Pulpotomy Procedures Research Articles

Pulpotomy v/s pulpectomy in 6 to 9 years old children

Background: The main goal of pulp treatment is to preserve the health and integrity of the oral tissues. Early primary tooth loss can result in malocclusion and temporary or permanent issues with appearance, phonetics, and function. While it is desirable to try to maintain pulp vitality wherever possible, the pulp can be completely removed without seriously impairing the tooth's ability to function. Aim: To compare the prevalence of pulpectomy and pulpotomy procedures done in 6 to 9 years old children Materials and method: The study was a retrospective cross-sectional analysis, evaluating dental outpatient records and analyzing data from 86,000 patients between June 2020 and April 2021 to collect case records of 6 to 9-year-old children undergoing pulpectomy and pulpotomy procedures. We selected children between the ages of 6 and 9 who underwent pulpectomy and pulpotomy procedures. Using the SPSS software, the data was compiled followed by statistical analysis. Results: Of the total number of children screened, about 96% of the patients between 6-9 years of age underwent pulpectomy whereas the remaining 4% underwent pulpotomy. Of these patients, 56% of them were males and about 44% of them were females. About 75% of these pulpectomy procedures were performed in posterior teeth whereas only 25% of them were done in anterior teeth Conclusion: From this study it can be concluded that in a university setting, pulpectomy was most predominantly performed in children of 6-9 years of age and the most commonly involved teeth were the posteriors.

Retrospective analysis of ferric sulfate and sodium hypochlorite pulpotomy procedures in primary molars.

Pulpotomy is a vital pulp treatment procedure frequently used in primary molars to preserve pulp vitality and function until tooth exfoliation. There is currently no pulp medicament with all the features of the ideal pulpotomy material. The present study compared the radiographic success of sodium hypochlorite with ferric sulfate (FS) when used for pulpotomy in primary molars. A retrospective analysis was performed to evaluate the success rates of primary molars pulpotomized using sodium hypochlorite or FS according to radiographic findings. Healthy 4‒10-year-old children who had pulpotomy procedures on primary molars between 2018 and 2021 at the pediatric dental clinic and had a control radiograph at least 12 months later were enrolled in the study. The chi-squared test was used to determine the differences in success between these two materials. A total of 142 teeth, including 85 (59.9%) first primary molars and 57 (40.1%) second primary molars, in 98 healthy children were evaluated. The mean follow-up period of the teeth included in the study was 585.1±249.4 days. Radiographic success rates for NaOCl and FS groups were 73.8% and 71.0%, respectively, with no statistically significant difference (P>0.05). Internal root resorption (IRR) was the most common cause of radiographic failure in both groups. Radiographic success rates of both materials were similar, and using these materials in primary molar pulpotomy procedures can be recommended in clinical practice.

Implications of root, pulp chamber, and canal anatomy on pulpotomy and revitalization procedures.

This review aims to discuss the implications of anatomy of the root, pulp chamber, and canals on pulpotomy and revitalization procedures (RPs) as treatment alternatives to root canal treatment procedures. This narrative review was undertaken to address two main questions - why remove vital pulp tissue in teeth with complex canal anatomy when it can be preserved? And why replace the necrotic pulp in teeth with mature roots with a synthetic material when we can revitalize? This review also aims to discuss anatomical challenges with pulpotomy and revitalization procedures. Maintaining the vitality of the pulp via partial or full pulpotomy procedures avoids the multiple potential challenges faced by clinicians during root canal treatment. However, carrying out pulpotomy procedures requires a meticulous understanding of the pulp chamber anatomy, which varies from tooth to tooth. Literature shows an increased interest in the application of RPs in teeth with mature roots; however, to date, the relation between the complexity of the root canal system and outcomes of RPs in necrotic multi-rooted teeth with mature roots is unclear and requires further robust comparative research and long-term follow-up. Whenever indicated, pulpotomy procedures are viable treatment options for vital teeth with mature roots; however, comparative, adequately powered studies with long-term follow-up are needed as a priority in this area. RPs show promising outcomes for necrotic teeth with mature roots that warrant more evidence in different tooth types with long-term follow-ups. CLINICAL RELEVANCE: Clinicians should be aware of the pulp chamber anatomy, which is subject to morphological changes by age or as a defensive mechanism against microbial irritation, before practicing partial and full pulpotomy procedures. RP is a promising treatment option for teeth with immature roots, but more evidence is needed for its applications in teeth with mature roots. A universal consensus and considerably more robust evidence are needed for the standardization of RPs in teeth with mature roots.

Pulpotomy: An alternative treatment modality to conventional root canal treatment

Vital pulp therapy is considered a successful treatment modality in primary and immature permanent teeth. The development of bioactive material has led to vital pulp therapy and pulpotomy treatment becoming a popular treatment modality in permanent teeth. This literature review investigates pulpotomy procedures on permanent teeth as a viable option, as opposed to conventional root canal treatment, as presented in the case report included.Aim The aim of this study is to evaluate literature on the reported success of pulpotomy treatment in mature permanent teeth. For this reason, the study specifically reviewed literature detailing the use of pulpotomies including the materials required for the procedure.MethodThe literature review is focused on studies using MTA and bioactive alternatives as pulpotomy material. An electronic search was done on EBSCOhost to source 58 articles published from 1979 to 2022. Results Literature investigated reports that pulpotomy treatment with bioactive materials shows promising results and therefore the possibility exists of it being a suitable treatment option or alternative to conventional root canal treatment.

EVALUATION OF OUTCOME OF FULL PULPOTOMY IN MATURE PERMANENT MOLARS WITH SYMPTOMATIC IRREVERSIBLE PULPITIS

Objectives: To assess the outcome of full pulpotomy in patients with symptomatic irreversible pulpitis. Materials and Methods: This observational study was done at the Endodontics Department, Rehman College of Dentistry, Peshawar from April 2022 to April 2023. Eighty-four patients within the age range of 18-50 years with painful vital permanent molar were selected using purposive sampling. Full Pulpotomy procedure was performed. Treatment was completed in two visits. In the first visit, after taking an informed consent the tooth was anesthetized, and full pulpotomy was done. A cotton pellet soaked in 3% sodium hypochlorite (NaOCL) was used to achieve hemostasis. After achieving hemostasis, a 2-4mm of mineral trioxide aggregate was used to seal the root stumps and restored with glass ionomer cement. In the second visit, the glass ionomer cement was removed, and tooth was permanently restored using composite fi lling material. Outcome was evaluated in terms of pain and periapical changes at one week and six month post-operatively. The outcome was considered successful in case of no or mild pain and no periapical changes post-operatively. Data was entered using SPSS version 26.0. Results: In the present study 46.4% males and 53.6% females were included. The mean age was 34.04±10.524. Follow-up showed 95.2% success after one week and 89.3% after six months. No significant association of the outcome with age, gender and tooth type was found (p value > 0.05). Conclusion: Full pulpotomy was successful in patients with symptomatic irreversible pulpitis.

The impact of pulpotomy on the long-term prognosis and survival of young permanent teeth

This review explores the impact of pulpotomies on the long-term prognosis and survival of primary and young permanent teeth. Pulpotomy is a vital pulp therapy procedure aiming to preserve pulp health and functions. The review covers various vital pulp therapy techniques, including indirect pulp treatment, direct pulp treatment, partial pulpotomy, and full pulpotomy. Apexogenesis, a procedure promoting root end formation, is also discussed. Long-term success in endodontic therapy requires an effective coronal seal to prevent microleakage and bacterial ingress into root canals. The study's methodology involved a comprehensive literature search to gather information on pulpotomy's effects on tooth prognosis and survival. Factors influencing the success of vital pulp therapy, such as the size of the exposure, the state of the pulp, and the choice of capping material, are analyzed. Bacterial contamination is identified as a crucial factor affecting the therapy's prognosis. Strategies to improve pulp healing and treatment outcomes are explored, offering insights into clinical decision-making for pulpotomy procedures.

Effectiveness of Pulpotomy Procedures in Mature Permanent Teeth with Irreversible Pulpitis

The standard treatment for permanent teeth diagnosed with irreversible pulpitis is pulpectomy and root canal therapy. However, with introduction of biomaterials like calcium silicate cements which are promoters of biomineralization, and vital pulp therapy procedures for preserving and maintaining pulp tissue, this position could be relative.

Development and preliminary validation of an Objective Structured Assessment of Technical Skills (OSATS) for a partial pulpotomy procedure.

To develop an Objective Structured Assessment of Technical Skills (OSATS) tool for partial pulpotomy and to preliminary assess the validity of this tool. Secondary objectives were to check internal consistency as well as the interrater reliability of this specific checklist and to compare it with the previously validated global rating score (GRS). The study assessed three groups of dental participants (mix of practitioners or students) possessing differing levels of clinical experience (7 novices, 7 intermediates, 7 experts), during a partial pulpotomy procedure on a simulated tooth with deep caries, using a bespoke procedure-specific checklist (PSC) and the GRS. Two independent examiners received the study participants in groups of two, in order to be able to directly observe their actions and grade the different steps of the procedure from 1 to 5 on the PSC and GRS. The internal validity of the specific checklist was assessed using a Cronbach's alpha test. As the construct validity of such a tool can be determined when the tool differentiates performance based on the level of experience, the total score of the PSC of the three groups (e.g., novice group, intermediate group, experienced group) were compared using the Kruskal-Wallis and post-hoc Mann-Whitney pairwise U test. The total scores of the GRS were also analysed in the same manner. A correlation test (Correlation Matrices Test) was carried out for the entire sample between the specific checklist and the GRS (on total score). The intraclass correlation coefficient was used to measure the degree of agreement between the two evaluators. The statistical analysis was performed with XLSTAT® and Statistica® (significance p = .05). The partial pulpotomy specific checklist graded from one to five demonstrated good internal consistency (0.86) and a good interrater reliability (0.91), a correct construct validity (p generally < .05) and a good positive correlation with the validated GRS (r = .92). To address the need to develop education in vital pulp treatment, and more specifically the technical skills assessment of partial pulpotomy, an OSATS-specific checklist was developed and preliminary validated. The checklist will need to be validated in larger cohorts.

Efficacy of Potassium Titanyl Phosphate Laser and Sodium Hypochlorite on Postoperative Pain Intensity Following Pulpotomy in Teeth with Symptomatic Irreversible Pulpitis: A Randomized Clinical Trial.

Introduction: This study evaluated the postoperative pain intensity in permanent teeth with symptomatic irreversible pulpitis treated by pulpotomy using physiological saline, sodium hypochlorite (NaOCl), or the potassium titanyl phosphate (KTP) laser. Materials and methods: Ninety patients diagnosed with symptomatic irreversible pulpitis in permanent molars were randomly divided into three groups according to the pulpotomy procedures. Preoperative pain levels were recorded. Complete hemostasis was achieved with physiological saline (control group), NaOCl, or the KTP laser after initial bleeding control. Patients were asked to mark their pain level on the visual pain scale at 6, 24, 48, and 72 h and 7 and 30 days depending on the severity of pain. The permanent restoration was completed after 7 days. Data were statistically analyzed using Kruskal-Wallis, Mann-Whitney U, Friedman, and Bonferroni tests at a significance level of p < 0.05. Results: According to the present study, the statistical difference between the groups in terms of preoperative pain and percussion pain levels was insignificant (p > 0.05). There was no significant difference between groups in terms of demographic data (p > 0.05). The postoperative pain level of the KTP laser group was significantly lower at 6 h compared with the saline group (p < 0.05). There was no significant difference between groups in terms of the postoperative pain level at other time intervals (p > 0.05). The highest pain scores were observed in all groups at 6 h (p < 0.05). Conclusions: The KTP laser can be preferred primarily for reducing postoperative pain in pulpotomy treatments. The KTP laser or NaOCl-assisted pulpotomy can be an effective treatment for pain reduction in permanent teeth with symptomatic irreversible pulpitis. This report is registered at clinicaltrials.gov (ID: NCT05424796).

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.

Primary tooth vital pulp therapy techniques taught in dental schools in Saudi Arabia: a cross-sectional study.

Worldwide, dental schools employ varying approaches to teaching vital pulp therapy (VPT) for primary teeth. However, little is known about the VPT techniques taught in dental schools in Saudi Arabia. Therefore, this study aimed to describe the approaches of VPT for primary teeth taught in undergraduate dental schools in Saudi Arabia. A nationwide cross-sectional study was conducted between January and June 2022, using an online questionnaire distributed to pediatric dentistry faculty members at all dental schools in Saudi Arabia. The questionnaire collected information on socio-demographic characteristics, educational background, work setting, and VPT teaching approaches. Descriptive statistics and logistic regression models assessed the association between participants' characteristics and the VPT techniques taught. Seventy-seven faculty members from 17 out of 27 dental colleges in Saudi Arabia participated in the study. Most respondents reported teaching indirect pulp capping (95%), with glass ionomer cement and calcium hydroxide being the most popular materials. Only 11 participants (14%) taught direct pulp capping, with mineral trioxide aggregate and calcium hydroxide being the most commonly used materials. Pulpotomy procedures were taught in all dental schools, with formocresol being the most commonly used medicament (84%). No significant associations were found between faculty member characteristics and the likelihood of teaching indirect pulp capping. However, older age categories had a significantly higher chance of teaching direct pulp capping (trend odds ratio: 2.27, p = 0.02). In conclusion, most faculty members (95%) reported teaching indirect pulp capping using glass ionomer cement and calcium hydroxide for primary teeth. Only 14% of the respondents taught direct pulp capping, and the use of mineral trioxide aggregate for direct pulp capping appears to be increasing. Formocresol was the most commonly used pulpotomy medicament. Further research is needed to investigate factors that influence the teaching of VPT for primary teeth in Saudi Arabia.

Fracture resistance of primary molars after pulpotomy procedure using mineral trioxide aggregate or Biodentine.

In this study, the effect of mineral trioxide aggregate (MTA) and Biodentine on the resistance to fracture of pulpotomized primary molars was evaluated. 75 primary molars were divided into 2 control groups (positive and negative) and 3 experimental groups with 15 teeth each. No treatment was applied to the teeth in the negative control group. In the teeth in the positive control group, pulpotomy cavities were performed, but not filled. In the teeth in the experimental group, pulpotomy cavities were performed, and filled as follows. Group 3: mineral trioxide aggregate + glass ionomer cement (GIC); Group 4: Biodentine + GIC and Group 5: zinc oxide-eugenol + GIC. Final restorations in teeth in all experimental groups were completed with composite filling material. 75 teeth were then subjected to fracture resistance testing. Obtained data were analyzed statistically. Sorting by fracture resistance; Group1 > Group 4 > Group 3 = Group 5 > Group 2 (p < 0.05). Restorable fracture type was predominant in experimental groups (p < 0.05). The use of Biodentine in teeth undergoing pulpotomy in primary teeth can be preferred as a suitable base material to increase resistance to fracture.

Evaluation of biodentine pulpotomy in caries-exposed symptomatic vital mature permanent teeth in 9‒13-year-old children: A 24-month clinico-radiographic observation.

The present study evaluated the clinical and radiographic outcomes of Biodentine pulpotomy for 24 months in symptomatic vital mature permanent teeth with caries exposure. Seventy-three patients with a chief complaint of spontaneous pain in permanent teeth were screened. Finally, 47 mature permanent teeth underwent a Biodentine pulpotomy procedure. Clinical evaluation of 47 teeth was carried out at 1, 3, 6, 9, 12, and 24 months and radiographic evaluations were made at 6, 12, and 24 months. The success of Biodentine pulpotomy was evaluated using Pearson's chi-square test. The significance level was determined at P<0.05. At 24 months, the clinical and radiographic success rate was 97.78%, with only one clinical failure at 9 months. The clinical and radiographic success of Biodentine pulpotomy was high (97.78%). Thus, Biodentine pulpotomy can be an alternative to root canal treatment (RCT) in symptomatic vital mature permanent teeth.

Modified pulpotomy procedure in immature permanent teeth with apical periodontitis: a randomised controlled trial

ObjectivesThe objective of this study was to evaluate the effectiveness of a modified pulpotomy (MP) procedure in immature permanent teeth with apical periodontitis (AP).DesignRandomised controlled trial.SettingOne public hospital in Shanghai,...

Factors that influence the outcome of pulpotomy in permanent teeth.

The promotion of minimally invasive treatments focussed on the maintenance of pulp vitality has become a priority area in Endodontics. These vital pulp treatments (VPT) include partial and full pulpotomy, during which diseased coronal pulp tissue is removed prior to placement of a capping biomaterial and restoration. Traditionally, pulpotomies were confined to the treatment of carious primary and traumatized permanent teeth. However, these treatments have now been proposed as definitive solutions for cariously exposed permanent teeth with mild symptoms or even symptoms indicative of irreversible disease. Until recently, it was recommended that carious exposure of mature permanent teeth be managed by root canal treatment. The promotion of pulpotomy as an alternative treatment has opened up a wave of laboratory and clinical research aimed at improving therapies or evaluating clinical outcomes. In modern evidence-based endodontics, it is imperative that the outcomes of both partial and full pulpotomy are considered and important prognostic factors identified, so that improvements can be made to aid clinical decision-making and to direct new research. In this narrative review, the outcomes of partial and full pulpotomy are discussed, before analysis of patient, intraoperative and postoperative factors that influence the outcome of the pulpotomy procedure. The review highlights that although partial and full pulpotomy for the treatment of even pulpal disease are highly successful procedures, this is based on low-quality evidence with a lack of prospective, comparative trials investigating potential prognostic factors. Based on current evidence, it appears that age, gender, tooth type, root development and intraoperative pulpal haemorrhage do not impact significantly on pulpotomy outcome, whilst others such as caries depth, inflammatory status of the pulp, capping material, level of inflammatory pulpal-biomarkers and the final restoration integrity do. Other factors, including the influence of exposure type, periodontal condition, pulpal lavage, magnification, operator experience, isolation of the operating field and type of pulpotomy, require further experimental investigation before definitive conclusions can be made relating to the success of the pulpotomy procedure. Finally, there is not only a need for future well-designed prospective research addressing these issues but also a widening of our understanding of outcome to include patient-reported as well as clinician-reported outcomes.

COMPARATIVE CLINICAL, RADIOGRAPHICAL AND HISTOLOGICAL EVALUATION OF CORONAL PULPOTOMY TECHNIQUE WITH PRF AND A NOVEL CROSSLINKED PRF AS AN ALTERNATIVE TO PULPECTOMY FOR PRESERVING THE TOOTH VITALITY IN CONTEXT OF TISSUE ENGINEERING.

Background: Removal of infected pulp tissue from the coronal portion leads to preservation of a remaining vital and functioning pulp. Preservation of pulp vitality by pulpotomy is one of the universally accepted treatment procedure with the aid of latest bioactive materials leading to a more conservative approach in the management of teeth involving the pulp based on clinical conditions To comparatively evaluate the . Aim: clinical and radiological and histological outcome of platelet-rich brin (PRF) and the novel crosslinked PRF (C-PRF) developed by us as pulpotomy agent in context of tissue engineering in permanent teeth. 20 permanent mol Materials and Methods: ar teeth from 20 healthy patient aged 18-40 years with permanent molar teeth cariously exposed pulps and diagnosed clinically as irreversible pulpitis were selected for the study. Written consent from the patients was taken. The patients were then randomly divided into 2 groups (n=10) . One group received PRF pulpotomy anther group received our novel crosslinked PRF (C-PRF) pulpotomy. In all patients coronal pulp was removed after preparation of the access cavity with rubber dam under Lignocaine 2 % local anaesthesia. After hemostasis, exposed pulps were covered using PRF membrane with Biodentine or C-PRF with Biodentine, and then all teeth were restored with glass-ionomer cement. Clinical and radiographic evaluation was undertaken at 1 day, 3month and 6 months intervals. The results were analyzed using appropriate statistical tests. After around six months one case of each group third molar teeth was extracted due to positional problem and causation of cheek ulceration. Histological examination of the extracted teeth was done. Statistical Analysis was performed with he Results: lp of Epi Info (TM) 7.2.2.2 EPI INFO is a trademark of the Centers for Disease Control and Prevention (CDC). Test of proportion was used to nd the Standard Normal Deviate (Z) to compare the difference proportions. p&lt;0.05 was taken to be statistically signicant. C-PRF could improve the prognosis Conclusion: of pulpotomy procedures of mature permanent

Biocompatibility and mineralization potential of new calcium silicate cements

Background/purposeAs calcium silicate cements (CSCs) have been successfully used in various types of vital pulp therapy, many new CSC products have been developed. The aim of this study was to evaluate the biocompatibilities and mineralization potential of new CSC. The experimental materials were NeoMTA Plus and EndoSequence Root Repair Material-Fast Set Putty (ERRM-FS) which were compared to ProRoot MTA. Materials and methodsIn vitro, the effects of the new CSC on stem cells were evaluated. Each CSC was prepared for cell viability testing, alkaline phosphatase (ALP) assay, and calcium ion release assay. In vivo, the exposed pulp model was used for the partial pulpotomy procedure. Thirty-six teeth were treated with three materials: ProRoot MTA, NeoMTA Plus, or ERRM-FS. After four weeks, the teeth were extracted and processed for histologic analysis. Dentin bridge formation, pulp inflammation, and odontoblastic cell layer were evaluated and the area of newly formed calcific barrier of each group was measured. ResultsThree CSCs demonstrated similar cell viability on stem cells and the levels of ALP and calcium release were not significantly different between tested materials. ProRoot MTA and ERRM-FS showed better tissue healing process than NeoMTA Plus after partial pulpotomy, in terms of quality of calcific barrier and pulp inflammation. The outcomes from measuring newly formed calcific area demonstrated no significant differences between the materials. ConclusionNeoMTA Plus and ERRM-FS displayed similar biocompatibilities and mineralization potential compared to ProRoot MTA. Therefore, these new CSCs can be used as desirable alternatives to ProRoot MTA.

Retrospective analysis of the outcomes of pulpotomies in traumatised permanent anterior teeth.

Complicated crown fractures are frequently encountered in the paediatric population and pulpotomy procedures (either partial or coronal) are recommended to maintain the pulp. The aim of this study was to determine the pulp outcomes of permanent teeth with complicated crown fractures treated with pulpotomy in a hospital-setting and to identify potential factors which may influence the outcomes. Data for this retrospective study were extracted from dental records of patients with complicated crown fractures and treated with pulpotomies at a single centre between 1 January 2015 and 30 August 2019. Pulp outcomes were determined, and the associations between the outcome and independent variables were assessed using the Chi-Square test of independence and the Point-Biserial Correlation Test. Predictors of outcome were identified using the binary logistic regression model. The overall success of pulpotomy in managing traumatised permanent teeth was 61%, which was lower than those previously reported. Pulp healing was seen in 54.1% and 73.7% of teeth treated with partial pulpotomies and coronal pulpotomies, respectively. The presence of a radiographically detectable dentine bridge (p < .01) and longer clinical experience of the clinician (p < .04) was significantly associated with successful outcomes. The history of pain and the stage of root development were identified as significant predictors of the outcome. Pulpotomy is a viable treatment modality for complicated crown fractures in the paediatric population. However, appropriate case selection and further training may be required to ensure improved pulp healing outcomes. A longer follow-up period should be considered to identify late-stage complications.

COMPARATIVE ASSESSMENT OF NOVEL 3D PRINTED RESIN CROWNS VERSUS DIRECT CELLULOID CROWNS IN RESTORING PULP TREATED PRIMARY MOLARS.

The primary objective of this randomized controlled trial is to compare the clinical impact of using crowns manufactured by 3D printing and direct composite celluloid crowns as a final restoration for primary molars after pulpotomy procedures. Fifty primary molars selected from the children needing treatment at the Pediatric Dentistry Clinic at Damascus University Faculty of Dentistry were randomized by using SPSS and divided into 2 groups based on fabricating methods: Group A: 3D-printed crowns with the utilization of biocompatible light-curing composite, and Group B: Crowns were made directly using composite carried out by prefabricated celluloid crown. The evaluation team assessed the crowns in each group using the United States Public Health Service (USPHS) criteria for retention, marginal integrity, and gingival health at baseline, followed by 3 follow-up sessions at 3, 6, and 12 months. Chi-Square statistical testing was accomplished using SPSS software to compare crown failure among the experimental group. At the 12-month follow-up, no statistically significant differences were noted between groups (P = .157). For gingival health assessment, the Mann-Whitney test was used. No statistically significant differences were recorded between the 2 groups in the third follow-up month (P = .058); However, a significant difference was noted in the 6th and 12th follow-up months (P = .023, P = .000). For marginal integrity comparison, Mann-Whitney statistical Test was used for the third, sixth, and twelfth-month follow-up sessions. A significant difference was noted in all follow-up periods (3-6-12 months) between the direct and indirect crowns (P = .025, P = .025, P = .002, respectively). The 2 types of experimental crowns (direct composite celluloid crowns and the resin crowns manufactured via 3D printer) were suitable esthetic alternatives for restoring pulp-treated primary molars with a notably higher rate of retention with direct composite crowns. 3D-printed resin crowns, however, portrayed superior gingival health in addition to greater marginal integrity.

The comparison of calcium hydroxide + biostimulation, calcium hydroxide, formocresol, and MTA pulpotomies without biostimulation in primary teeth: 12-months clinical and radiographic follow-up.

This study has aimed to evaluate the clinical and radiographic success rates of calcium hydroxide pulpotomy (CH) with biostimulation (PBMT) and compare them to that of CH, formocresol (FC), mineral trioxide aggregate (MTA) pulpotomies without PBMT in primary molars. A total of 172 pulpotomies were performed on primary first or second mandibular molars in 94 children who were 5-8years old. The pulpotomy procedure was performed with four different techniques. In the PBMT group, before the CH placement, 820-nm diode laser radiation was applied to each pulp-stump for 12s (10 mW, 2.5J/cm2). The clinical (lack of spontaneous pain, abscess or fistula, and pathological mobility) and radiographic success (lack of periapical/furcal lesions and internal/external resorption) were recorded at 6 and 12months. The data was statistically evaluated. p value < 0.05 was considered as significant. After 12months, the clinical and radiographic success rate (a tooth with at least one of the findings was considered unsuccessful) was 97%/92% for FC and 97%/95%, 87%/73%, and 71%/45% for MTA, CH + PBMT, and CH, respectively. There was no significant difference between the CH + PBMT and the other groups in clinical success, while a significant difference was found between CH and FC, MTA groups. In radiographic success, there was a significant difference between the CH and the other groups. No significant difference was found between the 6th- and 12th-month results in clinical success for all the groups. A decrease in success over time was seen only in the CH group for radiographic results. CH without PBMT showed the worst clinical and radiographic results among the groups. CH + PBMT showed similar clinical success compared to the MTA and FC groups. In radiographic success, CH + PBMT showed higher success compared to CH, but this success was not high as compared to MTA and FC.