Radiographic Success Research Articles

CORONARY OPENING USING THE BASTIEN TECHNIQUE IN THE LEFT LOWER FIRST PREMOLAR – CASE REPORT

This study aims to present a clinical case in which the first lower left premolar (34) was opened using the Bastien technique. The intraoral clinical examination revealed extensive caries on the vestibular surface. The radiographic findings showed the presence of a radiolucent area in the cervical third and an increase in the periodontal ligament space. The instruments recommended for root canal preparation were: Prodesign Logic 30.05. The obturation was performed using the single cone technique associated with BIO-C Sealer (Angelus) cement and the vestibular wall was restored with Opus bulk fill flow (FGM) composite resin. It is concluded that the treatment with modified access using the Bastien technique, performed on a lower premolar with caries on the vestibular surface, preserves the healthy coronal dentin, resulting in clinical and radiographic success, which may represent an advantage in relation to dental longevity.

Comparative Efficacy of Biodentine® and Calcium Hydroxide in Pulp Capping Treatment

Background: This study is focused on — Assessing Biodentine and Calcium hydroxide in indirect pulp capping procedures. Various materials have been used in indirect pulp capping but this comparative study may help appreciate which material produces better results: Biodentine or Calcium hydroxide. Objective: To compare treatment outcomes post indirect pulp capping treatment using Biodentine® and Calcium hydroxide (Ca(OH)2) . Materials and Methods: A blinded, randomized clinical control trial involving 50 consenting subjects, comparing Biodentine® (test) and Ca(OH)2 (control). Cavity preparation was done and the cavity was dressed with either Biodentine® or Ca(OH)2 and then restored with Glass ionomer cement. The subjects’ teeth were later examined clinically and radiographically at 3, 6, and 9 months post treatment. The indicators of clinical success were absence of pain, swellings, sinus, fistula, abscess, mobility, tenderness to percussion, normal response to electric pulp tester, and Endo-ice cold test. The indicator of radiographic success was absence of periapical pathosis. The probability level of p<0.05 was considered significant. Results: The success rate at three months was 100% for both groups; at six months, it was 92% for both groups and at nine months, 92% of subjects were successful in the Biodentine® group while the Ca(OH)2 group recorded 88% which was statistically insignificant (P=0.74). Conclusion: Biodentine® and Calcium hydroxide have shown comparable effectiveness in improving treatment outcomes, thus, contributing to the longevity of the teeth, and the period of optimum efficaciousness of the pulp capping materials in this study was three months.

Assessment of the Radiopacity of Different Fissure Sealants Compared to Dental Hard Tissues

Aim: The radiopacity of dental materials is crucial for assessing the radiographic success of restorations and can significantly influence clinicians' choice of materials. The objective of our study is to compare the radiopacity of five fissure sealants with that of compomer, composite, glass ionomer filling, and dental hard tissues using digital imaging techniques. Material and Method: Five different fissure sealants (Fuji Triage, BeautiSealant, Grandio Seal, Helioseal F Plus, Embrace Wetbond), compomer (Compoglass F), composite (Solare X), and glass ionomer filling (Equa Forte) materials were prepared as 5 samples each in disk form with a thickness of 2 mm. As controls, sections of primary and permanent teeth with a thickness of 2 mm, along with an aluminum step wedge were utilized. The mean gray values of the samples were measured using Image J software, and the equivalent aluminum thickness was subsequently determined. Statistics analysis using Kruskal-Wallis test at p<0.05. Results: The equivalent aluminum thicknesses related to the radiopacity of fissure sealants are ranked as follows: Fuji Triage (5.2±0.2) > Grandio Seal (3.9±0.2) = permanent tooth enamel (3.7±0.2) = Embrace Wetbond (3.6±0.6) = primary tooth enamel (3.6±0.3) = BeautiSealent (2.1±0.3) > Helioseal F Plus (1.1±0) (p<0.05). The radiopacity equivalent aluminum thicknesses of restorative materials are ranked as follows: Compoglass F (7.3±0.4) > Solare X (4.7±0.3) = Equa Forte (4.4±0.4) = permanent tooth enamel (3.7±0.2) = primary tooth enamel (3.6±0.3) (p<0.05). Conclusion: Materials like Fuji Triage and Compoglass F exhibit high radiopacity values, which can significantly aid clinical monitoring and restoration success.

A randomized controlled clinical trial of the performance of three bioactive endodontic cements in primary molar teeth diagnosed with reversible pulpitis: 1-year follow-up study

ObjectivesThe objective of this clinical trial was to evaluate and compare the clinical and radiographic successes of three bioactive endodontic cements (BEC) including novel portland cement-based material releasing fluoride, resin-modified silicate glass cement, and pure tricalcium silicate-based cement—in the treatment of primary molars diagnosed with reversible pulpitis via indirect pulp capping. MethodsEighty-six (86) participants with previously untreated first and second primary molars were included in this study. The teeth were randomly allocated into three groups: pure tricalcium silicate-based cement, resin-modified silicate glass cement, and novel portland cement-based material releasing fluoride. Cavities were capped with the assigned cement after caries excavation using standard protocols. The teeth that underwent treatment were restored using glass ionomer cement and composite resin. Clinical and radiographic evaluations were performed at 1, 6, and 12 months. The data were analyzed using Pearson chi-square, Kruskal–Wallis H and Z test (P = 0.05). ResultsThe success rate was 88 % (n = 25) in the pure tricalcium silicate-based cement group, 88.5 % (n = 26) in the resin-modified silicate glass cement group, and 100 % (n = 25) in the novel portland cement-based material releasing fluoride group. The differences at the 1st, 6th, and 12th month follow-up visits were not statistically significant among the groups (P > 0.05). No difference was found between the integrity of the resin composite restorations overlying pure tricalcium silicate-based cement, resin-modified silicate glass cement, and novel portland cement-based material releasing fluoride according to the USPHS criteria. ConclusionsNovel portland cement-based material releasing fluoride can be considered an alternative for preserving the tooth, as it showed a high success rate in treating primary molars diagnosed with reversible pulpitis via indirect pulp capping. Clinical significanceNovel Portland cement-based material releasing fluoride could be beneficial in the treatment of primary molars diagnosed with reversible pulpitis via indirect pulp capping.

Effect of lateral extent of pulp tissue removal on the outcome of partial pulpotomy for managing cariously exposed mature permanent molars with symptomatic irreversible pulpitis: A randomized clinical trial.

The aim of this study is to compare the outcomes of restricted partial pulpotomy (R-PP) versus extended partial pulpotomy (E-PP) for managing cariously exposed mature permanent molars with symptomatic irreversible pulpitis (SIP). This double-arm, parallel designed randomized clinical trial was registered at clinicaltrials.gov (registration number: NCT05406557). Following random allocation, 43 participants of each group received the designated intervention. In the R-PP group, 2-3 mm of superficial pulp tissue was removed only from the exposure site, while chamber was completely de-roofed and 2-3 mm of superficial pulp tissue from entire chamber was removed in the E-PP group. Haemostasis was achieved using 3% sodium hypochlorite-soaked cotton pellets. Upon haemostasis, ProRoot mineral trioxide aggregate (ProRoot MTA) was placed over the pulpal wound, overlaid with a resin-modified glass ionomer liner, and restored with composite resin in the same visit. Outcome measures included clinical and radiographic success evaluation at 6 and 12 months, and pain assessment using the visual analogue scale pre-operatively and daily for 7 post-operative days. Nonparametric tests were used for variables including patient's age, pain intensities, mean analgesic consumption, and haemostasis time. Categorical variables including gender, caries type, analgesic intake, hard tissue barrier formation, clinical and radiographic success, and pulp sensibility responses were assessed using Chi-square or Fisher's exact test. Tooth survival was analysed using Kaplan-Meier analysis. A total of 81 cases were analysed at 12 months follow-up. Comparable success was observed in both groups (97.6% in E-PP & 97.5% in R-PP; p > .05). The R-PP group reported significantly lower pain scores on the 1st and 2nd post-operative days than E-PP (p < .05) and required significantly less analgesic intake (p < .05). Hard tissue barrier formation was significantly lower in the R-PP group (p < .05). No significant differences were observed between groups regarding haemostasis time, pulp sensibility responses, and tooth survival (p > .05). Both the PP approaches exhibited comparable success for managing cariously exposed mature permanent molars with SIP. Given the conservative nature of R-PP, it may be used as preferred PP approach for managing such cases. Being the first study of this kind, further work is necessary to draw definitive conclusions.

A retrospective study on the outcome of pulpotomy with iRoot BP plus in primary molars and its relationship with hemostasis time

BackgroundPulpotomy is a crucial method to preserve primary teeth until natural exfoliation. This study aimed to evaluate the clinical and radiographic outcomes of pulpotomy with iRoot BP Plus in primary molars and to explore the association between hemostasis time and these outcomes.MethodsPrimary molars that underwent iRoot BP Plus pulpotomy and were followed for at least 12 months were selected for this study. Clinical and radiographic data were collected, and the success rate was analyzed in relation to factors such as hemostasis time, tooth type, and arch type. The tests of significance used were the chi-square test, Fisher’s exact test, or Kruskal-Wallis test. Statistical significance was set at P < 0.05.ResultsA total of 183 teeth in 106 patients were included in the analysis. The follow-up period fell into a range of 1–3 years, with a mean of 1.6 years. The clinical and radiographic success rates were 96.7% and 92.9%, respectively. The earliest time to observe the radiographic failures was half a year after the treatment, and the latest time was two years after the treatment. Among all the teeth, 130 were recorded with hemostasis time before the application of iRoot BP Plus. Compared to teeth with a hemostasis time of 5 min or less, teeth with a hemostasis time exceeding 5 min showed no significant differences in clinical and radiographic success (P = 1.000 and 0.879). Additionally, neither arch nor teeth type showed a relationship with the pulpotomy success rate (P > 0.05).ConclusionsPulpotomy using iRoot BP Plus in primary molars achieved favorable results. The hemostasis time may not significantly impact the outcomes of pulpotomy using iRoot BP Plus in primary molars.

Clinical and radiographic success of pulpotomy and pulpectomy in primary and permanent teeth: a Systematic Review and Meta-Analysis.

This systematic review evaluated the long-term clinical effectiveness of Biodentine in vital pulp therapy procedures. Two independent reviewers searched the PubMed, Scopus, Web of Science, Cochrane, LILACS, and DOSS databases for articles published until August 2023. Review Manager and GRADEpro software were used for the analysis, and the Revman5.3 program was used for the meta-analysis. Initially, 297 publications were found, of which 12 studies, including 1385 clinical evaluations and 881 radiographic evaluations, were considered for qualitative and quantitative analysis. Regarding the therapeutic indication, Biodentine presented a clinical success rate of: 96.38% for primary teeth submitted to pulpotomy, in a follow-up of 3-24 months, 97.18% for permanent teeth submitted to direct pulp capping in a follow-up of 3-54 months and 99.24% for primary teeth submitted to indirect pulp capping at a follow-up of 3-12 months. In radiographic analyses, a success rate of: 89.82% was observed for primary teeth submitted to pulpotomy at a follow-up of 3-24 months and for permanent teeth submitted to indirect pulp capping at a follow-up of 3-12 months. Biodentine is a reliable material for applications similar to that of mineral trioxide aggregate, with high long-term clinical and radiographic success rates, in primary and permanent teeth, regardless of the therapeutic indication. The efficacy and benefits of Biodentine, make it a promising endodontic material. Key words:Systematic review, Dental materials, Pulpotomy.

Calcium Silicate-Based Cements in Restorative Dentistry: Vital Pulp Therapy Clinical, Radiographic, and Histological Outcomes on Deciduous and Permanent Dentition-A Systematic Review and Meta-Analysis.

Vital pulp therapy aims to preserve the vitality of dental pulp exposed due to caries, trauma, or restorative procedures. The aim of the present review was to evaluate the clinical, radiographic, and histological outcomes of different calcium silicate-based cements used in vital pulp therapy for both primary and permanent teeth. The review included 40 randomized controlled trials from a search across PubMed, LILACS, and the Cochrane Collaboration, as well as manual searches and author inquiries according to specific inclusion and exclusion criteria. A critical assessment of studies was conducted, and after data extraction the results were submitted to a quantitative statistical analysis using meta-analysis. The studies, involving 1701 patients and 3168 teeth, compared a total of 18 different calcium silicate-based cements in both dentitions. The qualitative synthesis showed no significant differences in short-term outcomes (up to 6 months) between different calcium silicate-based cements in primary teeth. ProRoot MTA and Biodentine showed similar clinical and radiographic success rates at 6 and 12 months. In permanent teeth, although the global results appeared to be well balanced, ProRoot MTA generally seemed to perform better than other calcium silicate-based cements except for Biodentine, which had comparable or superior results at 6 months. Meta-analyses for selected comparisons showed no significant differences in clinical and radiographic outcomes between ProRoot MTA and Biodentine over follow-up periods. The present review highlights the need for standardized definitions of success and follow-up periods in future studies to better guide clinical decisions. Despite the introduction of new calcium silicate-based cements aiming to address limitations of the original MTA. ProRoot MTA and Biodentine remain the most used and reliable materials for vital pulp therapy, although the results did not deviate that much from the other calcium silicate-based cements. Further long-term studies are required to establish the optimal CSC for each clinical scenario in both dentitions.

Main findings from the use of ozone therapy alone or combined with conventional treatments in root canal treatment: a systematic review

Introduction: The positive effects of ozone on biological properties include antimicrobial, immunostimulating, and biosynthetic impacts used in the treatment and maintenance of good oral hygiene. Ozone results in alteration in the metabolism of cells by raising the partial pressure of oxygen in tissues which improves the transporting capacity of oxygen in the blood. Ozone causes more blood supply to the ischemic zones due to surgical interventions like tooth extractions and implant placement. In this context of decontamination of root and periapical canals, ozone has emerged as an important sanitizer. Objective: It was to develop a systematic review of the literature to list the main findings of the use of ozone therapy alone or combined with conventional treatments in the treatment of root canals. Methods: The PRISMA Platform systematic review rules were followed. The search was carried out from March to June 2024 in the Scopus, PubMed, Science Direct, Scielo, and Google Scholar databases. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: A total of 122 articles were found, 35 articles were evaluated in full and 11 were included and developed in the present systematic review study. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 25 studies with a high risk of bias and 22 studies that did not meet GRADE and AMSTAR-2. Most studies did not show homogeneity in their results, with X2=88.5%&lt;50%. Results and Conclusion: It is concluded that ultrasonic and sonic ozone activation resulted in less pain in patients undergoing single-session endodontics compared to no ozone treatment. Ozonated olive oil with zinc oxide and olive oil paste with zinc oxide demonstrated good clinical and radiographic success for pulpectomy of primary teeth. Furthermore, low-intensity laser and ozone therapy are useful methods for postoperative pain in vital symptomatic teeth, but they are not superior to each other.

Potassium nitrate in polycarboxylate cement in direct pulp capping of carious, immature permanent molars: An 18-month randomised controlled trail

AimThe current study aimed to compare the clinical and radiographic success of potassium nitrate in polycarboxylate cement (KNO3/PCA) compared to mineral trioxide aggregate (MTA) in direct pulp capping (DPC) of carious, immature permanent molars over an 18-month follow-up. Materials and methodsA two-armed parallel randomised trial included one hundred children with 104 M have been included and assigned equally. The success rate was evaluated clinically and radiographically. Chi-square and Fisher's exact tests were used to compare the clinical and radiographic success rates. The percentage change in radiographic parameters was tested using an independent sample t-test. The effect of time on the mean values of radiographic parameters was tested using the general linear model (GLM). A significant level was set at 5%. ResultsThe overall success rates after 18 months of follow-up for KNO3/PCA and MTA were 90.4% and 92.3%, respectively (p > 0.05). Similarly, root maturation indicators showed no significant difference between the two groups over the follow-up (p > 0.05). ConclusionWith comparable clinical and radiographic results to MTA, KNO3/PCA is an effective treatment option in the DPC of carious, immature permanent teeth.

To Evaluate and Compare Platelet-rich Fibrin and Mineral Trioxide Aggregate as Direct Pulp Capping Agents in Primary Molars: A Randomized Prospective Clinical Study.

This study aimed to evaluate and compare the clinical and radiographic success of platelet-rich fibrin (PRF) and mineral trioxide aggregate (MTA) as direct pulp capping (DPC) agents in primary molars. In this study, 50 primary first and second molars from healthy children aged 5-9 years requiring pulp therapy were randomly allocated into two groups. In the PRF group, after coronal pulp removal and hemostasis, the remaining pulp tissue was covered with PRF preparation. In the MTA group, after coronal pulp removal and hemostasis, MTA was placed, followed by a zinc oxide eugenol (ZOE) base and glass ionomer cement (GIC) in both groups. Clinical and radiographic evaluations were undertaken at 1-, 3-, 6-, 9-, and 12-month intervals. By the end of the 12th month, the overall success rate was 82.6% in the PRF group, whereas it was 61.9% in the MTA group. Platelet-rich fibrin can be used successfully as an appropriate alternative material in DPC of primary teeth when compared with MTA. Tiwari T, Tyagi P, Tiwari S, et al. To Evaluate and Compare Platelet-rich Fibrin and Mineral Trioxide Aggregate as Direct Pulp Capping Agents in Primary Molars: A Randomized Prospective Clinical Study. Int J Clin Pediatr Dent 2024;17(S-1):S25-S29.

Assessing the efficacy of Laser pulpotomy versus conventional pulpotomy in primary teeth: A systematic review and meta-analysis of clinical trials.

This study systematically reviewed the clinical and radiographic outcomes of laser versus conventional pulpotomy in primary teeth. It also compared the success and effectiveness of different lasers to enhance the understanding and use of laser pulpotomy as an alternative treatment. An electronic search was carried out in PubMed and Cochrane from 1st January 1999 to 31st December 2023. The published articles in the English language were searched using MeSH terms and text words. Only randomized controlled trials with a sample size of more than 10 and follow-ups over 6 months were included. Meta-analysis and forest plots were evaluated by utilizing Review Manager 5.4 software. Two reviewers assessed the risk of bias using the RoB 2 tool and discrepancies were resolved by the third reviewer. The success rates were combined using a random effects model to determine clinical and radiographic outcomes. We used risk ratios with 95% confidence intervals (CI) as the primary effect measures and set the significance level at 0.05. Only 18 studies met the inclusion criteria after an electronic search. Among them, 13 studies evaluated the clinical and radiographic outcomes of laser with formocresol pulpotomy, 2 studies compared with ferric sulfate pulpotomy, and the remaining studies with Mineral trioxide aggregate (MTA) pulpotomy. The various studies showed different levels of bias. There was no significant difference in the clinical success rate (p = 0.47; RR: 1.01; 95% CI 0.98-1.04; I2 = 0%; p = 0.70) and radiographic success rate (p = 0.94; RR: 1.00; 95% CI 0.91-1.09; I2 = 64%; p = 0.001) between laser pulpotomy and formocresol. Similarly, there was no significant difference between laser pulpotomy and ferric sulfate or MTA pulpotomy. Diode laser and LLLT can be considered as alternative pulpotomy agents to formocresol in primary teeth. However, high-quality trials are needed to confirm the accuracy and reliability of these findings.

Lesão endodôntica primária sumulando uma lesão endo-perio

This study aims to present a clinical case of retreatment with the regression of an endodontic lesion, which simulated an endospinal lesion, with monthly changes of calcium hydroxide paste (UltraCal®) and preservation of the lesion repair. A 47-year-old female patient was referred for dental treatment due to the need for retreatment in elements 45 and 46. On clinical examination, the presence of a periodontal pocket fistula of more than 10 millimeters on the mesia and distal surface, respectively, was observed. Cone-beam computed tomography demonstrated the presence of filling material, as well as periapical and lateral bone radiotransparency. The retreatment was performed with rotary instrumentation (Reciproc Blue®), and the preparation of the canal with Reciproc Blue. 2.5% Sodium Hypochlorite was used as an irrigating solution, and the intracanal medication used was calcium hydroxide paste (UltraCal®) and crown sealing was done with glass ionomer cement. After 3 months, a regression of the lesion was observed, at 6 months, treatment success was observed only with endodontic therapy, without the need for periodontal treatment, confirming the diagnosis of primary endodontic lesion with secondary periodontal involvement. It is concluded that endodontic retreatment associated with intracanal medication determined clinical and radiographic success, ruling out the need for periodontal therapy.

Femoral versus radial access for middle meningeal artery embolization for chronic subdural hematomas: multicenter propensity score matched study

BackgroundWith transradial access (TRA) being more progressively used in neuroendovascular procedures, we compared TRA with transfemoral access (TFA) in middle meningeal artery embolization (MMAE) for chronic subdural hematoma (cSDH).MethodsConsecutive patients...

Comparative Clinical and Radiographic Success Rate of Bioceramic Premix vs Biosilicate-based Medicament as Indirect Pulp Treatment Materials in Primary Molars: A Double-blind Randomized Trial with a Follow-up of 12 Months.

To evaluate and compare the clinical and radiographic success of NeoPUTTY® and Biodentine™ as indirect pulp treatment (IPT) materials in primary molars. This clinical trial was conducted on children aged 5-9 years. Class I carious lesions in primary molars indicated for IPT were divided into two groups-group I, NeoPUTTY®, and group II, Biodentine™. IPC was performed as per the standard protocols. The treated teeth were evaluated for clinical and radiographic success, along with the presence of a dentinal bridge at 6 and 12 months, by three blind examiners independently. All the data were tabulated, and statistical analysis was performed using the Mann-Whitney U test. Interexaminer reliability was analyzed using Fleiss κ statistics, and it showed "good" agreement. Clinical success was 100% in both groups at 6- and 12-month follow-up, while radiographic success was also 100% at 6-month follow-up for both groups. However, at 12-month follow-up, it was 93.33% for group I and 100% for group II. The difference was statistically nonsignificant. The presence of a dentinal bridge at 12-month follow-up was seen in 86.66% of cases in group I and 100% of cases in group II, but there was no statistical difference observed between them with a p-value of 0.555. Within the limitations of the study, we conclude that NeoPUTTY® and Biodentine™ are equally effective as IPT agents in primary teeth. Kothari P, Mathur A, Tirupathi S, et al. Comparative Clinical and Radiographic Success Rate of Bioceramic Premix vs Biosilicate-based Medicament as Indirect Pulp Treatment Materials in Primary Molars: A Double-blind Randomized Trial with a Follow-up of 12 Months. Int J Clin Pediatr Dent 2024;17(7):748-753.

Clinical and Radiographic Evaluation of Diode and Er,Cr:YSGG Lasers as an Alternative to Formocresol and Sodium Hypochlorite for Pulpotomy Techniques in Primary Molars: A Randomized Controlled Clinical Trial.

Background Pulpotomy treatment is one of the vital pulp therapies that can play a major role in the preservation of primary teeth until their natural exfoliation. The objective of this current clinical trial was to assess the clinical and radiographical success of diode and Er,Cr:YSGG lasers as a viable alternative to formocresol (FC) and sodium hypochlorite in the primary molar pulpotomies. Materials and methods Sixty primary molars were selected and randomly allocated to four groups. All treatment groups followed the same clinical protocol, except for the techniques used for hemostasis of the pulpotomy sites. In group A, hemostasis was achieved by applying a 1:5 dilution of FC solution, whereas in group B, 3% sodium hypochlorite was applied to achieve hemostasis. In group C, exposure to a diode laser of 940 nm was performed, whereas for group D, erbium laser irradiation with Er,Cr:YSGG laser of 2,780 nm was employed to achieve hemostasis. Radicular pulp stamps were covered with a 2 mm layer of mineral trioxide aggregate (MTA) paste. Stainless steel crowns were utilized for the final restorations of the primary teeth. The clinical and radiographic outcomes were evaluated at the six- and 12-month follow-up intervals. The investigation was registered with the ClinicalTrials.gov Protocol and Registration System (ID: NCT06002646). Results The overall clinical and radiographic success rates of pulpotomy were 92.3% for FC, 89% for sodium hypochlorite, 98.3% for a diode laser, and 98.7% for Er,Cr:YSGG lasers. There were no statistically significant differences among the four groups (p > 0.05). Conclusions Both the diode and Er,Cr:YSGG lasers showed outcomes comparable to those of FC and sodium hypochlorite. Therefore, they could be promising alternatives to primary tooth pulpotomies.

Comparative evaluation of the clinical and radiographic success of regenerative endodontic procedures in immature versus mature permanent incisors with apical periodontitis: A prospective observational study

ABSTRACT Aim: The aim of the study was to know the clinical and radiographic outcomes of regenerative endodontic procedures of immature versus mature in young permanent incisors with apical periodontitis. Methods: Twenty non-vital, young permanent incisors with traumatic exposure between the age of 7 and 13 years were taken. Patients were divided into two groups: Group I – immature (number of teeth included = 10) and Group II – mature (number of teeth included = 10). The procedure was performed by the blood clot method as a scaffold. Biodentine (about 2–3 mm) was placed as a capping material at the cementoenamel junction. Evaluation was based on the clinical (pain, sinus, tender on percussion, swelling, mobility, intact restoration) and radiographical (Nolla stage, thickening of walls, lamina dura continuity, calcification of pulp chamber and canal, periapical healing, PAI score) parameters. Results: All 19 teeth were clinically asymptomatic after the 12-month follow-up. Radiographically, the percentage of continuous root development (in the immature group) was 100% at 12 months (P = 0.000**). Radiography revealed a reduction in the PAI scores at 12 months in the immature and mature groups. None of the treated teeth responded to the cold test after a 12-month follow-up. One patient did not come for intervention in the mature group. All the statistical tests (Chi-square, Mann–Whitney U-test, and Fisher’s exact test) were performed at a 5% significance level. Conclusion: Outcomes did not differ significantly between immature and mature groups.

COMPARATIVE EVALUATION OF 3MIXTATIN WITH MTA AND FORMOCRESOL FOR PULPOTOMY OF PRIMARY MOLARS: AN IN-VIVO STUDY

Background- Preservation of pulp vitality is of utmost importance to the normal physiological functioning of tooth in situ and physiological process of exfoliation in a tooth affected by disease or trauma. Pulpotomy serves such a purpose using various medicaments applied directly on vital pulp. Aim- To compare and evaluate the clinical and radiographic success of 3Mixtatin with MTA and formocresol for pulpotomy of primary molars. Materials &amp; Methodology– Sixty primary molars were selected from 100 children aged between 5-9 years age who reported to Department of Pedodontics and Preventive Dentistry. All selected primary teeth were randomly divided in to three groups with 20 each depending on the type of pulpotomy medicament (Group I - Formocresol, Group II - MTA, Group III -3mixtatin) used. The children were then examined clinically and radiographically at 6 and 12 months. Results &amp; Observation– Overall clinical and radiographic success rate of three groups at 6 months and 12 months were Group I showed success rate of 91.7 percent ,81.7 percent Group II showed 100percent, 91.7percent Group III showed 95 percent,85 percent respectively. Conclusion– 3mixtatin can be considered as additional pulpotomy medicament in primary teeth because of its bio-compatible and bioinductive properties.

Optimal outcomes of pulpotomy in young patients: Long-term prospects for permanent molars with signs and symptoms indicative of irreversible pulpitis

ObjectivesLimited literature addresses the long-term success of complete pulpotomy in permanent molars with signs of irreversible pulpitis in young patients. The aim of this observational study was to prospectively evaluate the long-term outcomes of complete pulpotomy using mineral trioxide aggregate (MTA) over an average period exceeding 11 years. MethodsOut of 27 molars displaying signs suggestive of irreversible pulpitis which underwent MTA pulpotomy, 24 molars were followed-up for a mean duration of 11.0 ± 2.2 years (range 8.2 to 14.8 years). Clinical and radiographic assessments were periodically conducted, tailored to each patient's specific circumstances. Treatment failure criteria included clinical signs and symptoms and radiographic evidence suggesting a lack of pulpal or periapical healing. Results83 % of molars had signs and symptoms of symptomatic irreversible pulpitis, with 83 % displaying apical periodontitis. Clinically and radiographically, all pulpotomies (100 %) were considered successful. A hard tissue barrier was observed in 71 % of teeth, and continued root maturation was evident in all molars with open apices. Complete pulp canal obliteration (PCO) was present in 21 % of the molars. All radiographic apical radiolucencies completely resolved. ConclusionsThis study demonstrates a 100 % success rate over an average 11-year follow-up for complete pulpotomy in managing permanent molars with signs and symptoms of irreversible pulpitis in young patients. It offers evidence for its long-term efficacy in promoting healing of pulp and periapical tissues. Clinical significanceThis study showed high long-term success for complete pulpotomy in young permanent molars with irreversible pulpitis, with clinical and radiographic success over 11 years. Despite initial symptoms of pulpitis and apical periodontitis, the treatment resulted in tissue healing, root maturation, and resolution of periapical radiolucencies, suggesting it as an alternative to root canal therapy.

Hyaluronic acid as a pulpotomy material in primary molars: an up to 30 months retrospective study

BackgroundThe aim of this retrospective study was to determine the long-term clinical and radiographic success of our previous randomized clinical trial and to compare the success of hyaluronic acid, with the widely used formocresol and ferric sulphate agents.MethodsThis retrospective study is the extension of the 1-year survey of our randomized clinical trial that had compared the effectiveness of a hyaluronic acid pulpotomy over formocresol and ferric sulphate pulpotomies and included clinical and radiographic evaluations with a follow-up period of over 24 months for 44 children who applied to our clinic between May 2019 and September 2019. Long-term clinical and radiographic data were obtained from the periodic files of our department, wherein each tooth’s file was examined to identify any clinical and radiographic findings. Descriptive statistics and Pearson’s chi-square tests were used to evaluate the data. Statistical significance was considered as p < 0.05.ResultsThe clinical and radiographic success rates of the hyaluronic acid, formocresol, and ferric sulphate groups were not statistically different at > 24 months. None of the teeth in the hyaluronic acid group showed any clinical findings at > 24 months.ConclusionsHyaluronic acid pulpotomies exhibited comparable success rates to formocresol and ferric sulphate materials spanning over 24 months examinations. Because of convenient accessibility and applicability of hyaluronic acid, it may be recommended as a promising alternative medicament for pulpotomy treatments of primary molars. However, further long-term follow-up human studies are needed to better understand the effect of hyaluronic acid on the dental pulp of human primary molars.