Pulpotomy Of Primary Molars Research Articles

Zinc Oxide Zinc Sulfate versus Zinc Oxide Eugenol as Pulp Chamber Filling Materials in Primary Molar Pulpotomies.

The long-term effect of Zinc oxide zinc sulfate (Coltosol®) dressing material on pulpotomy success and tooth survival has not yet been studied. This study compared the success rates of Zinc oxide zinc sulfate and zinc oxide eugenol as coronal dressing materials post radicular pulp amputation in primary teeth pulpotomies. This study included healthy two- to ten-year-old children who had pulpotomies on primary molars between 2012 and 2018 at the Pediatric Dentistry Clinic of the School of Dental Medicine. Data were analyzed at several follow-ups of up to 60 months. Kaplan-Meier survival curves were used to estimate survival probabilities of Zinc oxide zinc sulfate versus zinc oxide eugenol. In the 107 children included in this study, 54 teeth were filled with Zinc oxide zinc sulfate and 53 were filled with zinc oxide eugenol. Follow-up ranged from 12.2 to 73.3 months. Overall survival of Coltosol® vs. IRM filled teeth was 87.1% and 79.3%, respectively. Overall survival probabilities for Coltosol®-filled teeth at 15.5, 24 and 45 months were 95%, 89.8% and 79.7%, respectively, while for IRM they were 93.7%, 83% and 67.7%, respectively. Treatment failure rates and type of treated teeth did not differ between boys and girls (p-value = 0.77 and 0.87, respectively). Zinc oxide zinc sulfate and zinc oxide eugenol exhibited comparable high long-term success rates of up to five years (p = 0.16).

Comparative evaluation of the efficacy of chitosan and formocresol as medicaments for pulpotomy in primary molars: A clinical pilot study

Aim: To compare the clinical and radiographic effectiveness of chitosan and formocresol as pulpotomy medicaments in primary molars. Methods: Children of age 4-8 years old, who were physically and mentally healthy without any known medical history of systemic conditions contraindicating pulp therapy with at least one deep carious primary molars indicated for pulpotomy, were recruited. Pulpotomies were performed on 64 teeth divided into 2 groups, Group A (chitosan) and Group B (formocresol), followed by stainless steel crowns. Evaluation of clinical and radiological success was done at 1, 3 and 6 months follow up. Chi Square Test was used to compare the clinical and radiological parameters between study groups at different time intervals (p < 0.05) Results: Clinical success rate in both groups was 96.6% and radiographic success rate in chitosan was 96.6%, but formocresol was 89.6%. Conclusions: Chitosan was found to be an effective medicament for pulpotomy in primary molars. While chitosan also showed improved success rate compared to formocresol, it was not statistically significant.

A Clinical and Radiographic Assessment of Sodium Hypochlorite Versus Formocresol Pulpotomy in Primary Molar Teeth: 12-month Follow-up.

Objective: The aim of this study was to compare the clinical and radiographic success rates of pulpotomy in primary molars using formocresol versus sodium hypochlorite.Methods: Twenty-three children aged 4-9 years with at least two primary molars requiring pulpotomy were randomly allocated into two groups. All teeth received stainless steel crown after conventional pulpotomy procedure with either NaOCl or formocresol. Clinical and radiographic signs/symptoms were recorded at six and 12 months. Outcomes were statistically analyzed using Fisher’s exact test and Chi-squaretest.Results: Clinical success rates at 6 and 12-month follow-up in both groups was 100%. At 6-month follow-up, radiographic success rate for NaOCl and formocresol groups was 100%. At 12-month recalls, in NaOCl group, 20 teeth (87%) and in formocresol group, 21 teeth (91.3%) had radiographic success. No significant difference was found in the radiographic success rates at 12 months (P=1.00). Internal root resorption was the most common radiographic pathologic finding in both groups.Conclusion:Clinical and radiographic success rates in NaOCl group was comparable with formocresol group, so NaOCL can be suggested as an alternative for primary teeth pulpotomies. However further clinical studies with long-term follow-ups are needed.

Clinical and Radiographic Assessment of Propolis and Propolis Mixed with Chitosan Effect on Pulp of Primary Molars Versus Formocresol: A Randomized Controlled Trial

Purpose: To evaluate clinically and radiographically the postoperative success of Propolis, Propolis mixed with Chitosan and Formocresol in pulpotomy procedure for primary molars. Materials and Methods: 30 Primary molars in 10 patients were selected according to the inclusion criteria. In this study pulpotomy was carried out on 30 molars and depending on the type of radicular pulp medicament, the molars were divided randomly and equally into three groups: Group I (formocresol group), Group II (Propolis and Chitosan mixture group) and Group III (Propolis group). Clinical follow up was done after 1, 3 and 6 months. Periapical radiographs also were taken at 1, 3 and 6 months follow up visits. Results: No statistically significant difference between groups in the overall cumulative clinical or radiographic success at follow up visits P value ≤. 0.05 Conclusion: Propolis mixed with Chitosan can be considered as a good natural alternative to formocresol in primary molars pulpotomy.

Evaluation of Biodentine in Pulpotomies of Primary Teeth with Different Stages of Root Resorption Using a Novel Composite Outcome Score.

This study aimed to assess the success of pulpotomy in primary molars using Biodentine, new-developed tri-calcium, di-calcium-based silicate cement, at 6 and 12 months. The hypothesis was that stages of root resorption could influence the treatment success. A novel composite score was used based on five clinical and radiographic outcomes: soft-tissue pathology, pain to percussion, pathologic mobility, radiolucency and pathologic root resorption. Patients’ compliance and intraoperative pain experience were recorded using the Frankl scale and the Wong–Baker scale. A total of 22 primary molars, 9 in stage S (stability) and 13 in stage R (resorption) were submitted to pulpotomy using Biodentine and restored with composite resin. The success rate was 92.3% in the R group compared to 100% in the S group at both 6 and 12 months (p = 0.850). There was no statistically significant effect of type of molar, tooth position and type of carious lesions on the composite outcome (all p > 0.05). Overall, 73% of the children experienced no or mild/moderate pain and 77% had a cooperative attitude. Children younger than 7 years old experienced more pain (p = 0.04). Biodentine is a promising biomaterial for pulpotomy of primary teeth regardless of the stage of root resorption.

Comparison between MTA and Biodentine on treatment of accidently recent furcal perforation in primary molars : A prospective clinical trial

Objective : Pulptomy and pulpectomy usually are the most common techniques for pulp therapy for primary teeth and despite the relative ease of performing this techniques iatrogenic errors may occurs such as furcal perforation . MTA and biodentine were selected to test their ability to repair the furcal perforation in primary molars. Subjects and Methods : thirty patients with thirty accidently furcally perforated molars discovered at and sealed immediately at the same visit with either biodentine or MTA and then completed by conventional pulp therapy treatment either by pulptomy or pulpectomy then followed up clinically and radiographically for 12 months. Result: both materials showed highly success rate, the first group of MTA show 100% success. And group II Showed (93.3%) showed success with no significant difference (p= 1.000). Conclusion : MTA and biodentine can successfully used in treatment o f Iatrogenic recent furcal perforations that may occur during pulpotomy in primary molars.

POSTOPERATIVE PAIN EVALUATION OF MINERAL TRIOXIDE AGGREGATE AND PROPOLIS AFTER PULPOTOMY IN CARIOUS PRIMARY MOLARS: A RANDOMIZED CONTROLLED TRIAL

Aim: The aim of this study is to evaluate the postoperative pain of mineral trioxide aggregate (MTA) and propolis after pulpotomy in carious lower primary molars. Methodology: 28 Healthy children aging 5-8 years old with at least one carious primary molar at each side. Each child received MTA in right or left side and Propolis in the other side. Clinical follow up was done at 3, 6, and 9 months. Radiographic follow up was done at 6 and 9 months. Results: All cases were free of pain along the follow up period except one case in propolis group showed pain after 6 months then disappeared at 9 months. Sinus tract appeared in 3.85% in propolis group at 6 months and 4% in both groups at 9 months. Regarding periapical radiolucency, in MTA group, 3 cases (11.54%) were affected after 6 months and 4 cases (16%) after 9 months. In propolis, 4 (15.38%) of cases were affected after 6 months, and 6 (24%) of cases after 9 months. Furcation Involvement, appeared in MTA group, in 2 (7.69%) cases were affected after 6 months. While in propolis group, 6 (23.08%) cases were affected after 6 months. Conclusions: The clinical outcome of propolis is comparable to that of MTA at both 6 and 9 months follow up period. On the other hand, MTA showed better results in all radiographic outcomes when compared to propolis.

Long-term evaluation of primary teeth molar pulpotomies with Biodentine and MTA: a CONSORT randomized clinical trial.

Calcium silicate-based materials have become widely used in recent years due to their positive effect on pulp cells, which stimulate tertiary dentin formation. The aim of the present study was to evaluate and compare clinically and radiographically the performance of MTA and Biodentine as pulp-dressing materials following pulpotomy in primary molars at 24-month follow-up. Molars from patients aged 4-9years scheduled for pulpotomy were treated with either MTA or Biodentine followed by a stainless-steel crown. These molars were clinically and radiographically followed up at 6, 12, 18, and 24months. Statistical analysis was performed to detect differences between the two groups. A total of 84 pulpotomies were performed obtaining a total success rate of 99.4 and 97.2% for Biodentine and MTA, respectively, at 24months, showing no statistically significant differences between the two groups. 24-month follow-up showed that Biodentine and MTA have similar effectiveness.

A randomized clinical trial of two bioceramic materials in primary molar pulpotomies

Objective: To compare the success rates of iRoot BP Plus and mineral trioxide aggregate (MTA) used as pulp capping materials respectively in pulpotomies of human primary molars and to evaluate the clinical efficacy of iRoot BP Plus. Methods: Children who had at least one pair of carious primary molars and needed to receive pulpotomy under general anesthesia were selected in the present split-mouth trail from August to December, 2018. Each pair of the molars was randomly divided into iRoot BP Plus (experimental group) and MTA group (control group). Children were recalled after 3, 6 and 12 months of treatment both for clinical and radiographic evaluations. Relevant medical and radiographic records were collected. Success rates of two groups were compared and influence factors were analyzed. Results: Totally 20 children (10 boys and 10 girls), 28 pairs of split-mouth molars (56 molars, 28 in experimental group and 28 in control group) were included in the study. At the end of the study, 23 pairs of molars were received the 12-month follow-up. The success rates of 3, 6 and 12 months were 96% (25/26), 92% (22/24) and 87% (20/23) in the experimental group, and 100% (26/26), 96% (23/24), 96% (22/23) in the control group, respectively. There were no significant differences between each of the follow-ups in two groups (P>0.05). The success rate of iRoot BP Plus was significantly influenced by the time of hemostasis after amputating the coronal pulp (P<0.05). Conclusions: Pulpotomies of human primary molars with either iRoot BP Plus or MTA had favorable treatment outcomes. The iRoot BP Plus could be a promising biomaterial in pulpotomy.

Efficacy of Tactile Method versus Visual Method to Define Needle Insertion Site of Inferior Alveolar Nerve Block for Pulpotomy in Children: A double-Blind, Randomized, Cross-over Study

Background Effective pain control is a prerequisite for successful child dental treatment.This study was designed to evaluate the efficacy of tactile versus visual method to define needle insertion point of IANB for pulpotomy in children. Materials and Methods: In this double-blind, cross-over, randomized clinical trial, 40 children (7-9 years old) requiring primary mandibular second molars pulpotomy were recruited. Study was performed in Zahedan Dental School in 2016. Children were randomly divided into two groups. Group I received IANB using tactile method in the right side in the first session, and using visual method in the left side in the second session. Group II received the visual method for the right and the tactile method for the left in two sessions respectively. Objective and subjective pains during injection were recorded using SEM and FIS, respectively. Reaction during cavity preparation; recorded by SEM, was evaluated as sign of anesthesia failure. Data were analyzed using the Mann-Whitney U, Wilcoxon Signed Rank and Fisher's Exact Tests at a significance level of 0.05. Results: Regarding tactile method, comparing groups I and II showed no significant difference in any of the variables (P> 0.05). About visual method two groups showed a significant difference only in subjective pain (P= 0.013). In group I, visual method showed significant differences in objective and subjective pain versus tactile method (p <0.05). In group II, no significant differences were found between the two methods in variables. Totally, all variables were significantly different in favor of visual method versus tactile method (p <0.05). Conclusion The visual method reduced objective and subjective pain and yielded superior anesthesia success compared to tactile method.

Clinical and Radiographic Evaluation of Vital Pulpotomy in Primary Molar using Antioxidant Mix as a Novel Pulpotomy Medication versus Formcresol: A Randomized Clinical Trial.

Background: Formocresol (FC) reported high success rates when used in pulpotomy of primary molars , however many concerns have been raised regarding its mutagenicity, carcinogenicity, its local toxicity, Objectives: to assess the success rates of Antioxidant mix and FC, used as pulpotopmy agents in vital primary molars, both clinically and radiographically. Materials and Methods: Randomized clinical trial. Fifty-two (52) primary mandibular molars in thirty-five (35) children ranging in age from four to eight years were included in the study. Molars were divided into two equal groups (n= 26), Antioxidant mix (group 1) & FC (group 2) as a pulp medicament. All pulpotomized teeth were finally restored with stainless steel crowns. Subjects were monitored clinically & radiographically at three, six and nine months. Results: The clinical and radiographic success rates of Antioxidant mix & FC by the end of the nine months were [(84.6 & 46.2%) & (88.4 & 84.6%)] respectively. Conclusion: Antioxidant mix may not provide a reliable biological method for vital pulp therapy in primary molars.

Clinical and radiographic evaluation of the effect of salvadora persica as a pulpotomy medicament versus formocresol and calcium hydroxide

Objective: The objective of this study was to compare between the clinical and radiographic effects of three medicaments (Salvadora Persica SP, Formocresol and Calcium hydroxide) on non-vital pulpotomy of primary and young permanent molars. Subjects and Methods: The present study was a randomized controlled study comprised of 24 children. These teeth were classified into two equal groups. The patients were with age from 4-8 years old. In (Group 1) the radicular pulp of the primary teeth was capped with formocresol in (subgroup 1A) and SP in (subgroup 1B) after pulpotomy procedures. In (Group 2) the radicular pulp of young permanenet molar was capped with calclium hydroxide in (subgroup 2A) and SP in (subgroup 2B) after pulpotomy procedures. The teeth were assessed clinically and radiographically after 3 months. Result: The present study revealed that, in (Group1) the clinical and radiographic success rate of salvadora persica was 83.3%, while the success rate of formocresol was 100% . In (Group2) SP showed no success as a pulpotomy medicament for vital pulpotomy of young permanenet molars. Conclusion: Based on the present finding, it may be concluded that, - Salvadora Persica proved good clinical and radiographic result as a pulp medicament for non-vital pulpotomy of primary molars. - Salvadora Persica showed no success as a pulpotomy medicament for vital pulpotomy of young permanenet molars.

Comparative evaluation of diode laser and simvastatin gel in pulpotomy of primary molars: A randomized clinical trial.

Pulpotomy is a vital pulp therapy performed in carious pulp exposures in teeth in which the inflamed coronal pulp is removed and medicament is placed to conserve the vital root pulps. Recently, simvastatin which is a cholesterol-lowering drug has been found to be associated with the pulp regenerative potential. The aim of this parallel two-arm randomized control trial was to evaluate and compare the clinical and radiographic efficacy of diode laser (DL) and simvastatin gel (SG) in pulpotomy of carious primary molars. Hundred primary molars (in 98 children, 65 males, 33 females with age 4-8 years) requiring pulpotomy were randomized into the DL or SG group. Pulpotomy was performed as per the standardized protocol; thereafter, all teeth were restored with resin modified glass ionomer cement followed by stainless steel crowns. Follow-up evaluations were done at 3 and 12 months using clinical and radiographic criteria. Statistical analysis was done using Chi-square test at a significance level of 0.05. At 12 months, out of 92 teeth available for clinical and radiographic evaluation by blinded evaluators, DL group showed clinical and radiographic success rates of 76.1% and 52.1%, while SG group showed 80.4% and 65.2% success rates, respectively. There was no statistically significant difference between the efficacy of two techniques clinically (P = 0.49) or radiographically (P = 0.30). Both SG and DL had similar efficacy for primary tooth pulpotomy, clinically and radiographically after 12 months. Considering its ease of application and low-cost, SG can be recommended as a potential pulpotomy medicament in primary molars.

Ferric Sulfate Versus Calcium-Enriched Mixture Cement in Pulpotomy of Primary Molars: A Randomized Clinical Trial

Objective: To evaluate the postoperative pain and clinical and radiographic success of pulpotomized primary molars using two materials, Ferric Sulfate (FS) and Calcium-Enriched Mixture (CEM) cement, over a period of 3 and 6 months. Material and Methods: This randomized clinical trial was conducted on a total of 38 teeth selected from 19 patients aged 3-9 years. FS 15.5% and CEM cement were used as pulpotomy agents. Permanent restorations were Stainless Steel Crowns (SSCs) in both groups. Patients were recalled for follow-up at 3 and 6 months intervals for clinical and radiographic assessment. Postoperative pain was recorded by using Visual Analogue Scale up to ten days following the treatment. The data were statistically analyzed using chi-square test and repeated measures ANOVA. Results: At 6 months, a 100% clinical success rate was observed in the FS and CEM cement groups. The radiographic success rate in the FS group was 94.7%, whereas 100% in the CEM cement group at 6 months. No statistically significant difference was found between the two groups (p>0.05). There was no significant difference in postoperative pain between the teeth that received either FS or CEM cement as pulpotomy agents following the procedure (p>0.05). Conclusion: There were favorable outcomes of FS and CEM cement in pulpotomy of primary molar teeth.

The clinical and radiographic evaluation of Allium sativum oil (garlic oil) in comparison with mineral trioxide aggregate in primary molar pulpotomy.

Background:Mineral trioxide aggregate (MTA) is known as a common biomaterial for pulpotomy of primary molars, with limitation including high cost, difficult handling, and long setting time. This study was conducted to compare the clinical and radiographic success rate of Allium sativum oil and MTA in pulpotomy of primary molar teeth.Materials and Methods:This randomized, controlled, clinical trial was performed on a group of children with at least two symptom-free primary molars requiring pulpotomy. A total of 90 teeth were randomly assigned into two groups: After pulp amputation and hemostasis, Group I received MTA as medication in the pulp chamber and Group II received Allium sativum oil over the pulp stumps. Pulp chamber was then filled with reinforced ZOE paste (zinc oxide eugenol) and teeth were restored using stainless steel crowns. The follow-up scheme of 6, 12, and 18 months was set, and teeth evaluation was conducted by a calibrated pediatric dentist based on the modified criteria proposed by Zurn and Seale. The results were analyzed using the generalized estimating equation analysis with the P = 0.05 as the level of significance.Results:The clinical success rate was 100% in both groups after all follow-ups. The radiographic success rate was, however, 91.1% after 6.75. 6% after 12 and 18 months in Group II while it was 95.6% after 6, 91.1% after 12 and 18 months in Group I in those follow-up points. The difference between the two groups was not statistically significant.Conclusion:According to the results, Allium sativum oil has a high clinical and radiographic success rate comparable to those of MTA.

Evaluation of medicative endodontic materials in primary molar pulpotomy: a systematic review

Evaluation of medicative endodontic materials in primary molar pulpotomy: a systematic review

Comparison of anaesthetic efficacy of 4% articaine buccal infiltration versus 2% lidocaine inferior alveolar nerve block for pulpotomy in mandibular primary second molars.

Pain control and proper anesthesia during pulp therapy is one of the most important aspects of behavior management in pediatric dentistry. Aims: This study compared the success rate of inferior alveolar nerve block (IANB) using 2% lidocaine and infiltration using 4% articaine for pulpotomy of mandibular primary second molars. The present clinical trial was conducted on 40 children aged 5-8 referred to the Department of Pediatric Dentistry, Guilan University of Medical Sciences, who needed pulpotomy treatment in both mandibular second molars. The patients were randomly divided into two groups (A and B). At the first session, Group A received articaine infiltration and Group B experienced IANB using lidocaine. At the next visit, this trend was reversed. Pain intensity was measured upon the initiation of the pulp exposure using a facial image scale (FIS) and the patients' behavior during pulpotomy was measured using sound eye motor (SEM). Wilcoxon signed-rank test was used for the analysis of data. A significant level of differences was taken as P ≤ 0.05. According to FIS, the pain upon the initiation of the pulp exposure was significantly lower in the lidocaine group (P = 0.028). Patients' behavior was also significantly better in the lidocaine group according to SEM (P = 0.028). IANB using lidocaine has higher anesthetic efficacy in the pulp therapy of the mandibular primary second molars compared to articaine infiltration.

Photobiomodulation 810 nm Diode Laser and Formocresol for primary molar Pulpotomy: A Randomized Clinical Trial

Objectives: Low-level laser therapy (LLLT), commonly referred to as photobiomodulation therapy, has become a technique of interest due to its anti-inflammatory action. The aim of this study was to assess and compare the clinical and radiographic success rates of LLLT (PBM)1 and formocresol (FC) for pulpotomy in human primary teeth. Methods: This randomized split-mouth clinical trial included a sample of 106 primary molars from 36 children aged between 5-8 years. Selected teeth were equally assigned to two groups: LLLT (PBM) and FC groups. The treated teeth were evaluated clinically after 3 and 9 months and radiographically after 9 months. Mc-Nemar test was used to compare the outcomes between groups. Results: After 3 and 9 months, the clinical success rates were 98% for both groups. The radiographic success rates were 100% in the LLLT (PBM) group and 98% for the FC group at the 9-month follow-up interval. Conclusions: Our results suggest that LLLT (PBM) yielded favorable initial outcomes when compared to FC in human primary molar teeth over a 9-month follow-up period. Further studies with a longer follow-up period is still required in addition to histological studies for the potential healing effects of LLLT (PBM) to support the initial clinical and radiographic outcomes. Trial Registration: This trial was retrospectively registered at ClinicalTrials.gov under the ID, NCT03782714, on 22nd of December 2018.

Success of Biodentine and Ferric Sulfate as Pulpotomy Materials in Primary Molars: A Retrospective Study.

To determine the clinical and radiographic success of Biodentine® (BD) and Ferric Sulfate (FS) as primary molar pulpotomy materials and to compare their outcomes. Retrospective data was obtained from the electronic health records (EHR) of a university-based pediatric dental clinic. Participants were enrolled according to specified inclusion and exclusion criteria. Two trained and calibrated examiners evaluated the EHR using validated criteria for clinical and radiographic outcomes. Study data was numerically coded and analyzed. Cohen's Kappa and Chi-square tests were used (p<0.05). Eighty-three participants (62.7% females, age range two to eight years, average age of 4.5 years) with 102 pulpotomies were enrolled. FS was used in 78% (n=79) and BD in 22% (n=23) of the cases. Follow-up periods ranged from six to 36 months (mean of 17 months). BD showed 100% clinical and radiographic success, while FS demonstrated 84% clinical and 70% radiographic success. The two groups were compared at one year with no statistically significant differences. At 18 months, BD outperformed FS clinically (p=.012) and radiographically (p=.001). Intra-rater and inter-rater agreement were κ>0.88. Both materials can be recommended for clinical practice, however BD may be the preferred choice for its better outcomes at 18 months.

Evaluation of A Light-Cured Calcium Silicate (Theracal Lc) in Primary Molars Pulpotomy after 12 Months; A Randomized Controlled Trial

Evaluation of A Light-Cured Calcium Silicate (Theracal Lc) in Primary Molars Pulpotomy after 12 Months; A Randomized Controlled Trial