Materials For Primary Teeth Research Articles

Assessment of calcium hydroxide-formocresol mix, zinc oxide and calcium hydroxide-iodoform pastes as a root filling in primary teeth (clinical and radiographic study)

ABSTRACT Objective of this study is to evaluate clinically and radiographically the calcium – hydroxide formocresol mix as a root filling material in primary teeth . Materials & Methods: The study was performed on 75 primary molars of patients aged from 4-8 years that indicated for pulpectomy. The teeth were divided randomly into 3 main equal groups. Each group formed of 25 primary molars. Group A: 25 children teeth in which zinc oxide and eugenol (ZO/E) was used as filling material . Group B: 25 children teeth in which calcium hydroxide formocresol mix was used as a filling material. Group C : 25 children teeth In which matapex was used as filling material . The teeth were assessed clinically and radiographically at 5 different intervals (preoperative, 24 hours, 6 weeks , 3 months and 6 month postoperative), using standard clinical and radiographic criteria. Results: It was found that Maetapex offers best clinical and radiographical results when compared with ZO/E and calcium hydroxide fromocresol mix . ZO/E (group A) showed (84%) success rate, while the Calcuim hydroxide fromocresol mix (group B) showed a higher success rate (88%) than (ZO/E) . Metapex (group c) show best success rate of all groups (94%) while failure rate showed (16%) , (12% ) and (6%) respectively. Conclusion: Metapex is the best material as root filling material with a high success rate and showing competitive properties to ZO/E and Calcium hydroxide formocresol mix . calcium hydroxide formocresol mix shows better result than ZO/E .

Parental acceptability of coloured compomer as a restorative material in primary teeth of children - A randomized split mouth clinical trial

Coloured compomer materials have been introduced in Pediatric Dentistry and gained popularity as it develops a positive behaviour in the child and makes further treatment stress-free. However, parental satisfaction regarding the appearance of coloured compomer is questionable. This study aimed to compare the parental acceptability of coloured compomer compared to conventional compomer for the restoration of primary teeth in children. A total of sixty sites, divided into two groups, with thirty subjects in each group using split-mouth design were chosen amongst patients aged between 5 to 10 years reporting to the Department of Pedodontics and Preventive Dentistry. In the control group, conventional compomer(Material A) were placed, similarly coloured compomers(Material B) were placed in the experimental group under the standard operating protocol. Parental preference was noted by asking them to tick or point to the appropriate box labelled Material A and Material B, and the results were evaluated by statistical analysis using SPSS version 21.0. A statistically significant difference was found in parents in preference of conventional tooth coloured compomer as the restorative material. (p<0.05)Thus, the preference of parents regarding the placement of coloured compomer in primary teeth is comparatively low. Though the coloured compomer material positively influences the behaviour and treatment outcome in children, the parental satisfaction is found to be comparatively low as parents feel that it lacks the aesthetic appeal when compared to the conventional tooth-coloured restorations.

Cytotoxicity of Novel Polymeric Gel Matrix Triple Antibiotic Paste—an In Vitro Study

The study evaluated the in vitro cytotoxicity profile of a novel polymeric gel matrix triple antibiotic paste. The novel polymeric gel matrix triple antibiotic paste (TAOP) was formulated as thermo-modulated in situ hydrogel, by blending chitosan-carbopol and poloxamer gels with clindamycin (5%), metronidazole (5%), and doxycycline (1%). All the test materials (TAOP—test material 1), zinc oxide eugenol (ZOE—test material 2), and calcium hydroxide iodoform paste (Metapex—positive control) were divided into multiple concentrations from 400 to 12.5 μg/mL serially. The precultured human gingival fibroblasts (HGFs) were contacted directly to all the test materials, against untreated cells (negative control). MTT assay was evaluated for cell survival after 48 h, followed by half-maximal inhibitory concentrations (IC50) estimation. Data was analyzed using one-way ANOVA with Tuckey’s post hoc HSD test and Bonferroni’s correction followed by t test for pairwise comparison of groups at all concentrations (p < 0.05). The novel polymeric gel matrix TAOP exhibited lowest cytotoxicity followed by Metapex and highest with ZOE after 48 h. The IC50 concentration of TAOP was highest (701.6 μg/mL), followed by ZOE (632.1 μg/mL) and least for Metapex (609.4 μg/mL). However, the intergroup comparisons of the HGF responses for the test materials at all the concentrations showed a statistically nonsignificant difference. Novel polymeric gel matrix triple antibiotic gel is less toxic to HGF than other obturating materials maintaining their viability. The recently developed material can be used as an obturating material in primary teeth or intracanal medicament in permanent teeth to disinfect endodontic spaces with the least cytotoxicity. The present study focuses on the development and cytotoxic evaluation of a newly formulated polymeric gel matrix triple antibiotic paste followed by evaluation of its cytotoxicity against zinc oxide eugenol and metapex (calcium hydroxide iodoform), respectively. Human gingival fibroblasts (HGFs) were grown with novel polymeric gel matrix triple antibiotic paste, zinc oxide eugenol, and Metapex, against untreated cells. The cytotoxic profile and half-maximal inhibitory concentrations (IC50) of test materials were also estimated. Thus, the cytotoxic evaluation of newly formulated material and other test materials was evaluated to prevent damage to the native tissues enhancing new tissue regeneration during their usage.

THE UTILIZATION PATTERNS OF RESTORATIVE MATERIALS IN PRIMARY MOLARS AMONG PEDIATRIC DENTISTS.

Background: Many changes have occurred in development and availability of dental restorative materials for primary teeth. To date, there has been no emphasis to identify the approaches and materials used by pediatric dentists for primary teeth. The present study was conducted to assess the preferred choice of restorative materials among pediatric dentists for restoring primary teeth in children.&#x0D; Methodology: A self-administered questionnaire was utilized to obtain demographic information. Six hypothetical clinical scenarios were presented and clinicians choice of material for each of these scenario was evaluated.&#x0D; Statistical Analysis: Statistical analysis was done based on chi-square test. Results were displayed as percentages.&#x0D; Results: A total of 62 pediatric dentists completed the questionnaire, of which 97% preferred tooth-coloured materials over amalgam. Respondents reported the most influencing factors in the choice of restorative materials as age, behaviour of child and caries experience.&#x0D; Conclusion: Responses to various hypothetical clinical scenarios showed preference of tooth coloured materials and uniform choice of materials was noted among pediatric dentists irrespective of age or years of clinical experience.&#x0D; Keywords: restorative materials, primary teeth, pediatric dentists

Clinical and radiographic evaluation of chitosan-zinc oxide eugenol mix in pulp capping of primary teeth

Objective of this study was to evaluate clinically and radiographically the chitosan-zinc oxide eugenol mix as pulp capping material in primary teeth. Materials & Methods: The study was performed on 36 primary molars of patients aged from 4-8 years that indicated for pulpotomy. The teeth were divided randomly into 2 main equal groups. Each group formed of 18 primary molars. Group A: 18 children teeth in which zinc oxide and eugenol (ZO/E) was used as pulp capping material after formocresol (FC) application. Group B: 18 children teeth in which Chitosan-ZO/E mix was used as pulp capping material. The teeth were assessed clinically and radiographically at 4 different intervals (preoperative, 24 hours, 6 weeks and 3 months postoperative), using standard clinical and radiographic criteria. Results: It was found that chitosan-ZO/E mix offers good clinical and radiographical results when compared with ZO/E after application of FC but with no statistically significant differences. ZO/E after application of FC (group A) showed (83.33%) success rate, while the Chitosan-ZO/E mix (group B) showed a higher success rate (94.44%) while failure rate showed (16.67%) and (5.56%) respectively. Conclusion: Chitosan-ZO/E mix is a promising material as pulp capping material with a high success rate and showing competitive properties to ZO/E after FC application. It has the power to be an alternative for ZO/E after FC application in pulpotomized primary molars.

Usage of glass ionomer cements for reconstructions in the head region

Glass ionomer cements are a two-component hybrid material, consisting of inorganic glass particles, surrounded by an insoluble hydrogel matrix. They are a group of materials based on the acid/ base reaction between poly (alkenoic) acid and an ion-leachable silicate glass. Their biocompatibility, osteoconductive behavior, and ability to bond to bone and metals have generated interest in the material for medical applications. GIC are widely used in dental medicine as an obturation material in primary teeth for treatment and prophylaxis of dental caries, because they have the ability to create a physicochemical bond to tooth structure and to release fluoride. They are currently frequently used in otological and neuro-otological surgery. Apart from ossicular chain reconstruction, they are used for repair of tegmen defects, outer ear canal reconstruction, mastoid obli teration, and stabilization of some hearing prostheses.

Comparative evaluation of three different an obturating materials in pulpectomy; An in vivo study

Objectives: The aim of this study was to clinically evaluate, radiographically zinc oxide eugenol (ZOE) paste, metapex, and Alo vera gel with zinc oxide powder as root canal filling material in primary teeth. Methodology: In the present study, pulpectomies were performed on 51 primary second molar in 55 children, aged between 4 and 9 years, of these, 24 children were randomly divided into three groups of 17 teeth each selected for endodontic treatment. Obturation was done with a mixture of ZOE paste, metapex and A. vera gel with ZOE powder. Clinical, radiographic evaluation was done after 3 months, 6 months, and 12 months. Data were analyzed using Fisher's exact test and Cochran's Q-test, and the value of P was set at 0.05. Results: The three pastes achieved convergent clinical and radiographic success within the three observation periods (P > 0.05). ZOE paste was the slowest in its resorption. Conclusion: Zinc oxide powder with A. vera gel can be used as alternatives to ZOE and metapex.

Comparative Evaluation of Quality of Obturation using Endoflas and Endoflas Powder with Aloevera Gel as Obturating Materials in Primary Mandibular Molars: A Double Blinded Randomized Controlled Trial

Paediatric endodontics is an evolving stream in paediatric dentistry and so is the materials used as obturating agents in primary teeth. A paradigm-shift change has been witnessed in the genre of obturating agents where more of natural plant products are preferred to be used as obturating materials in primary teeth due to its enriched biological and biocompatible properties.The aim of the present study is to comparatively evaluate the quality of obturation using Endoflas and Endoflas powder with Aloevera gel as an obturating material in primary mandibular molars.A double-blinded randomized clinical trial was conducted for recruiting participants in an age group of 4-9 years old requiring endodontic treatment (i.e; pulpectomy) in primary mandibular molars. Post-treatment, an immediate intra-oral periapical radiograph (IOPAR) was taken for assessment of the quality of obturation. Obturation quality was assessed using the modified Coll and Sadrian’s criteria. Highest percentage of optimal fillings were observed in endoflas group (15/75%) followed by endoflas powder with aloe vera gel group (10/50%) while increased percentage of overfilling was found in endoflas powder mixed with aloe vera gel (7/35%) followed by endoflas group (4/20%). In case of underfilling quality of obturation, more of underfilled cases were found in endoflas powder mixed with aloe vera gel (3/15%) while only one underfilled case was seen in endoflas group. The difference in the quality of obturation was found to be statistically significant (p= 0.019). Endoflas powder with aloe vera gel can be used as an alternative and suitable obturating agent in primary teeth due to its wide repertoire of medicinal properties which are highly beneficial in alleviating the persistent periapical infection in primary teeth.

Clinical and Radiographic Evaluation of Compomer and Composite used for Restoring Primary Teeth

This study assessed different restorative materials in primary teeth over a one-year period. Sixty carious primary molars were selected from 30 patients; ages 5-10 years. Class I and II cavities were divided into four groups: Group I: 15 Class I cavities were restored with a compomer, Group II: 15 Class I cavities were restored with a resin composite, Group III: 15 Class II cavities were restored with a compomer and Group IV: 15 Class II cavities were restored with a resin composite. Each child had two teeth restored, one with compomer and the other with composite resin as control. Direct clinical and radiographic evaluations were performed by one examiner after 24 hours, 6- and 12-months. Indirect clinical evaluations were performed using a Scanning Electron Microscope after 24 hours and 12-months periodically. Clinical and radiographic evaluations revealed no significant differences between the compomer and resin composite at 6- and 12-months. Indirect clinical evaluation showed good marginal interfaces between the restorations and the tooth structure throughout the evaluation periods. Both materials presented significant clinical and radiographic performances in Class I and II restorations of primary molars after one year.

A Comparative study of Biodentine and Calcium Hydroxide as Pulpotomy Material in Primary Teeth.

Background: Pulpotomy is measured as one of the most worldwide accepted favourable clinical procedure for the treatment of deciduous tooth with reversible pulpitis with carious destruction of tooth tissue.&#x0D; Objectives: To evaluate the clinical and radio-graphical findings of primary tooth with reversible pulpitis by Biodentine and Calcium Hydroxide as pulpotomy material.&#x0D; Study Design: Randomized comparative study.&#x0D; Study place and period: Conservative Dentistry &amp; endodontics department of Bangabandhu Sheikh Mujib Medical University, Dhaka, September 2013 to September 2014.&#x0D; Study Population: The study population comprised of patients having primary tooth with reversible pulpitis irrespective of sex.&#x0D; Methods/Procedure: According to inclusion and exclusion criteria, out of 100 primary teeth 50 teeth were treated with Biodentine (Group-A) and the remaining 50 teeth were treated with Ca(OH)2 (Group-B). Clinical and radiographic follow up examination were done at 3months,6 months and 12 months’ interval to evaluate the rate of postoperative pain, swelling and periapical radiolucency. Statistical package for Social Science (SPSS) version 17 was used to analyze the collected data&#x0D; Main outcomes measures (s): 01. Pain 02. Dentinal bridge 03. Root resorption&#x0D; Results: At 3 months observation period, Biodentine and Ca(OH)2 pulptomy of primary teeth showed 100% success rate in treating teeth with reversible pulpitis; neither pain nor swelling or radiographic sign of resorption was observed. At 6 and 12 months following the completion of treatment except in two case in group A and four case in group B in observation period, there results were similar to that of 3 months. Two Biodentine (4%) and four Ca(OH)2 (8%) therapy reported pain, swelling. There was no statistical difference between the two group (p&gt;0.05).&#x0D; Conclusion: So, we can say that clinical and radiographic end result of Biodentine is better than Ca(OH)2 as a pulpotomy material in mature primary tooth with reversible pulpitis.&#x0D; Update Dent. Coll. j: 2019; 9 (1): 37-41

Antimicrobial Activities of Commercially Available Obturating Materials in Primary Teeth

Antimicrobial Activities of Commercially Available Obturating Materials in Primary Teeth

Antimicrobial efficacy of herbal extracts combined with zinc oxide eugenol as an obturating material in primary teeth – An in vitro study

Background and Aims: The aim of this study is to evaluate the antimicrobial efficacy of synthetic obturating material (Zinc oxide eugenol) individually and combined with medicinal plant extracts (Triphala, Aloevera, Tulsi) against four bacterial strains (Streptococcus mutans, Enterococcus faecalis, Staphylococcus aureus, Escherichia coli). Methods: The herbal extracts were independently mixed in different ratios with zinc oxide powder, followed by mixing with eugenol to know the effective concentration using antibacterial assay. Initially different concentrations of each test material were placed into Agar diffusion wells and zones of inhibition were measured against the selected bacteria. The concentration with maximum zone of inhibition for each test material was assessed and grouped as Group I- Triphala and zinc oxide eugenol (80:20), Group II- Aloevera and zinc oxide eugenol (80:20), Group III- Tulsi and zinc oxide eugenol (50:50) and Group IV- Plain zinc oxide eugenol. Results: All the groups exhibited varied antimicrobial activity against test microorganisms which were statistically significant. Highest antimicrobial efficacy was noticed in the group I followed by group II, III and the least with group IV samples. Conclusion: The formulations obtained by incorporating Triphala, Aloevera, Tulsi in Zinc oxide exhibited substantial antimicrobial activity when compared to Zinc oxide eugenol alone. Even though, the tested materials showed good antibacterial activity in this in vitro study, clinical trials need to be conducted before recommending them as obturating materials in primary teeth.

Bonding behavior of restorative materials in primary teeth submitted to erosive challenge − Evidence from an in vitro study

PurposeTo evaluate bond stability of restorative materials to eroded primary teeth after aging. Methods120 primary molars were assigned into 12 groups, in according to substrate – enamel or dentin, precondition of substrate – sound or eroded, and restorative material – resin composite/adhesive system-RC, high-viscosity glass ionomer cement–HVGIC or resin-modified GIC–RMGIC. Eroded groups were subjected to erosive challenge prior to bonding procedures. Polyethylene tubes were placed on flat surfaces of substrates and filled up with one of materials. After 24 h, half of the specimens were submitted to microshear bond strength (BS) test, and the other half after 12 months. ResultsGenerally, sound substrates resulted in higher BS values than eroded ones, with exception of HVGIC that obtained similar performance in both substrates. Furthermore, the storage period negatively influenced BS values for RC groups on dentin assessment. The other groups did not show reduction in BS values after 12 months. RC showed better bonding performance than others materials. ConclusionPreviously eroded substrates result in the worst performance of RC and RMGIC. Moreover, the water storage affects the bonding stability of RC to dentin. On the other hand, HVGIC is not affected by precondition of substrate neither storage.

Restorations in primary teeth: a systematic review on survival and reasons for failures.

Several restorative materials with specific indications are used for filling cavities in primary teeth. To systematically review the literature in order to investigate the longevity of primary teeth restorations and the reasons for failure. Electronic databases were screened, and eligible studies were hand-searched to find longitudinal clinical studies evaluating the survival of restorations (class I, class II, and crown) placed with different materials in primary teeth with at least one year of follow-up. Thirty-one studies were included, and a high bias risk was observed. Overall, 12,047 restorations were evaluated with 12.5% of failure rate. A high variation on annual failure rate (AFR) was detected (0-29.9%). Composite resin showed the lowest AFRs (1.7-12.9%). Stainless steel crowns (SSC) had the highest success rate (96.1%). Class I restorations and restorations placed using rubber dam presented better AFR. The main reason for failure observed was secondary caries (36.5%). An elevated number of failures were observed due to recurrent caries, highlighting the need for professionals to work with a health-promoting approach. The high variation on failure rate among the materials can be due to children's behavior during the procedure, which demands short dental appointments and a controlled environment.

Clinical and Radiographic Efficacy of Portland Cement as Pulpotomy Material in Human Primary Molar

Mineral trioxide aggregates (MTA) has been considered one of the most effective pulpotomy materials as it induces the formation of dentine at a greater rate with superior structural integrity, minimal inflammation and nominal hyperplasia. Portland cement (PC), posing the principal chemical elements with similar mechanisms of action, physical properties and biocompatibility like MTA, may be considered as effective alternative for the same. So, the objective of the study was to compare the clinical and radiographic outcome of Portland cement and mineral trioxide aggregates as pulpotomy material in primary teeth. A total of 40 patients having deep carious primary tooth with mild thermal sensitivity were enrolled in this study. Pulpotomy 20 patients were treated with Portland cement and the remaining 20 patients were treated with mineral trioxide aggregates, those considered as group A and group B respectively. Then, clinical and radiological examinations were performed at 3, 6 and 12 months interval to investigate the incidence of postoperative pain, swelling, dentinal bridge formation and root resorption. After a period of one year, a total of 60.0% teeth treated by Portland Cement and 50.0% teeth treated by MTA group came out successfully both clinically and radiographically. All these treated teeth that came out successful remained vital having no pain clinically along with radiological evidence of dentin bridge formation and absence of internal resorption. The difference between the tested groups was not statistically significant (p&gt;0.05). It can be considered that Portland cement (PC) can also be used as successful pulpotomy material as an effective and economic substitute of MTA.

Microleakage of glass ionomer based restorative materials in primary teeth: An In vitro study.

Using AutoCAD, we examined the microleakage of dye at the edges of primary-teeth restorations using three glass ionomer-based restorative materials. A total of 30 extracted noncarious primary molars were used. Class V cavities were adjusted on the buccal surfaces. The teeth were randomly divided into three groups of 10 teeth each as follows: Group A (Ketac Molar), Group B (Photac Fil), and Group C (Dyract XP). All specimens were stored for 24 h at 37°C in distilled water. The teeth were thermocycled 1000 times between 5°C ± 2°C and 55°C ± 2°C before immersion in 0.5% basic fuchsin for 24 h. Two mesiodistal cuts of each tooth were photographed under a stereomicroscope equipped with a digital camera. The dye-infiltrated surface area was measured. Statistical evaluations were performed by the Kolmogorov-Smirnov test, Levene test, one-way analysis of variance, and Tukey's honestly significant difference test. The mean microleakage ratio differed significantly among the groups (P < 0.05). Group C exhibited a significantly smaller area (P < 0.001) than the other groups. Group A had a nonsignificantly higher mean microleakage value than Group B (P > 0.05). Polyacid-modified composite resin may be a useful restorative material in primary teeth in terms of minimizing microleakage.

Direct Pulp Capping in Primary Molars using Mineral Trioxide Aggregate: An in Vivo Study.

To do a clinical and radiographic evaluation of the effectiveness of MTA when used as a direct pulp capping material in primary molars. Clinical and radiographic follow-up was performed on 30 primary molars with deep caries lesions in 30 patients from 3 to 9.75 years of age. Pulps exposed during cavity preparation were treated by direct pulp capping with MTA. The follow-up clinical and radiographic examinations were carried out at different time intervals: 6, 7-12, 13-18, 19-24, and >24 months after treatment. Twenty-four teeth were evaluated during the entire observation period. Positive clinical and radiographic outcomes were achieved in 19 teeth (13 teeth were saved and 6 were exfoliated). In five teeth, complications were observed only in children under 7 years old. Based on these clinical and radiographic results, MTA was found to be successful when used as a direct pulp capping material in primary teeth.

Bovine Tooth Discoloration Induced by Endodontic Filling Materials for Primary Teeth.

Objective. This study evaluated the discoloration potential of endodontic materials used in primary teeth. Material and Methods. Dentine-enamel blocks were prepared from 75 bovine teeth, assorted in five experimental groups (n = 15). The tested materials included an MTA-based material; zinc oxide and eugenol cement (ZOE); Vitapex; and calcium hydroxide thickened with zinc oxide (Calen + ZO). The color measurements were performed using a spectrophotometer at the following intervals: prior to (T0) and after placement of the filling (T1) and after 1 week (T2), 1 month (T3), 3 months (T4), 6 months (T5), and 9 months (T6). Data were submitted to ANOVA with repeated measures and Tukey's test. Results. The time had a significant effect on the color variation (ΔE00⁎) (p < 0.0001). The effect of the materials on the color variation (ΔE00⁎) was statistically significant (p = 0.004). Interactions between time and materials demonstrated a significant effect on the values (ΔE00⁎) (p < 0.0001). The ZOE cement showed the highest darkening effect (p = 0.018). Conclusion. The MTA-based material showed the smallest discoloration during the experimental time; however, it was similar to the other materials and to the control group. Zinc oxide and eugenol showed higher discoloration.

Eugenol Hypersensitivity in Pediatric Dental Patient: A Rare Case Report

ABSTRACT Eugenol is a phenolic compound commonly used in dentistry as an analgesic and anti-inflammatory drug. Zinc oxide eugenol is an important root canal filling material in primary teeth with excellent documented success. Its cytotoxic effect is documented in some cases due to production of zinc eugenolate which is highly unstable and induces type IV hypersensitivity reactions and even generalized anaphylactic symptoms. But, the case reports documenting immediate hypersensitivity reaction to eugenol are very rare. This was a case of type I immediate hypersensitivity reaction to eugenol in a 3 years old pediatric patient. During the full mouth rehabilitation under general anesthesia, hard indurated swelling of lower lip was observed at the time of obturation of mandibular primary teeth. The procedure was stopped immediately suspecting an allergic response which was later confirmed to be eugenol allergy by patch test. Hence, it is important to evaluate all local allergies even if the patient fails to report allergy history. How to cite this article Beniwal A, Chaturvedi S, Bhatt T, Sharma A, Nigam AG. Eugenol Hypersensitivity in Pediatric Dental Patient: A Rare Case Report. J Mahatma Gandhi Univ Med Sci Tech 2016;1(2):68-70.

Resorption of Extruded Obturating Material in Primary Teeth

The main objective in paediatric dentistry is to maintain primary teeth in the oral cavity till exfoliation. Endodontic therapy has to be done to treat infected pulp. Various obturating materials are zinc oxide eugenol (ZOE), iodoform, Vitapex, metapex, calcium hydroxide, Endoflas, etc. were used in primary teeth but none of these materials have the ideal obturating properties. In primary teeth, a tight apical seal, complete debridement of the canals and obliteration of the canal space is not always possible, even in pulpectomies that succeed. Because of open apices due to resorption there is no apical barrier that can prevent the extrusion of the filling material.