Pulp Treatment Of Primary Teeth Research Articles

Comparative Study of Calcium Phosphate versus Formocresol in Pulp Treatment of Primary Teeth

:Purpose: Clinical and radiographic evaluation of the postoperative success of Calcium Phosphate and formocreosl (FC) materials in pulpotomy treatment of primary teeth. Materials and Method: 75 Primary molars in 25 patients were chosen according to specific criteria. Teeth were devided depending on the pulpotomy material into 3 groups: Group I (Calcium phosphate with physiologic saline cleansing group), Group II (Calcium phosphate with Sodium hypochlorite) and GroupIII (formcresol group). This was followed by clinical follow up after 1, 6 months and a year. In addition, Periapical radiographs were collected post-operatively, 6 and 12 months visits. Results: Despite decreasing with time, the results showed no statistically significant difference in the cumulative clinical success between all three groups on the study period. Also, Radiographic success had a similar pattern over a year with no significant difference between groups. Conclusion: Calcium Phosphate as a pulpotomy material was observed to be a valuable alternative to regularly used formocresol with greater biocompatibility, mouldability, and osteoconductivity.

Comparative Study of Calcium Phosphate versus Formocresol in Pulp Treatment of Primary Teeth

:Purpose: Clinical and radiographic evaluation of the postoperative success of Calcium Phosphate and formocreosl (FC) materials in pulpotomy treatment of primary teeth. Materials and Method: 75 Primary molars in 25 patients were chosen according to specific criteria. Teeth were devided depending on the pulpotomy material into 3 groups: Group I (Calcium phosphate with physiologic saline cleansing group), Group II (Calcium phosphate with Sodium hypochlorite) and GroupIII (formcresol group). This was followed by clinical follow up after 1, 6 months and a year. In addition, Periapical radiographs were collected post-operatively, 6 and 12 months visits. Results: Despite decreasing with time, the results showed no statistically significant difference in the cumulative clinical success between all three groups on the study period. Also, Radiographic success had a similar pattern over a year with no significant difference between groups. Conclusion: Calcium Phosphate as a pulpotomy material was observed to be a valuable alternative to regularly used formocresol with greater biocompatibility, mouldability, and osteoconductivity.

Update in the Diagnosis and Treatment of Root Canal Therapy in Temporary Dentition through Different Rotatory Systems: A Systematic Review.

The need to perform fast, effective and efficient pulpectomies has led to the development of numerous valid rotary systems. Its technical features allow the clinician to obtain good results in less working time. The objective of this study is to compare the characteristics of the different current rotary systems to favor a correct diagnosis and subsequent treatment. A systematic review of the literature has been carried out in accordance with the PRISMA recommendations. A search was carried out in PubMed, Embase Scopus, Cochrane and Web of Science databases, and was completed with a manual search. The following variables were extracted from the selected studies: author, year, sample, rotary systems used (length, diameter, taper, speed), obturation material and irrigant. From the initial electronic search of the five databases, 315 articles were identified. Once the duplicate articles were eliminated, a total of 233 remained. After reading both title and abstract, 200 articles were eliminated, leaving 33. On account of reading the full text, 22 were eliminated for not answering the research question or the inclusion criteria, leaving a total of 11 articles for the systematic review. Rotary systems which are able to adapt to the root anatomy of primary teeth and allow rapid and simple instrumentation, without producing excessive extrusion of debris at the root apex, will be the ones that provide the best results to the pediatric dentist during the performance of pulp treatment in primary teeth. Clinical success will only be achieved through proper prior diagnosis.

Biocompatibility, Bioactivity and Gene Expression Analysis of SHEDS Cultured in Various Calcium Silicate Based Cements: A Systematic Review and Meta-Analysis of in Vitro Studies.

To assess the biocompatibility, bioactivity and gene expression analysis of SHEDs incubated in various Calcium Silicate Based Cements. Following PRISMA statement, a search was carried out in the electronic databases-PubMed, Scopus, Embase, Google Scholar, JSTOR, and DOAJ from January 2000 to 31 May 2021. In vitro trials examining the response of SHEDs to the treatment with CSCs were eligible. 10 trials were included after the selection process. These trials involved the assessment of cell viability, cell migration, cell adhesion, mineralization potential and gene expression analysis of SHEDs cultured in MTA, Biodentine, EndoCem Zr, RetroMTA, TheraCal & iRoot BP plus. MTA, Biodentine, EndoCem Zr, RetroMTA and iRoot BP showed adequate biocompatibility, bioactivity and genetic expression towards SHEDs, to support their clinical use in vital pulp treatment of primary teeth.

Clinical Outcome of Direct Pulp Therapy in Primary Teeth: A Systematic Review and Meta-analysis.

Direct pulp treatment is carried out when a healthy pulp gets mechanically/accidentally exposed during the operative procedures or trauma. To determine the effects of various direct pulp capping materials as measured by the clinical and radiographic analysis. Two reviewers performed a database search of the studies published between January 2005 and November 2020. The inclusion criteria were papers published in the English language; children aged 3-12 years having deep carious lesions in primary teeth. All potential studies were acknowledged by their title and abstract. The full-text analysis of potentially relevant studies, the selected studies were included in the systematic review. A meta-analysis calculation was performed for the overall data and the subgroup data. The database searching led to 57 articles, which were of direct pulp treatment in primary teeth, after the removal of duplicates, 55 records remained but did not meet all inclusion criteria. A high variability was observed among the papers. Further filtering with criteria led to nine articles, which met all inclusion criteria. Meta-analysis demonstrated the success rates of DPT in primary teeth (95% confidence interval -0.799-0.898); P < 0.001. Clinical assessments of various direct pulp capping materials suggested 84.9% of success irrespective of the material used. The nine studies were heterogeneous according to the random effect model (P < 0.001, I2 = 84.08%). Direct pulp treatment has the advantage of being a conservative vital pulp therapy reducing the need for a more invasive treatment.

Clinical, radiographic, and histological evaluation of three different pulp-capping materials in indirect pulp treatment of primary teeth: a randomized clinical trial.

The aim of this randomized, controlled, three-arm parallel group, and double-blinded clinical trial was to evaluate the clinical, radiographic, and histopathological success of three different pulp-capping materials in one-stage indirect pulp treatment of primary teeth. The study included a total of 109 patients aged 5-9years who had primary teeth with deep carious lesions and symptoms of reversible pulpitis. The teeth were divided into three groups according to the pulp-capping agents: (I) hard-setting calcium hydroxide (Dycal) (control group) (n = 36), (II) bioactive tricalcium silicate (Biodentine) (n = 37), and (III) resin-based tricalcium silicate (TheraCal LC) (n = 36). All the teeth were evaluated clinically and radiographically at 6, 12, 18, and 24months postoperatively. A total of 23 primary mandibular second molars that were in their regular exfoliation period (24-40months) were extracted and fixed in 10% formaldehyde solution. The specimens were evaluated histologically to assess the integrity of the odontoblastic layer, tertiary dentin formation quality of the dentin formed, severity of pulpitis, and other pulpal changes. Data were analyzed using Fisher's exact test, Pearson's chi-square test, and McNemar's test (p = 0.05). At the end of the 24-month follow-up period, the clinical and radiographic success rates for Dycal, Biodentine, and TheraCal LC were 100%, 100%, and 93.3%, respectively, and there was no significant difference among the groups (p > 0.05). However, the TheraCal LC group was statistically unsuccessful when compared to the other groups with regard to the integrity of the odontoblastic layer, severity of pulpitis, and other pulpal changes in histological examination (p < 0.05). Indirect pulp capping exhibited high clinical and radiographic success rates in the treatment of primary teeth regardless of the chosen pulp-capping agent. However, histological examination indicated that the pulp status was affected by the chosen capping material especially when selecting a resin-containing material such as TheraCal LC. Resin-free calcium silicate-based materials appear to be more favorable in the indirect pulp treatment of primary teeth, particularly in young-age groups that require long-term success.

Proteção da vitalidade dentino-pulpar em odontopediatria: uma revisão de literatura

Dentin and pulp are considered interdependent substrates, known as the dentin-pulp complex. In front of injuries such as caries and trauma, this complex should be protected with restorative materials considered to be protective agents. An ideal material should have properties such as biocompatibility, be antimicrobial, be insoluble in the oral environment, be thermal and electrically insulating, have therapeutic potential, and adequate mechanical properties. As these characteristics are not found in all materials, the dentist must know the advantages and disadvantages of those that are available. This study aimed to perform a critical review of the indirect materials indicated for the protection of dentin-pulp vitality (PDPV) to ensure the success of indirect pulp treatment in primary teeth. A search was carried out in books, theses, dissertations, monographs, printed articles and databases, PubMed, SciELO, and MEDLINE. According to the literature, the success in protecting the dentin-pulp vitality is achieved through an excellent marginal seal, preventing bacterial infiltration in the dentin and controlling the progression of caries. Further clinical studies are needed to evaluate other outcomes after indirect pulp treatment. There isn’t a material that has all the desired characteristics for PDPV, and recent studies show that the key to PDPV isn’t found in the protective material, but in the restorations marginal sealing, enabling the inactivation of the progression of dental caries.

For pulp treatment in primary teeth, rotary canal instrumentation may be modestly time efficient, but otherwise similar to manual canal instrumentation

A systematic review and meta-analysis of randomized clinical trials comparing rotary canal instrumentation techniques with manual instrumentation techniques in primary teeth. Manchanda S, Sardana D, Yiu CKY. Int Endod J. 2020;53(3):333-353. Information not available. Systematic review with meta-analysis of data.

Effects of National Dental Screening on Dental Caries Experience, Treatment, and Cost in Children

This study aimed to evaluate the effects of national dental screening for children in Korea in the aspects of prevention of dental caries, the number of treatments related to dental caries, and cost of dental care.The study used the national cohort data on children health screening provided by National Health Insurance Service, and analyzed 32,937 1st dental screening, 22,608 2nd dental screening, 13,708 3rd dental screening, and 241,043 cases from the dental care of 27,944 children born in year 2008 and 2009. The decayed-filled teeth index and decayed-filled person rate, calculated from the results of the 2nd and 3rd dental screening, decreased as the number of preceding dental screening increased. Glass ionomer and amalgam restoration, pulp treatment of primary teeth and extraction of primary canine and molar were shown to decrease as the number of examined dental screening increased, and the total cost of dental care covered by national health insurance also decreased as the number of dental screening increased.In conclusion, national dental screening for children is an efficient and economical oral health care method that prevents dental caries and lowers the possibility of dental caries related treatment, thereby reducing cost of dental care.

Evaluation of Three Different Pulp Capping Materials in Indirect Pulp Treatment of Primary Teeth

Evaluation of Three Different Pulp Capping Materials in Indirect Pulp Treatment of Primary Teeth

Twoyear outcomes and the influence factors of indirect pulp treatment in primary teeth: a retrospective study

To evaluate the outcomes and to find out the influence factors of indirect pulp treatment in primary teeth. Children who received indirect pulp treatment in primary teeth in the Department of Pediatric Dentistry in Peking University School and Hospital of Stomatology from August, 2014 to September, 2016 were collected in the Electronic Medical Record Database of Peking University School and Hospital of Stomatology, via the database for scientific research provided by the corporation of Kaientai. The children selected as the subjects of this study were followed up over 1.5 years, and they were under 9 years old if in the group of primary molars while the children in the group of primary anterior teeth were under 4 and a half years old. Those children who were not reviewed regularly or didn't have complete medical records were removed. Basic information, the relevant medical records and radiographic records of those children were collected. All teeth were examined clinically and classified into 2 outcomes, teeth in group H were regarded as succeeded, and teeth in group P were regarded as failed. Survival analysis was applied. The survival rate and survival time of the deciduous teeth calculated. Multivariate analysis was performed by using Cox proportional hazard model. One hundred and six children were finally included, aged from 1.6 to 8.8 years, with the mean age of (5.0±1.7) years. 168 primary teeth (122 primary molars, 46 primary anterior teeth) were included, and the average follow up time was (729±244) days. Thirty-five primary teeth (23 primary molars, 12 primary anterior teeth) failed upon clinical or radiographic examinations by September, 2018. The cumulative survival probability of half a year, one year, one year and a half, two years, two and a half years for the indirect pulp treatment was 93.5%, 92.9%, 87.5%, 82.7%, and 75.5% through the KaplanMeier method, respectively. Through the analysis of Cox proportional hazard model, in primary molars, the survival probability tended to be lower when the number of tooth surface affected by caries was greater (OR=1.709, P<0.05). Compared with primary molars, the survival probability of primary anterior teeth was lower, but the difference was not significant. Complying the current instructions in our department, the cumulative survival probability of two and a half years after the indirect pulp treatment in primary teeth was 75.5%. In primary molars, the survival probability tended to be lower when the number of tooth surfaces affected by caries increased.

Comparative Study of Some Natural Materials Versus Traditional Medicaments used for Pulp Treatment of Primary Teeth

Purpose: To evaluate clinically, radiographically and histologically the postoperative success of Miswak, Allium sativum and Nigella sativa extracts use in pulpotomy procedures for primary teeth Materials and Method: 92 Primary teeth found in 26 patients were selected according to inclusion criteria. In the first part of the study pulpotomy was accomplished in 20participants having 80 teeth and depending on the type of radicular pulp medicament, the teeth were divided randomly and equally into four groups: Group I (Miswak group),GroupII (Nigella sativa group),GroupIII(Allium sativum group) ,Group IV(formocresol group). Clinical follow up was done after 1,3, and 6 months.Periapical radiographs also were taken at 3and 6months follow up visits only. In the second part of the study 12 primary molars planned for extraction due to orthodontic purpose were treated by pulpotomy procedure and then the teeth were grouped into four groups and then the teeth extracted after 2 months and were observed under light microscope. Results: No statistically significant difference between groups in the overall cumulative clinical or radiographic success at follow up visits. Histopathological examination revealed dentine bridge formation in primary molars treated with Miswak, Nigella sativa treated primary molars showed absense of odontoblastic layer, Allium sativum showedwell organized odontoblastic layer and chronic inflammatorycellular infiltration, whileformocresolspecimens showed sever hyperemia and hyalinization of pulp stroma. Conclusion: Miswak, and Allium sativum can be considered as good natural alternatives to formocresol in primary molars pulpotomy,however Nigella sativa cannot be a suitable substitute to formocresol.

Materials used for indirect pulp treatment in primary teeth: a mixed treatment comparisons meta-analysis.

This study aimed to systematically review the literature to address the question regarding the influence of different materials in the clinical and radiographic success of indirect pulp treatment in primary teeth. A literature search was carried out for articles published prior to January 2017 in PubMed/MEDLINE, CENTRAL, Scopus, TRIP and ClinicalTrials databases; relevant articles included randomized clinical trials that compared materials used for indirect pulp treatment in primary teeth. Two reviewers independently selected the studies and extracted the data. The effects of each material on the outcome (clinical and radiographic failures) were analyzed using a mixed treatment comparisons meta-analysis. The ranking of treatments according to their probability of being the best choice was also calculated. From 1,088 potentially eligible studies, 11 were selected for full-text analysis, and 4 were included in the meta-analysis. In all papers, calcium hydroxide liner was used as the control group versus an adhesive system, resin-modified glass ionomer cement or placebo. The follow-up period ranged from 24 to 48 months, with dropout rates of 0-25.7%. The material type did not significantly affect the risk of failure of the indirect pulp treatment. However, calcium hydroxide presented a higher probability of failure. In conclusion, there is no scientific evidence showing the superiority of any material used for indirect pulp treatment in primary teeth.

Dental Concerns of Children with Down’s Syndrome - An Overview

Down’s syndrome is a condition known to be associated with a chromosomal abnormality. This is usually in the form of three in place of a pair of chromosomes 21, hence the name ‘trisomy 21’ the incidence of Down’s syndrome in the population has been variably estimated between 1 and 4 per 1000 and which occurs in all races. These children are mentally retarded to some degree, they are generally smaller than average in height for their age, Midface dysplasia, flat broad bridge of the nose, “lop” ears, Epicanthal folds with slanting almond-shaped eyes which was responsible for the term mongoloid. The majority of the children exhibit brachycephaly (broad, short head) and lack of supraorbital ridges and hypotelerism, Absence of frontal sinuses and absent or reduced maxillary sinuses, nasal septum or nasal conchl deviations are often observed which can produce a partially obstructed or narrow air passage and can contribute to the problem of mouth breathing, prone to infections especially upper respiratory tract infections. They have congenitally missing lateral incisors, the morphology of the teeth may also be affected. Teeth are smaller than normal, peg shaped and tend to be rounded or bulbous, roots of the incisors are short and most of the children are having tongue thrusting habit with lack of lip seal and high frenal attachment. They have a remarkable resistance to dental caries and at least half of them are caries free, preventive procedures along with chlorhexidine mouth wash may be beneficial and they suffer from a moderate to severe degree of periodontal disease. Down’s syndrome children with congenital heart disease extractions and deep scaling should be done under antibiotic coverage and pulp treatment in primary teeth is contraindicated in patients with cardiac problems because of the risk of bacteremia whereas in permanent teeth it can be considered if an adequate apical seal can be obtained. Both orthodontic and prosthodontics appliances are usually contraindicated. Nitrous oxide analgesia or Tell show do in mildly apprehensive patients can be used, general anesthesia in severe resistance to dental treatment. This article discusses about etiological factors, clinical features and management aspects.

Clinical and Radiographic Evaluation of Success of Two commercially Available Pulpotomy Agents in Primary Teeth: An in vivo Study

The aim of this study is to evaluate and compare Biodentine and mineral trioxide aggregate (MTA) as pulpotomy agents by clinical and radiological assessments in primary teeth. In this study, 90 decayed primary molars indicated for pulpotomy were chosen and are divided into two groups. Soft enamel and dentinal caries were removed using spoon excavator. Access opening was done using highspeed cool water handpiece. Normal saline was used to irrigate pulp chamber, later saline moistened cotton pellet was used to obtain hemostasis in both groups. Restorations were placed in respective groups and immediate postoperative radiographs were taken. Follow-ups were done at every 3 months intervals, i.e., 3, 6, 9, and 12 months respectively. Statistical evaluation was carried out by using paired t-test which showed no significant difference between the two groups (p ≥ 0.05) with high success rate of 95.5%. Pulpotomy with MTA and Biodentine is a reliable biological method for pulp treatment of primary teeth. Mineral trioxide aggregate and Biodentine could be considered as a reliable biological method for pulp-otomy of primary teeth.

Treatment of primary teeth using formocresol pulpotomy for patients attending a University Dental School Clinic: best practice implementation project

Background Dental caries is a significant worldwide dental health problem with high prevalence rates in primary teeth. Pulp treatment of primary teeth provides an alternative option to extraction when decay spreads into the pulp. Formocresol is the medicament of choice in the treatment of reversible pulpitis in the University of Ghana Dental School. Objectives The aim of this project was to audit the current practice in the use of formocresol pulpotomy in the treatment of reversible pulpitis, identify barriers and implement a plan of action to conform to best practice, re-audit findings and implement future projects based on these findings. Methods Records of 20 patients who had undergone formocresol pulpotomy were retrieved. A base line audit using the criteria as outlined in Joanna Briggs Institute (JBI) Practical Application of Clinical Evidence System (PACES) program was conducted. Barriers were identified and action plan implemented for a follow up audit using different patients but the same sample size. Results In four of the criteria, which were 100% at the baseline level, there was no change. The rest of the criteria showed a marked improvement in results. The formulation of a treatment protocol and the improvement of supervision greatly contributed to the outcomes. Conclusions Through the use of JBI PACES to conduct an evidence based audit in the use of formocresol pulpotomy in the treatment of reversible pulpitis, practical implementation of strategies proved effective to overcome barriers encountered, and successful post implementation audit results were achieved.

Retrospective Study of Pulpectomy with Vitapex® and LSTR with Three Antibiotics Combination (3Mix) for Non-Vital Pulp Treatment in Primary Teeth

Pulpectomy with Vitapex ® and Lesion Sterilization and Tissue Repair Therapy (LSTR) with 3Mix MP are treatment options for non-vital pulp treatment in primary teeth. The outcomes of both treatments have been reported, but with limited follow-up periods. Moreover, the factors relevant to their success have yet to be determined. The aim of this research was to evaluate the success of non-vital pulp treatments with Vitapex® pulpectomy and LSTR with 3Mix MP in different follow-up periods and to determine the factors that influence success of the treatment. This was a retrospective study of 73 teeth that had non-vital pulp treatment, either with Vitapex® or 3Mix MP, in healthy children, aged 3-10 years, at the Pediatric Dentistry Clinic, Chiang Mai University, Thailand. The records included clinical and radiographic examinations at follow-up periods ranging from 6-72 months. Success rates of both groups and the various factors that may influence success were determined by descriptive analysis. Including all follow-up periods (from 6 to 72 months), the average success rates of the Vitapex ® group determined by clinical and radiographic evaluations were 89.0% and 64.6%, respectively. The success rates of the 3Mix MP group determined by clinical and radiographic evaluations were 84.6% and 65.2%, respectively. The influences of various permanent restorations and the time elapsed between the temporary and permanent restorations were found to influence the success of non-vital pulp treatment in primary teeth. Both pulpectomy with Vitapex ® and LSTR with 3Mix MP were acceptable treatment options of non-vital pulp treatment in primary teeth.

Materials for primary tooth pulp treatment: the present and the future

Many materials have been used for pulp treatment in primary teeth, but not many of them are extensively supported in the dental literature. In recent years, new materials have been introduced along with new procedures, and these will be reviewed in this article. Many of these new materials have shown promising results in the short run but can only be thoroughly evaluated after longer use and more extensive applications. There is clearly a need for long‐term studies to identify the best materials for pulp treatment of primary teeth.

Mineral trioxide aggregate and formocresol pulpotomy of primary teeth: a 2‐year follow‐up

To compare the clinical and radiographic response of primary teeth to vital pulpotomy using mineral trioxide aggregate (MTA) or formocresol (FC). A group of 17 children aged 4-9 were selected from those referred to the Paedodontic Department at Shahid Beheshti University, Dental School. Cases with at least two matching teeth were selected (40 teeth), showing signs of pulp involvement. A pulpotomy procedure was carried out in all cases with FC in control teeth whilst MTA was placed in experimental teeth. Clinical and radiographic evaluations were performed at 1-, 6-, 12- and 24-month recall. Statistical analysis using a Fischer exact test was performed on the data to determine significant differences between the groups. Overall, 22 second and 18 first primary molars were included. The gender ratio was one male to three female. No significant difference was found between the clinical and radiographic outcomes of the two groups at 6-, 12- and 24-month follow-up (P > 0.05). Internal resorption was seen significantly more often in FC cases after 12 months than MTA cases. Overall radiographic appearance of normal structures at 24th month was seen in more than 95% of the cases in MTA and 90% in the FC-treated group (P > 0.05). Mineral trioxide aggregate for pulp treatment of primary teeth can be considered a replacement for FC.

Vital pulpotomy in primary teeth with mineral trioxide aggregate (MTA)

SUMMARY Mortal pulpotomy is the most commonly used technique in Bulgaria for treatment of pulp chronic infections in primary teeth. Data from the special literature reveal another method for pulp treatment in primary teeth – vital pulpotomy associated with good adaptive healing response. During the past several years, special attention has been paid to Mineral Trioxide Aggregate -MTA as probable alternative of formocresol. According to the current trends in dental medicine about cessation of arsenic usage and limitation on formalin – containing medicaments usage, there will be a revision of commonly used method of mortal amputation, including application of arsenic, tricresolformalin, resorcine or resorcine –formalin solutions. The aims of this study are to aprobate and popularize the technique of vital pulpotomy in primary teeth with MTA. The study was carried out with children (the children’s age was 4 – 8 years) with primary molars approximately equally affected by a carious process which had reached the dental pulp and had to be treated. The total number of studied primary teeth was 33. The methodology is “one visit” and was performed following equal clinical protocol for all teeth. The pulp stump was covered with an MTA paste- Angelus (Solucoes Odontologicas, Londrina, Brazil), prepared by mixing MTA powder with sterile saline using 3:1 powder/saline ratio. Restoration of the teeth was performed with GIC. All treated teeth were follow-up clinically and radiographically during 6 months, at 6 and 12 month after vital pulpotomy. Results: The success rate of all pulpotomized teeth with MTA was 100 % after 6 months and shows statistically insignificant decrease to 90, 9% after 12 months (p > 0, 05). The number of teeth with unsuccessful treatment is 3 or 9, 1 %. Conclusion: Vital amputation with MTA is a reliable biological method for pulp treatment of primary teeth and could be recommended for the clinical practice. Despite the advance in knowledge about the onset, nature, progression, prevention opportunities and nonoperative treatment of carious process, the disease and its complication are still main clinical problem (23). Extensive dental decay in the primary dentition, that reaches and progresses to the dental pulp, remains a serious problem in