemical-mechanical preparation, child's behavior, apical limit of the obturation, and post-operative pain. This secondary data from a randomized clinical trial with two parallel arms evaluated endodontic instrumentation in 88 children aged 4-9years. Stratified and block randomization was performed into two groups: K-file hand and ProDesign Logic rotary files. The evaluated outcomes were the chemical-mechanical preparation time, child's behavior using the Frankl scale, apical limit of the obturation, and post-operative pain using the Faces Pain Scale-Revised. One operator and all outcome appraisers were blinded to the chemical-mechanical technique. Multiple linear regression, chi-square, and Fisher's exact test were performed. The mean time for chemical-mechanical preparation using hand files was 24.5 (SD 4.0) minutes, and using rotary files, it was 17.0 (SD 2.5) minutes (P<.001). No difference was found between the instrumentation methods in the child's behavior, apical limit of the obturation, or post-operative pain. The ProDesign Logic file reduced the average procedure time but presented no difference in the other variables studied when compared to the K-file.

Photodynamic therapy for endodontic treatment of primary teeth: A randomized controlled clinical trial.

This study aimed to evaluate the reduction in bacterial load following conventional endodontic treatment with and without antimicrobial photodynamic therapy (a-PDT) in primary teeth. Thirty primary anterior teeth with a diagnosis of pulp necrosis were selected. Patients were randomly allocated to two groups as follows: Group I, patients undergoing conventional root canal therapy (n = 15) and Group II, patients undergoing conventional root canal therapy combined with antimicrobial PDT (n = 15). For PDT, methylene blue, at a concentration of 0.005 %, was used as the photosensitizing agent, which was applied to the interior of the canal with a sterile paper cone for 3 min, followed by the administration of laser light for 40 s (wavelength: 660 nm, energy density: 4 J/cm², power: 100 mW), delivered in direct contact at the entrance to the root canal. Two microbiological samples of the intra-canal content were taken (one before and one immediately after treatment in both groups) using paper cones. Clinical follow-up involved the investigation of fistulas and mobility and was performed 1- and 3 months after treatment. Data were statistically analyzed. The reduction in bacterial load was 93 % in Group I and 99 % in Group II, with no statistically significant difference. Conventional treatment combined with antimicrobial PDT with parameters used in this study proved effective but presented equal efficacious capability to conventional endodontic treatment alone. The use of PDT has been studied in endodontic treatment protocols in permanent teeth. However, clinical trials in deciduous teeth are necessary for establishing the effectiveness and parameters of this application. The present study analyzes the results of PDT in the endodontic treatment of deciduous teeth.

Root canal morphology of primary maxillary second molars: a micro-computed tomography analysis.

Successful endodontic treatment of primary teeth requires comprehensive knowledge and understanding of root canal morphology. The purpose of this study was to investigate the root canal configurations of primary maxillary second molars using micro-computed tomography. Extracted human primary maxillary second molars (n = 57) were scanned using micro-computed tomography and reconstructed to produce three-dimensional models. Each root canal system was analysed qualitatively according to Vertucci's classification. 22.8% (n = 13) of the sample presented with the fusion of the disto-buccal and palatal roots; of these, Type V was the most prevalent classification. For teeth with three separate roots (n = 44), the most common root canal type was Type 1 for the palatal canal (100%) and disto-buccal canal (77.3%) and Type V for the mesio-buccal canal (36.4%). Overall, 7% (n = 4) of mesio-buccal canals were 'unclassifiable'. The root canal systems of primary maxillary second molars were not only complex but had a range of configurations that may contribute to unfavourable clinical outcomes after endodontic treatment.

Endodontic treatment and premature tooth loss in primary dentition. Reasons and distribution

INTRODUCTION: Primary dentition has its own role in every individual’s life affecting the general health by ensuring the integrity of the permanent dentition. It has significant impact on the position, teeth and jaw relations as well as the vocal and eating functions. Thus, preventing its health is very important for the children. AIM: The aim of this article is to investigate the relative share of the primary teeth with d4 carious lesions and traumatic injuries indicated for endodontic treatment, reasons for retreatment, premature loss, and extraction of primary teeth. MATERIALS AND METHODS: A retrospective descriptive study was conducted by examining 1159 children 3 to 12 years old, from Varna in the University Medical Dental Center – Varna, where a d4mf/d4mf (T+t) was assessed in the period 2016-2019. Teeth indicated for endodontic treatment and endodontic retreatment were investigated. Teeth for extraction due to orthodontic issues and teeth with normal exfoliation were not taken into account. RESULTS: It was established that 37.8% of 1159 children were with a diagnosed d4 carious lesions. The main reason for endodontic treatment of primary teeth in 62% of the children diagnosed with complicated caries was irreversible pulpitis. A total of 34% of the children were diagnosed with periodontitis. Traumatic injuries with pulp necrosis represented 14% of the complications. The main reasons for premature extraction of primary teeth were carious process complications (36%) and unsuccessful previous endodontic treatment (49%). CONCLUSION: Although people use their primary dentition for just 6% of their lifetime, it has crucial impact on the health, orthognathic relations, and positions of permanent teeth.

Efficacy of digital radiographic systems in the quality assessment of intracanal materials used for primary teeth

Aim: To evaluate the performance of three digital radiographic systems in the analysis of root canal filling quality using different intracanal materials for primary teeth. Methods: Twenty-five bovine teeth were divided into 5 groups: Calen® combined with iodoform; Calen® combined with zinc oxide; zinc oxide and eugenol; UltraCal®XS, and 2% chlorhexidine combined with Ca(OH)2 + zinc oxide. Periapical radiographs were obtained with the VistaScan, Express, and SnapShot systems. The quality of the images was evaluated objectively (radiopacity) and subjectively (apical sealing and filling homogeneity). As the reference standard, the teeth were scanned with a micro-CT device. Results: Radiopacity differed among the radiographic systems and materials tested. In general, the greatest difference was observed between the Express and VistaScan systems; Calen® combined with iodoform resulted in the highest radiopacity. The radiographic systems did not differ in terms of homogeneity. However, Calen® combined with iodoform differed from the other materials and exhibited the best results. Regarding apical sealing, the SnapShot system and Calen® combined with zinc oxide provided the best results. Conclusion: Direct digital systems show better performance in evaluating the quality of endodontic treatment in primary teeth and should be preferred for this purpose.