Pulpotomy Material Research Articles

Histopathological and immunohistochemical profiles of pulp tissues in immature dogs’ teeth to two recently introduced pulpotomy materials

ObjectiveThe pulpal response to Hoffmann’s Pulpine mineral (PMIN) and Pulpine NE (PNE) was compared to mineral trioxide aggregate (MTA) when used as pulpotomy materials in immature permanent teeth in dogs.Materials and methodsImmature premolars were randomly divided according to the observation period into three equal groups (n = 24) (10 days, 30 days, and 90 days) then furtherly subdivided into 3 subgroups according to the material used. Histopathological analysis regarding inflammatory cell infiltration and dentin bridge (DB) formation was done. Immunohistochemical analysis was performed using osteopontin marker.ResultsThe results showed that after 90 days, both MTA and PMIN subgroups had 100% complete thick DB without inflammation in 87.5% of the samples, while the PNE subgroup failed to form DB in 37.5% of the samples and 50% of samples showed thin initial DB with heavy inflammation in 62.5% of the samples. There was no significant difference between MTA and PMIN, while there was a statistically significant difference between PNE and the two other subgroups in DB formation and inflammatory cell infiltration (P > 0.05). After 90 days, MTA showed the highest mean value of osteopontin positive fraction area followed by PMIN without statistically significant differences, while the least value was recorded in PNE subgroup with statistically significant difference with the remaining subgroups (P < 0.05).ConclusionPMIN is a promising alternative to MTA when used for pulpotomy.Clinical relevanceVital pulp therapy in immature teeth can be done using PMIN as an alternative to MTA.

CLINICAL AND RADIOGRAPHIC EVALUATION OF NANOHYDROXYAPATITE AND PLATELETS-RICH FIBRIN AS PULPOTOMY MATERIALS FOR PRIMARY MOLARS

Objectives: Pulpotomy works to retain a healthy tooth in the mouth till exfoliation by protecting the radicular pulp. The coronal pulp must be removed, and the radicular pulp must be given medication, in order to maintain the tooths health and function. Subject and Methods: The children who took part in this clinical investigation were chosen aged 4 to 8 years old, following approval from the Ethical Committee and obtaining signed informed consent from their parents. Based on the type of pulpotomy material used, the NHAp group and the PRF group, and 40 mandibular primary teeth that needed pulpotomy treatment were split into two groups (n=20). The split-mouth prospective clinical trial design for this study was authorized. Three distinct follow-up intervals of 6 weeks, six, and twelve months were used to note and evaluate the clinical and radiological outcomes. Results: The teeth treated with PRF had improved clinical and radiographic outcomes at the three distinct follow-up intervals of 6 weeks, 6, and 12 months, but there was no statistically significant difference between them and the teeth treated with NHAp. Conclusion: The results of the pulpotomized primary molars clinical and radiographic outcomes could be improved by using PRF as a pulp dressing agent.

A histopathological comparison of formocresol, propolis, and growth factor as pulpotomy medicaments in primary teeth: An in vivo study

Pulpotomy is the most common pulp treatment of primary molars, where surgical amputation of infected coronal pulp results in preserving the vitality and function of radicular pulp. With introduction of newer materials, the emphasis has shifted towards regeneration, in this scenario; novel materials such as platelet derived growth factor (PDGF) and propolis (PS) have been considered. This was a single-blind in vivo study; ninety human primary teeth from children aged between 5 and 10 years were divided into three equal groups in whom pulpotomy procedure was performed and they were recalled after 3- and 6-month interval for histological evaluation. Observations were subjected to statistical analysis using Pearson's Chi-square test. No statistically significant difference was found between the three materials with respect to inflammatory response, soft-tissue organization, and dentin bridge formation (P > 0.05). Majority of the samples in both growth factor and propolis exhibited dentin bridges at the interface of the exposed pulp, bringing or attempting to bridge the site exposed to the pulpotomy material. The ability of the material to evoke a foreign and inflammatory cell response in the pulpal tissue was not significant. The samples of both formocresol and growth factor group showed signs of pulpal necrosis which revealed the presence of a mild necrotic zone in one specimen at 3 months. One specimen from the propolis group showed mild areas of necrosis at the end of 6 months, where none of the specimens in the growth factor group showed areas of necrosis at the end of 6 months. The results of the present study showed a positive outcome for growth factor and propolis groups. Further clinical trials with a larger sample size and long-term review have to be conducted for the material to be used widely.

Effect of sonication and reflux treatment on silica characteristics of rice husk ash as raw material for dental pulpotomy

Abstrak. Penelitian ini bertujuan untuk mengekstraksi dan memunikan silika dari abu sekam padi (ASP) dan melihat karakteristik silika yang dihasilkan apabila diberi perlakuan sonikasi dan refluks. Metode yang digunakan dalam penelitian ini adalah sol-gel menggunakan pelarut NaOH dan HCl kemudian diberi perlakuan sonikasi dan refluks serta pencucian untuk meminimalisir keberadaan natrium pada silika yang dihasilkan. Berdasarkan penelitian yang dilakukan, presentase silika dari metode sonikasi dan refluks adalah 96,4% dan 93%. Silika yang dihasilkan dari kedua metode mempunyai fase amorf dengan puncak melebar pada (2θ) 22º. Spektra FTIR antara kedua metode tidak menunjukkan perbedaan dengan puncak pada pita serapan 470 cm-1, 802 cm-1, dan1103 cm-1 yaitu vibrasi dari Si-O siloksan (≡Si-O-Si≡). Pita serapan 3448 cm-1 adalah vibrasi ulur –OH dari silanol (≡Si-OH). Citra SEM menunjukkan bentuk yang berbeda pada silika yang dimurnikan dengan metode sonikasi dan refluks yaitu agregasi bulat teratur dan tak beraturan. Ukuran partikel dari silika dari metode sonikasi adalah 0,4448 µm. Berdasarkan hasil karakterisasi yang dilakukan, dapat disimpulkan bahwa ekstraksi silika sebagai bahan baku pembuatan material pulpotomi dapat efektif dilakukan menggunakan metode sol-gel dan dimurnikan menggunakan sonikasi. Abstract. This study aims to extract and purify silica from rice husk ash (RHA) and see the characteristics of the silica produced when treated with sonication and reflux. The method used in this study was sol-gel using NaOH and HCl solvents and then treated with sonication and reflux and washing to minimize the presence of sodium in the silica. Based on the research, the percentage of silica from the sonication and reflux method was 96.4% and 93%, respectively. Silica produced by both methods has an amorphous phase with a broad peak at (2θ) 22º. The FTIR spectra between the two methods showed no difference with peaks in the absorption bands of 470 cm-1, 802 cm-1, and 1103 cm-1, namely the vibration of Si-O siloxane (≡Si-O-Si≡). The absorption band of 3448 cm-1 is the –OH stretching vibration of silanol (≡Si-OH). SEM images show different shapes of silica purified by sonication and reflux methods, namely regular aggregation, and irregular form. The particle size of silica from the sonication method is 0.4448 µm. Based on the results of the characterization carried out, it can be concluded that the extraction of silica as a raw material for the of pulpotomy can be effectively carried out using the sol-gel method and purified using sonication.

Immature permanent incisors with complicated crown fractures treated with partial pulpotomy using white mineral trioxide aggregate and IRoot BP plus-a retrospective long-term study.

Calcium silicate cements have been widely used for pulpotomies in immature permanent teeth with complicated crown fractures due to their superior properties. However, few studies have evaluated the long-term outcomes of white mineral trioxide aggregate (WMTA) and iRoot BP Plus for partial pulpotomies. The aim of this study was to investigate the long-term clinical and radiographic outcomes of WMTA and iRoot BP Plus for partial pulpotomies in immature permanent incisors with complicated crown fractures. Children who had partial pulpotomies of immature permanent incisors with complicated crown fractures using WMTA or iRoot BP Plus as capping agents were enrolled. Eighty immature permanent incisors in 68 children (aged 8-13 years) were included. They were divided into two groups (WMTA and iRoot BP Plus) according to the capping agents. Clinical and radiographic information was collected during a 5-year follow-up period. Study data were analyzed using Chi-square tests or Fisher exact tests. The clinical and radiographic success rates in the WMTA (n=36) and iRoot BP Plus groups (n=44) were 94.4% versus 97.7% and 88.9% versus 97.7%, respectively (both p < .05). The average observation period was 74.5 ± 13.2months and 61.9 ± 1.6months in the WMTA and iRoot BP Plus groups, respectively (p < .01). Five cases presented with periapical radiolucencies. The WMTA group had four cases of pulp canal calcification (11.1%), while the iRoot BP Plus group had two cases (4.6%). There was crown discolouration in all cases in the WMTA group, but none in the iRoot BP Plus group. Both WMTA and iRoot BP Plus had favorable outcomes in promoting physiological development and maintaining the basic functions of immature permanent incisors with complicated crown fractures. As a partial pulpotomy material, iRoot BP Plus may be more suitable for the esthetic zone than WMTA.

Effect of Propolis and Castor Oil Cement as Pulpotomy Materials on the Properties and Osteogenic Differentiation of Stem Cells Isolated from Human Exfoliated Deciduous Teeth (SHED)

Effect of Propolis and Castor Oil Cement as Pulpotomy Materials on the Properties and Osteogenic Differentiation of Stem Cells Isolated from Human Exfoliated Deciduous Teeth (SHED)

Treatment Outcomes of Pulpotomy with Propolis in Comparison with MTA in Human Primary Molars: A 24-month Follow-up Randomized Controlled Trial.

Aim and objectiveTo evaluate the clinical efficacy of propolis as pulpotomy medicament in human primary molars.Materials and methodsThis randomized controlled trial is a two-arm, parallel group study with blinded outcome assessment. The study included a total of 60 primary molars that require pulpotomy treatment in 4- 8-year old children. Teeth were assigned to two groups randomly: Propolis (Test group); Mineral trioxide aggregate (MTA) (Control group). All the pulpotomized teeth were given stainless steel crowns and the teeth were evaluated clinically and radiographically at 6, 12, and 24 months to grade them as either success or failure. Chi-square test was employed to analyze the data.ResultsSuccess rates of pulpotomy with propolis and MTA were 80% and 93.1% respectively at 24 months of follow-up interval. Propolis has shown success rates of 90% and 80% at 6- and 12-month follow-up, while MTA has shown a consistent success rate of 93.1% at all the follow-up intervals. The difference in success rate between the groups at all the time intervals is statistically nonsignificant.ConclusionPropolis has demonstrated a clinically acceptable success rate comparable to MTA as pulpotomy medicament in primary teeth.Clinical significanceBiocompatible materials with regenerative potential have drawn the momentum in vital pulp therapy. In this regard, MTA has been emerged as most successful material, but its high cost has limited its use. Hence, there is an absolute need of cost-effective pulpotomy material with regenerative potential. This study provides an evidence that propolis has clinically acceptable success rate as pulpotomy medicament. Considering its low cost and ready availability, it can be recommended as a cost-effective alternative for primary teeth pulpotomy.How to cite this articleRojaRamya KS, Chandrasekhar R, Uloopi KS, et al. Treatment Outcomes of Pulpotomy with Propolis in Comparison with MTA in Human Primary Molars: A 24-month Follow-up Randomized Controlled Trial. Int J Clin Pediatr Dent 2022;15(S-1):S3-S7.

Pulp Dressing Agents Used in Primary Teeth: A Review of the Literature

Background: Pulpotomy is a technique of vital pulp therapy which can be performed in a primary tooth with pulp exposure due to caries or trauma when there is no clinical or radiographic sign of irreversible pulpitis or necrosis. Since today many different medicaments and techniques have been researched as pulpotomy agents and studies have shown the effectiveness but also the limitations of them. &#x0D; Aim: The aim of this literature review is to overview the medicaments which were used in the past for pulpotomy in primary teeth, but also to evaluate the techniques and medicaments from the present and the future. &#x0D; Results: Formocresol was the first-choice material for many decades, but its use has been limited due to potential mutogenetic and carcinogenetic effects in humans. In addition, glutaraldehyde is no longer used as a material for pulpotomy due to its toxicity. Mineral trioxide aggregate (MTA) seems to have better or comparable success rates as the old gold standard – formocresol, while other materials have high effectiveness. Calcium hydroxide was related to lower success rate and due to adverse effects as the internal root resorption is no longer recommended. Electrosurgery and laser are alternative techniques, while collagen and enamel matrix derivative (EMD) have been researched the last years and also studies about the bone morphogenetic proteins (BMPs) presented promising results. Also, other medicaments, which have been evaluated as pulp dressing materials, are included in this review and they seem to lead to acceptable results.&#x0D; Conclusions: MTA seems to be the new gold-standard for pulpotomy, while also other medicaments as ferric sulfate, sodium hypochloride, Portland cement, Biodentine can lead to comparable results. Electrosurgery and laser pulpotomy are alternative and non-pharmacological techniques with good success rates, while also other alternative materials seem to have promising results, but further research is needed.

In vivo comparison of bioceramic putty and mineral trioxide aggregate as pulpotomy medicament in primary molars. A 12-month follow-up randomized clinical trial

Pulpotomy is one of the common vital pulp therapy procedures for primary molars. The present trend in pulpotomy materials is to use regenerative materials that promote dentinogenesis. Mineral trioxide aggregate (MTA) is a very popular pulpotomy material. However, it has some limitations including difficult handling characteristics and long setting time. Tricalcium silicate cements evolved, in which bioceramic cements came into existence, have better properties than MTA. The aims and objectives of the study are to evaluate the efficacy of bioceramic putty with MTA as a pulp medicament in primary molars. In this randomized in vivo study, sixty primary molars in children aged 4-9 years indicated for pulpotomy were selected. They were assigned using nonprobability convenient sampling technique into two groups: test group - bioceramic putty (EndoSequence Root Repair Material) and control group - MTA (Angelus). After pulp therapy, teeth were restored with stainless steel crowns. Recall clinical and radiographic evaluation was done at 3-, 6-, and 12-month interval to assess success rate. The data were statistically analyzed using Chi-square test, and P ≤ 0.05 was set for statistical significance. At 3-month interval, the success rates were 96.7% and 93.1% with bioceramic and MTA groups, respectively. At 6- and 12-month interval, the success rates were 93.3% and 93.1% with bioceramic and MTA groups, respectively. However, the difference in success rate between the groups was statistically not significant at all the time intervals (P = 0.533 at 3 months, P = 0.972 at 6 and 12 months). Bioceramic putty exhibited comparable results to MTA. Hence, it can be considered alternative pulpotomy agent.

SHED's Response to Various Pulpotomy Materials: Cytotoxicity and Gene Expression Analysis.

To examine the cytotoxicity and genetic expression of SHEDs cultured in eluates of various calcium silicate based pulpotomy materials. MTT assay, flow cytometry, alizarin red staining and scratch assay was used to assess the cellular viability, apoptosis, calcium matrix deposits and cell migration respectively. The gene expression of ALP, OCN and BMP -2, were measured with rtPCR. One way ANNOVA and Bonferroni post test was used for statistical analysis. MTT assay analysis reported that all the test specimen had no cytotoxic effects. The highest number of live cells [ % ] was found in RetroMTA. The highest percentage of cell migration was observed in SHEDs cultured in EndoCem Zr. The mean absorbance for calcium matrix deposition was higher or similar in all test specimens, when compared to control groups. The expression of BMP -2 and OCN were significantly higher in cells exposed to RetroMTA and NeoMTA respectively after 24 hrs of incubation. After 72 hrs of incubation the mRNA expression of ALP was significantly higher in MTA. SHEDs cultured in eluates of various calcium silicate based cements exhibited cytocompatibility and maintained odontogenic like phenotype differentiation in SHEDs.

Quantifying Coronal Permanent Tooth Discoloration Caused by Different Pulpotomy Materials.

Bioceramic materials, gray and white mineral trioxide aggregate (GMTA, WMTA), have been shown to have high rates of success in various endodontic applications. A major drawback is their tendency to discolor teeth compared to Biodentine (BD), that has been claimed not to discolor teeth. The aim of this study was to compare tooth discoloration after applying different pulpotomy base materials (BD, GMTA and WMTA). Forty human incisors teeth were used in this study. Coronal access was achieved by a Tungsten Carbide drill, and the pulp chambers were accessed and chemo-mechanically debrided. Each material was placed in the pulp chamber, up to the cervical sectioning level. All specimens were incubated at 37°C and 100% humidity for three months and have been evaluated before the study and weekly. Color was assessed according to the CIE L*a*b* color space system. ΔE of all experimental groups (GMTA, WMTA and BD) were significantly different from the control group at all time points (P<0.05). Color changes in the GMTA and WMTA groups, had no statistically significant differences, but showed higher discoloration compared to BD group in the cervical part of the crown, since week 1 (P<0.05). WMTA group showed significant discoloration in the cervical part as of week 1 (P<0.05), and gradually increased over time (Figure 2). BD group showed no significantly discoloration over time. GMTA group showed the significant discoloration at week 1 and week 14 (P<0.05). both GMTA and WMTA pulpotomy materials may discolor tooth structure over time in an extracted permanent anterior tooth model. When choosing bioceramic pulpotomy material, BD may be preferable in esthetic area.

Assessment of Clinical and Radiographic Success Rate of Formocresol-based Pulpotomy versus Collagen-based Pulpotomy: An In Vivo Study

The aim of the study is (a) To use collagen as a pulpotomy material in comparison with the gold standard formocresol-based pulpotomy, (b) to assess the clinical and radiographic success rate of formocresol pulpotomy and collagen-based pulpotomy, and (c) to compare the success rate of formocresol-based pulpotomy and collagen-based pulpotomy over a definitive interval of time. Totally 30 primary first or second molars indicated for pulpotomy after confirming with the operative diagnosis were taken as samples for this study. This split-mouth technique consists of two groups: Group 1-formocresol pulpotomy (n = 15), and group 2-collagen-based pulpotomy (n = 15). Both the procedures were done in the same patient on regular appointments. Pre- and postoperative radiographs were taken. The children were recalled for clinical and radiographic follow-up at 2, 4, and 6 months. The success of the procedure was assessed based on clinical signs (pain, tenderness to percussion, abscess, swelling, fistula, and pathologic mobility) and radiographic findings (radicular radiolucency, internal and external root resorption, periodontal ligament (PDL) space widening, and furcation radiolucency). The Chi-square test was used to compare the differences between the groups. The overall success rate for formocresol pulpotomy (n = 15) was 14, 13, and 10 for the second-, fourth-, and sixth-month review period, respectively. For collagen pulpotomy group (n = 15), the overall success rate was 14, 14, and 14 for the second-, fourth-, and sixth-month review period, respectively. The obtained data from the overall success rate were subjected to statistical analysis, and chi-square test was used. The p-value less than 0.1 was considered a statistically significant result. The chi-square value for the fourth- and sixth-month review was 0.37 and 3.33, respectively. Statistically significant value was obtained from the sixth-month review period (p <0.1), which describes that the overall success rate was better for the collagen pulpotomy group when compared with the formocresol pulpotomy group. Collagen had proven to be a very good alternative for formocresol, its biocompatibility, and regenerative efficiency and is a benchmark for a better clinical success rate in dentistry. However, its implication in pulpotomy should be subjected to further comparative research study on mineral trioxide aggregate (MTA), Biodentine, etc. Keywords: Collagen-based pulpotomy, Formocresol-based pulpotomy.

An Update on Newer Pulpotomy Agents in Primary Teeth: A Literature Review.

Primary molars with asymptomatic reversible pulpitis are commonly treated by pulpotomy procedure. Different pulpotomy materials used so far for pulpotomy that have been mentioned in the literature have been included in this article. This literature review includes all medicaments including natural alternatives. Many significant medicaments with their success rates have been mentioned in this paper. To increase the therapeutic success of pulpotomy procedure, it is necessary to identify a novel effective and preferably natural pulpotomy medicament.

Tooth Discoloration Induced by Different Calcium Silicate-Based Cements: A Two-Year Spectrophotometric and Photographic Evaluation in Vitro.

Calcium silicate-based cements (CSCs) may lead to coronal staining in young permanent teeth over the time. The purpose of this study was to evaluate and compare the long-term tooth discoloration induced by different CSCs. Ninety freshly-extracted human molars were assigned randomly into 6 groups (n=15/group) according to the CSC used as a pulpotomy material: ProRoot MTA, MTA Angelus, NeoMTA, EndoSequence Putty, Biodentine and Negative control (No cement). The color was assessed at baseline, and thereafter at 3, 6, 12 and 24 months by using both a spectrophotometer and digital images taken with and without a cross-polarizing filter. The time-dependent changes in color (ΔE) were compared within and among groups using Analysis of Variance. Angelus MTA and ProRooT MTA showed severe coronal discoloration (p>0.05) starting at 3 months. ΔE values of NeoMTA, EndoSequence Bioceramic Putty and Biodentine were below the perceptibility threshold, with Biodentine showing greater ΔE values than NeoMTA and EndoSequence Putty in the absence of statistical significance (p>0.05). Discoloration elicited by CSCs may develop soon after placement, and continue to increase for up to two years. Angelus MTA and ProRooT MTA cannot be recommended for vital pulp therapies in the esthetic zone of young individuals.

Modern methods for treatment of deciduous teeth pulpitis: a literature review

Relevance . Pulpitis is one of the most common diseases. Currently, the development of pediatric dentistry does not allow achieving complete success in the treatment of deciduous tooth pulpitis. The relevance of pulpitis treatment method exploration is obvious. Materials and methods. The study analyzed 75 sources of literature describing four main methods for pulpitis treatment in deciduous teeth: indirect pulp capping, direct pulp capping, pulpotomy (amputation) and pulpectomy (extirpation). Results . The effectiveness of primary tooth pulpitis treatment is questionable and ranges from 40% to 100%, depending on the method and duration of observation. Mineral trioxide aggregate (MTA), calcium hydroxide, zinc oxide-eugenol paste, formocresol, ferric sulphate are the most studied materials for the endodontic treatment of the deciduous teeth. Studies on the new biocompatible materials, such as tricalcium silicate (Biodentine), CEM (calcium-enriched mixture), enamel matrix proteins (Emdogain), etc., confirm their effectiveness, but the evidence is still inconclusive. In indirect pulp capping, non-resorbable biocompatible cements showed better results provided a tight seal of the restoration was achieved. Glass ionomer cements may be an option. Direct pulp capping is a controversial technique for the treatment of deciduous tooth pulpitis. MTA is the most effective material for pulpotomy. No hard evidence is provided for the comparative evaluation of a certain material effectiveness in pulpectomy; both ZOE and calcium hydroxide with iodoform can be used for root canal filling. Conclusions . Biologically based methods for the treatment of pulpitis, which preserve the viability of the pulp as much as possible, are currently considered preferable. Further research is needed to assess the effectiveness of the new biocompatible materials with regenerative properties.

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 Mineral Trioxide Aggregate and Biodentine as pulpotomy agents in immature first permanent molars with carious pulp exposure: A randomised clinical trial.

There is insufficient evidence on the outcome of pulpotomies in carious exposed young permanent molars with newer biomaterials. This study aimed to compare Mineral Trioxide Aggregate (MTA) and Biodentine as pulpotomy materials in carious exposed vital immature mandibular first permanent molars. Study design: Sixty immature first mandibular permanent molars, with carious exposure were randomly assigned to an MTA or Biodentine group in a split-mouth design. After the amputation of the coronal pulp, the pulp stumps were covered with one of the study materials and coronal restorations placed. Blinded clinical and radiographic evaluations were performed at baseline. Following this there were evaluations at 6, 12 and 18 months where comparisons between and within the two groups were made. A high success was observed in both groups for all outcome measures for clinical success, with no significant difference between them. The mean survival time for the Biodentine and MTA groups was (17.8 and 18 months) with 95% confidence interval (17.4-18.2) and (18 .0-18.0) months respectively. Similarly, there were no significant differences between the Biodentine and MTA groups for radiographic success (P<0.001) with an increase in root length and increasing apical closure observed in both groups. Both materials were equally effective in the treatment of cariously exposed vital immature mandibular first permanent molars.

Effect of Simvastatin and Antioxidant mix on pulpotomized young permanent teeth: A clinical and radiographic study

Objective of this study to evaluate, clinically and radiographically, the effect of Simvastatin and Antioxidant mix on pulpotomized young permanent teeth. Patients & Methods: Pulpotomy were performed in 54 vital decayed young permanent molars that indicated for vital pulp therapy. The molars were classified randomly into three equal groups • Group A: molars were receiving Simvastatin after pulpotomy (n=18). • Group B: molars were receiving Antioxidant mix after pulpotomy(n=18). • Group C: molars were receiving calcium hydroxide after pulpotomy(n=18). The treated teeth were followed up clinically and radiographically after variable intervals (immediately, 1 month and 3months) after treatment. The assessment of treated teeth was performed by visual inspection of the signs and symptoms and by periapical radiographs Result: According to pain, mobility and swelling in simvastatin 83.3% of cases was Success and 16.7% of cases was failure. Antioxidant mix 88.9 % of cases was Success and 11.1% of cases was failure. calcium hydroxide,88.9 % of cases was Success and 11.1% of cases was failure. According to Internal or external resorption, widening of periodontal ligament and Periapical radiolucency in simvastatin ,83.3% of cases was Success and16.7% of cases was failure. Antioxidant mix, , 88.9 % of cases was Success and 11.1% of cases was failure. calcium hydroxide , 88.9 % of cases was Success and 11.1% of cases was failure. Conclusion: simvastatin and Antioxidant mix pulpotomy are more cost, ease in handling, biocompatible. It has been proven potentially to be an ideal pulpotomy materials in treatment of vital young permanent teeth.

The effect of partial pulpotomy with iRoot BP Plus in traumatized immature permanent teeth: A randomized prospective controlled trial

A new bioceramic material iRoot BP Plus has been introduced and reported to have good biocompatibility, sealing ability and antibacterial activity. It has also been reported to be successfully used for procedures such as pulpotomy, pulp floor perforation repair and so on. However, there are only a few reports on the use of iRoot BP Plus in the management of traumatised teeth with an exposed pulp. The aim of this study was to investigate the clinical and radiographic outcomes of partial pulpotomy with iRoot BP Plus in immature permanent teeth with complicated crown fracture or complicated crown-root fracture. The study was prospectively designed and 110 immature permanent teeth with complicated crown fracture or complicated crown-root fracture were randomly allocated into two groups (n = 55). All teeth were clinically and radiographically assessed at 1, 3, 6, 12, 18 and 24 months after partial pulpotomy with iRoot BP Plus (experimental group, n=50) or calcium hydroxide (control group,n=49) as the pulp capping agent. Eleven cases were lost during follow-up, and 99 teeth were finally analysed. There were no intergroup differences in the survival rate, survival time, root length and dentin wall thickness. The calcific bridge was significantly thinner in the iRoot BP Plus group than in the calcium hydroxide group (0.97±0.13mm vs. 1.36±0.12mm; F=5.128, P=0.029). iRoot BP Plus may be an effective capping material for partial pulpotomy.

A comparison of MTA and Biodentine as medicaments for pulpotomy in traumatized anterior immature permanent teeth: A randomized clinical trial.

The placement of a biocompatible material after performing pulp therapy in traumatically exposed permanent incisors is one of the important factors that determine pulp healing. The aim of this study was to assess the clinical and radiographic outcomes when using mineral trioxide aggregate (MTA) and Biodentine as pulpotomy materials to maintain the vitality of traumatized immature anterior permanent teeth with pulp exposure. Fifty traumatized immature anterior permanent teeth with exposed pulps were included in the study. Teeth were equally divided and randomly assigned to two groups MTA or Biodentine. After pulpotomy, pulp stumps were covered with MTA or Biodentine followed by a permanent restoration. Blinded clinical and radiographic evaluations were performed at baseline, immediate post-operative and after 6, 12 and 18 months according to pre-determined clinical and radiographic criteria. No statistically significant differences were observed between MTA and Biodentine for any of the clinical parameters, except for discoloration, which was significantly more prevalent in the MTA group (P < .001). No significant statistical difference was observed in the radiographic outcomes between MTA and Biodentine, as evidenced by continued root development and by an increased prevalence of root formation stage H in both groups. Both MTA and Biodentine showed similar clinical and radiographic outcomes when used as pulpotomy materials in the treatment of traumatized immature anterior permanent teeth. However, discoloration was significantly more prevalent in the MTA group.