Treatment Of Primary Molars Research Articles

Comparative evaluation of the remaining dentin volume following instrumentation with rotary, reciprocating, and hand files during root canal treatment in primary molars: An ex vivo study

Background/purposeThe effectiveness of root canal treatments with different file systems in primary teeth is important in terms of clinical practice and the use of file systems that work with different principles in primary tooth pulpectomy is becoming widespread. The amount of remaining dentin in the coronal region of the root is important in terms of the prognosis of the tooth and the long-term success of the treatment in teeth that have undergone root canal treatment. The aim of this study was to evaluate the remaining dentin volume in the coronal part of the root after the use of rotary, reciprocating, and conventional hand files in primary tooth pulpectomy. Materials and methodsA total of 30 primary molars were divided into three groups. In each group, the preparations were made with three different file types: WaveOne Gold, which works with reciprocating motion; TruNatomy, which works with rotational motion; and conventional hand files. The three-dimensional images were evaluated for remaining dentin volume in the 2-mm coronal part of the root. Group means were compared using one-way analysis of variance, and post hoc analyses were performed with the Tukey test. ResultsThere was no statistically significant difference between the groups in terms of preoperative and postoperative dentin volume (P > 0.05). The mean difference after preparation was observed the most in the WaveOne Gold group and the least in the TruNatomy group. When the mean percentage differences were evaluated, it was observed that statistically significantly more dentin volume was preserved after the preparation with TruNatomy than with WaveOne Gold (P = 0.021). ConclusionIn primary tooth pulpectomy, file systems working with rotational motion can be preferred over file systems working with reciprocating motion in preserving the amount of dentin in the 2-mm coronal part of the root.

The results of vital pulp therapy for primary molars in children with negative behaviour

Relevance. Сhildren's negative behaviour may affect pulpitis treatment results. The study aimed to study the vital pulp therapy effectiveness for chronic fibrous pulpitis treatment in primary molars of children with negative behaviour.Material and methods. The study involved 60 children aged 3-6 years with negative behaviour (according to the Frankl scale). Before the treatment, the children had non-pharmacological psychological behaviour management. One hundred and twenty primary molars were treated for pulpitis using the biological method. Follow-ups assessed the condition of the fillings and the presence/absence of clinical and radiographic signs of complications after 6, 12, 18 and 24 months. Tooth survival rate determined the effectiveness of pulpitis treatment.Results. The after-pulpitis-treatment complication rate where tooth extraction was necessary amounted to 15.0% after six months and 1.7% after 12 months (p<0.001); there were no complications after 18 and 24 months. During the first 12 months, 4.1% of cases required retreatment of pulpitis by pulpotomy. The retreatment rate due to filling defects was 20.8% after six months, and it then significantly decreased to 1.0-3.3% (p < 0,001). The tooth survival rate after pulpitis treatment was 83.3% after 24 months. There were no statistically significant differences between the pulpitis treatment results based on the children’s age, the localization of the carious cavities, and direct or indirect pulp capping.Conclusion. The biological method of chronic fibrous pulpitis treatment in primary molars of children aged 3-6 years with negative behaviour had high 24-month effectiveness at an outpatient dental appointment (with preliminary psychological behaviour management). Most complications developed during the first six months after the treatment, to which dental filling defects contributed.

The results of vital pulp therapy for primary molars in children with negative behaviour

Relevance. Сhildren's negative behaviour may affect pulpitis treatment results. The study aimed to study the vital pulp therapy effectiveness for chronic fibrous pulpitis treatment in primary molars of children with negative behaviour.Material and methods. The study involved 60 children aged 3-6 years with negative behaviour (according to the Frankl scale). Before the treatment, the children had non-pharmacological psychological behaviour management. One hundred and twenty primary molars were treated for pulpitis using the biological method. Follow-ups assessed the condition of the fillings and the presence/absence of clinical and radiographic signs of complications after 6, 12, 18 and 24 months. Tooth survival rate determined the effectiveness of pulpitis treatment.Results. The after-pulpitis-treatment complication rate where tooth extraction was necessary amounted to 15.0% after six months and 1.7% after 12 months (p<0.001); there were no complications after 18 and 24 months. During the first 12 months, 4.1% of cases required retreatment of pulpitis by pulpotomy. The retreatment rate due to filling defects was 20.8% after six months, and it then significantly decreased to 1.0-3.3% (p < 0,001). The tooth survival rate after pulpitis treatment was 83.3% after 24 months. There were no statistically significant differences between the pulpitis treatment results based on the children’s age, the localization of the carious cavities, and direct or indirect pulp capping.Conclusion. The biological method of chronic fibrous pulpitis treatment in primary molars of children aged 3-6 years with negative behaviour had high 24-month effectiveness at an outpatient dental appointment (with preliminary psychological behaviour management). Most complications developed during the first six months after the treatment, to which dental filling defects contributed.

Evaluation and Comparison of Effectiveness of Kedo-S Pediatric Rotary Files vs Manual Instrumentation for Root Canal Treatment in Primary Molars.

To evaluate and compare the clinical and radiographic success of Kedo-S pediatric rotary files vs manual K-Files for pulpectomy in primary mandibular molars. A sample of 30 primary mandibular molars with irreversible pulpitis was taken per group. The groups were divided as below mentioned-group I (n = 30) was treated using the Kedo-S file system. Group II (n = 30)-treated using manual stainless steel K-File. The clinical and radiographic success was compared of both techniques. Statistical analysis involved t-test, Chi-squared test, and Cochran's Q test. The overall clinical success at 3, 6, and 9 months in group I were 72.4, 89.7, and 93%, respectively and in group II were 82.1, 92.9, and 92.9%, respectively. The overall radiographic success in group I at 3, 6, and 9 months were 6.9, 17.2, and 69%, respectively and in group II were 0, 7.1, and 35.7%, respectively. According to the Frankl behavior rating scale, 19 children in group I (65.5%) showed negative behavior, and 15 children in group II (53.57%) showed positive behavior. The mean instrumentation time in group I (Kedo-S pediatric rotary file group) and group II (hand K-File group) was 8.03 ± 0.823 and 11.25 ± 0.928, respectively. There was a statistically significant/highly significant difference in intergroup comparison postoperative behavior among the children in the two study groups. There was a statistically significant difference between the two study groups with relation to instrumentation time. The trend that was observed in the clinical and radiographic profile was that group I (Kedo-S rotary files) cases had more success when absolute numbers and figures were compared than group II (hand stainless steel K-File) in which success rates were comparable; however, the difference between the groups were found to be statistically nonsignificant. Rajain T, Tsomu K, Namdev R. Evaluation and Comparison of Effectiveness of Kedo-S Pediatric Rotary Files vs Manual Instrumentation for Root Canal Treatment in Primary Molars. Int J Clin Pediatr Dent 2023;16(1):22-29.

Evaluation of Caries Removal Efficacy Using BRIX 3000 and Atraumatic Restorative Treatment in Primary Molars: A Clinical Comparative Study

The aim of the present study was to compare and evaluate the efficacy of two minimally invasive methods in the removal of infected carious dentin in primary molars. Eighty primary molars with class I occlusal caries involving dentin were selected and allocated to either of the two groups using convenient sampling. Group A (n = 40) caries were excavated using BRIX 3000 and in Group B (n = 40) atraumatic restorative treatment (ART) caries were excavated using hand instruments only. In both groups, caries removal efficacy was evaluated clinically using caries detection dye (Sable and Sleek), and the patient's discomfort level was noted using the Wong-Baker faces pain rating scale (WBFPS). The results indicated that BRIX 3000 was effective in the removal of caries from primary molars with a significant difference. While there was no statistically significant difference seen in pain perception on caries excavation using both the methods. Although, a mild discomfort was noted in Group B. Comparing the two minimally invasive techniques, the new chemomechanical solution (BRIX 3000) was an effective method for the removal of caries from primary molars. So, it can be considered an alternative to the conventional caries removal method in treating pediatric dental patients. BRIX 3000 gel is effective in the removal of caries in children who are anxious and apprehensive as it is a noninvasive method of treatment in the pediatric age group.

What’s new for the clinician– summaries of recently published papers

More than 90% of the world’s population suffer from one or more oral conditions that affects their oral health related quality of life. Edentulism (partial or full) is a major public health problem especially in poorer settings where people have limited options to manage tooth pain, tooth decay or periodontal disease. Often the only treatment option available is tooth extraction resulting in early tooth loss. In other settings, for example, the Western Cape, cultural and traditional norms practiced over generations has resulted in some of the highest edentulism rates in the world.
 Placement of a stainless steel crown (SSC) is the most commonly recommended restoration following endodontic treatment of primary molars,1 as it provides a good coronal seal, preventing microbial infiltration or restoration failure over time. However, dental aesthetics are compromised due to colour characteristics of the SSCs, which may influence child's and parent's acceptance, especially when compared to more aesthetic options such as composite resins (CRs).

Three-year results of the Hall technique use for caries treatment in primary molars

Three-year results of the Hall technique use for caries treatment in primary molars

Pain assessment following endodontic treatment using two automated systems compared to manual treatment in primary molars.

Root canal treatment in primary teeth is quite difficult and time-consuming, especially canal preparation. Pain is the most common negative outcome following root canal treatment, occurring hours or days after treatment. It is an unpleasant experience for both the patient and the dentist. The objective of this study was to assess the severity and duration of pain following the endodontic treatment of primary molars with the use of rotary and reciprocating preparation systems compared to the traditional manual method. The research sample consisted of 157 asymptomatic primary lower second molars with non-vital pulp that were indicated for root canal treatment. The patients were randomly divided into 3 groups: in the 1st group, the molars (n = 52) were prepared using the manual method; in the 2nd group (n = 53), a reciprocating automated preparation system (WaveOne®) was used; and in the 3rd group (n = 52), a rotary preparation system (ProTaper Next®) was used. Pain assessment was carried out after 6, 12, 24, 48, and 72 h, and after 1 week, using a four-face facial pain scale. The manual method provided a higher pain score through 6, 12 and 24 h (p < 0.05) as compared to the 2 automated preparation systems. The intensity of pain did not vary between the 2 machine preparation systems after 6, 12 , 24, and 48 h (p > 0.05). There were no differences between the 3 methods after 72 h and after 1 week (p > 0.05). The manual method caused more pain than the other 2 preparation systems, but there was no difference between the 2 automated methods. Automated root canal preparation systems could be used to reduce the intensity of postoperative pain after the endodontic treatment of primary teeth.

Stainless steel crown vs bulk fill composites for the restoration of primary molars post-pulpectomy: 1-year survival and acceptance results of a randomized clinical trial.

A key factor for the success and longevity of the endodontic treatment is sealing of the cavity after restorative treatment. The aim of this randomised clinical trial was to evaluate the 1-year survival of endodontic treatment in primary molars restored with stainless steel crowns (SSCs) and bulk fill composite resin (BF). As a secondary outcome, the acceptance of both children and parents was evaluated. Ninety-one 3- to 8-year-old children with at least one primary molar requiring endodontic treatment were selected. Participants were randomized to SSC or BF and evaluated after 1, 3, 6, and 12months. An acceptance questionnaire was completed immediately after the treatment. The primary outcome was the endodontic treatment success, evaluated in the intention-to-treat (ITT) population using the Kaplan-Meier and non-inferiority Cox regression analyses, with a non-inferiority limit of 15%. Sensitivity analysis between the success rates after 1year was performed using Miettinen-Nurminen's method. The Mann-Whitney test was used to compare the treatment acceptance (α=5%). The survival rate after 1year was BF=75% and SSC=88% (HR=1.41; 90% CI 0.57-3.43). ITT analysis showed a success rate of BF=86.7% and SSC=82.6% (RR=0.95; 0.78-1.16). The non-inferiority hypothesis between the survival of endodontic treatment could not be proved in both analyses (P>.05). The overall acceptance scores did not differ between the restorative groups (P>.05). This study failed to show non-inferiority of BF compared with the SSC. The materials were well accepted by both children and their parents.

Rubber dam isolation for restorative treatment in dental patients.

The effective control of moisture and microbes is necessary for the success of restoration procedures. The rubber dam, as an isolation method, has been widely used in dental restorative treatments. The effects of rubber dam usage on the longevity and quality of dental restorations still require evidence-based discussion. This review compares the effects of rubber dam with other isolation methods in dental restorative treatments. This is an update of the Cochrane Review first published in 2016. To assess the effects of rubber dam isolation compared with other types of isolation used for direct and indirect restorative treatments in dental patients. Cochrane Oral Health's Information specialist searched the following electronic databases: Cochrane Oral Health's Trials Register (searched 13 January 2021), Cochrane Central Register of Controlled Trials (CENTRAL; 2020, Issue 12) in the Cochrane Library (searched 13 January 2021), MEDLINE Ovid (1946 to 13 January 2021), Embase Ovid (1980 to 13 January 2021), LILACS BIREME Virtual Health Library (Latin American and Caribbean Health Science Information database; 1982 to 13 January 2021), and SciELO BIREME Virtual Health Library (1998 to 13 January 2021). We also searched Chinese BioMedical Literature Database (CBM, in Chinese) (1978 to 13 January 2021), VIP database (in Chinese) (1989 to 13 January 2021), and China National Knowledge Infrastructure (CNKI, in Chinese) (1994 to 13 January 2021). We searched ClinicalTrials.gov and the World Health Organization International Clinical Trials Registry Platform, OpenGrey, and Sciencepaper Online (in Chinese) for ongoing trials. There were no restrictions on the language or date of publication when searching the electronic databases. We included randomised controlled trials (including split-mouth trials) over one month in length assessing the effects of rubber dam compared with alternative isolation methods for dental restorative treatments. Two review authors independently screened the results of the electronic searches, extracted data, and assessed the risk of bias of the included studies. Disagreement was resolved by discussion. We strictly followed Cochrane's statistical guidelines and assessed the certainty of the evidence using GRADE. We included six studies conducted worldwide between 2010 and 2015 involving a total of 1342 participants (of which 233 participants were lost to follow-up). All the included studies were at high risk of bias. Five studies compared rubber dam with traditional cotton rolls isolation. One study was excluded from the analysis due to inconsistencies in the presented data. Of the four remaining trials, three reported survival rates of the restorations with a minimum follow-up of six months. Pooled results from two studies involving 192 participants indicated that the use of rubber dam isolation may increase the survival rates of direct composite restorations of non-carious cervical lesions (NCCLs) at six months (odds ratio (OR) 2.29, 95% confidence interval (CI) 1.05 to 4.99; low-certainty evidence). However, the use of rubber dam in NCCLs composite restorations may have little to no effect on the survival rates of the restorations compared to cotton rolls at 12 months (OR 1.38, 95% CI 0.45 to 4.28; 1 study, 30 participants; very low-certainty evidence) and at 18 months (OR 1.00, 95% CI 0.45 to 2.25; 1 study, 30 participants; very low-certainty evidence) but the evidence is very uncertain. At 24 months, the use of rubber dam may decrease the risk of failure of the restorations in children undergoing proximal atraumatic restorative treatment in primary molars but the evidence is very uncertain (hazard ratio (HR) 0.80, 95% CI 0.66 to 0.97; 1 study, 559 participants; very low-certainty evidence). None of the included studies mentioned adverse effects or reported the direct cost of the treatment. This review found some low-certainty evidence that the use of rubber dam in dental direct restorative treatments may lead to a lower failure rate of the restorations compared with cotton roll usage after six months. At other time points, the evidence is very uncertain. Further high-quality research evaluating the effects of rubber dam usage on different types of restorative treatments is required.

A randomized control trial comparing the efficacy of 3Mixtatin and Modified 3Mix-MP paste using lesion sterilization and tissue repair technique to conventional root canal treatment in primary molars of children aged 4-8 years: An in vivo study.

Background:The aim of this study was to evaluate clinical and radiographic success rates of 3Mixtatin and Modified 3Mix-MP paste and compare it with conventional root canal treatment procedure in primary molars requiring pulpectomy.Materials and Methods:In this in vivo study, 66 primary molars in 52 children aged between 4 and 8 years with primary molars having chronic periapical abscess were treated randomly with 3Mixtatin, Modified 3Mix-MP paste, and Metapex. The subjects were reviewed at 6 and 12 months both clinically and radiographically after pulpal therapy to evaluate and compare the healing process. The data obtained were subjected to statistical analysis at a significance level of 0.05.Results:By the end of 12-month follow-up among the three groups, Group I seemed to be performing consistently better as compared to the other two groups when evaluated clinically and radiographically. However, Group III resulted in the greatest number of failures, with success rate being mere 42.9% at the end of follow-up period.Conclusion:Radiographic and clinical healing occurred in all the three groups; however, based on our results, Group I seemed to be performing consistently better among the three groups at 12-month follow-up. Hence, it can be inferred that 3Mixtatin used as a localized agent is effective and comparable to both Modified 3Mix-MP paste and conventional pulpectomy procedure involving calcium hydroxide and iodoform paste in primary teeth.

Cavity treatment in primary molars and malocclusion: quasi-randomised clinical trial.

BackgroundAn innovative caries treatment protocol for primary teeth, termed Ultra-Conservative Treatment (UCT), restores small cavities through the Atraumatic Restorative Treatment (ART) protocol and cleans medium to large open cavities with toothbrush and fluoride toothpaste. However, UCT-treated primary molars were found to exfoliate earlier than amalgam (CRT) and ART-restored cavities, which may lead to unacceptable loss of space for normal eruption of permanent successors. The null-hypothesis tested was that there is no difference between the three treatment protocols and the intra-arch distances, and index of orthodontic treatment need (IOTN) after 4 years.MethodsDental casts were taken at baseline (T0) and four (T4) years. The space of the premolars (D + E space), arch perimeter, anterior and total arch depth were measured using a morphometric computer programme. The presence and level of malocclusion were assessed according to the IOTN index. Dependent variables were all intra-arch distances and the IOTN while the independent variable was treatment protocol (CRT, ART and UCT). Data were analysed using linear and logistic regression.ResultsThe sample consisted of 867 pairs of casts of 272 initial 6–7-year-olds. No difference was observed between the UCT protocol and the two restorative protocols for the intra-arch variables in both maxilla and mandible over the 4 year period. There was no difference between the UCT and the CRT and ART protocols regarding the occurrence of orthodontic treatment need (malocclusion). In conclusion, the UCT treatment protocol does not differ significantly from the traditional amalgam (CRT) and ART restorative protocols with respect to intra-arch distances and malocclusion. The earlier exfoliation of UCT-treated primary molars does not lead to a worsening of the eruption pattern of permanent successors.

Rubber dam may increase the survival time of dental restorations.

Data sourcesCochrane Oral Health's Trials Register, Cochrane Central Register of Controlled Trials (CENTRAL), Medline, Embase, LILACS, SciELO, Chinese BioMedical Literature Database, VIP, China National Knowledge Infrastructure, ClinicalTrials.gov, World Health Organization International Clinical Trials Registry Platform, OpenGrey and Sciencepaper Online databases. Handsearches in a number of journals.Study selectionRandomised controlled trials, including split-mouth studies assessing the effects of rubber dam isolation for restorative treatments in dental patients.Data extraction and synthesisTwo review authors independently screened the results of the electronic searches, extracted data and assessed the risk of bias of the included studies.ResultsFour studies involving a total of 1,270 patients were included. The studies were at high risk of bias. One trial was excluded from the analysis due to inconsistencies in the presented data. Restorations had a significantly higher survival rate in the rubber dam isolation group compared to the cotton roll isolation group at six months in participants receiving composite restorative treatment of non-carious cervical lesions (risk ratio (RR) 1.19, 95% confidence interval (CI) 1.04 to 1.37, very low-quality evidence). The rubber dam group had a lower risk of failure at two years in children undergoing proximal atraumatic restorative treatment in primary molars (hazard ratio (HR) 0.80, 95% CI 0.66 to 0.97, very low-quality evidence). One trial reported limited data showing that rubber dam usage during fissure sealing might shorten the treatment time. None of the included studies mentioned adverse effects or reported the direct cost of the treatment, or the level of patient acceptance/satisfaction. There was also no evidence evaluating the effects of rubber dam usage on the quality of the restorations.ConclusionsWe found some very low-quality evidence, from single studies, suggesting that rubber dam usage in dental direct restorative treatments may lead to a lower failure rate of the restorations, compared with the failure rate for cotton roll usage. Further high quality research evaluating the effects of rubber dam usage on different types of restorative treatments is required.

Effect of Ultrasonic Instrumentation in Treatment of Primary Molars.

The aim of this study is to describe the protocol used in the treatment of pulpally necrosed primary molars and to evaluate the effectiveness of ultrasonic instrumentation technique in primary dentition. A total of 50 primary molars in 40 children, ranging from 8 to 10 years of age, were endodonti-cally treated using standard protocols and ultrasonic instrumentation. The follow-up was done for each case ranging from 1 to 2/4 years. Clinical and radiographic controls showed a success rate of 97.5%, considering an evaluation time of 19 ± 9.02 months. The use of ultrasonic instrumentation in primary molars with pulpal necrosis succeeded in reducing appointment time and showed a high success rate. Ultrasonic instrumentation should be used as a standard protocol in instrumentation of endodontic treatment of primary molars so as to increase the success rate of primary teeth pulpectomies.

Rubber dam isolation for restorative treatment in dental patients.

Successful restorations in dental patients depend largely on the effective control of moisture and microbes during the procedure. The rubber dam technique has been one of the most widely used isolation methods in dental restorative treatments. The evidence on the effects of rubber dam usage on the longevity of dental restorations is conflicting. Therefore, it is important to summarise the available evidence to determine the effects of this method. To assess the effects of rubber dam isolation compared with other types of isolation used for direct and indirect restorative treatments in dental patients. We searched the following electronic databases: Cochrane Oral Health's Trials Register (searched 17 August 2016), Cochrane Central Register of Controlled Trials (CENTRAL; 2016, Issue 7) in the Cochrane Library (searched 17 August 2016), MEDLINE Ovid (1946 to 17 August 2016), Embase Ovid (1980 to 17 August 2016), LILACS BIREME Virtual Health Library (Latin American and Caribbean Health Science Information database; 1982 to 17 August 2016), SciELO BIREME Virtual Health Library (1998 to 17 August 2016), Chinese BioMedical Literature Database (CBM, in Chinese) (1978 to 30 August 2016), VIP (in Chinese) (1989 to 30 August 2016), and China National Knowledge Infrastructure (CNKI, in Chinese) (1994 to 30 August 2016). We searched ClinicalTrials.gov and the World Health Organization International Clinical Trials Registry Platform, OpenGrey and Sciencepaper Online (in Chinese) for ongoing trials. There were no restrictions on the language or date of publication when searching the electronic databases. We included randomised controlled trials (including split-mouth trials) assessing the effects of rubber dam isolation for restorative treatments in dental patients. Two review authors independently screened the results of the electronic searches, extracted data and assessed the risk of bias of the included studies. We resolved disagreement by discussion. We included four studies that analysed 1270 participants (among which 233 participants were lost to follow-up). All the included studies were at high risk of bias. We excluded one trial from the analysis due to inconsistencies in the presented data.The results indicated that dental restorations had a significantly higher survival rate in the rubber dam isolation group compared to the cotton roll isolation group at six months in participants receiving composite restorative treatment of non-carious cervical lesions (risk ratio (RR) 1.19, 95% confidence interval (CI) 1.04 to 1.37, very low-quality evidence). It also showed that the rubber dam group had a lower risk of failure at two years in children undergoing proximal atraumatic restorative treatment in primary molars (hazard ratio (HR) 0.80, 95% CI 0.66 to 0.97, very low-quality evidence). One trial reported limited data showing that rubber dam usage during fissure sealing might shorten the treatment time. None of the included studies mentioned adverse effects or reported the direct cost of the treatment, or the level of patient acceptance/satisfaction. There was also no evidence evaluating the effects of rubber dam usage on the quality of the restorations. We found some very low-quality evidence, from single studies, suggesting that rubber dam usage in dental direct restorative treatments may lead to a lower failure rate of the restorations, compared with the failure rate for cotton roll usage. Further high quality research evaluating the effects of rubber dam usage on different types of restorative treatments is required.

Sealing ability of mineral trioxide aggregate Plus™ and Biodentine™ for repair of furcal perforation in primary molars: An in vitro study.

Background:One of the unfavorable outcomes of endodontic treatment in primary molars is furcal perforation. During treatment, bacterial infection at the site of perforation should be prevented for better prognosis.Aim:This study aims to compare sealing ability of mineral trioxide aggregate (MTA) Plus™ and Biodentine™ for the repair of furcal perforation in primary molars using spectrophotometry.Materials and Methods:Access opening was done for all ninety extracted teeth. Perforation was made in furcation area in all the teeth. The sample size consisted of ninety extracted teeth. They were divided into four groups, Group 1 (n = 30) in which perforations were repaired with MTA Plus™, Group 2 (n = 30) in which perforations were repaired with Biodentine™. The other two groups were considered as control groups, Group 3 (n = 15) in which perforations were left unsealed (positive control) and Group 4 (n = 15) without perforations (negative control). Dye extraction method was used to compare the sealing ability of MTA Plus™ and Biodentine™. Statistical analysis was done using ANOVA test to compare the mean between the different groups. Intergroup comparison was performed using post hoc Scheffe test.Results:The highest dye absorbance was seen in the positive control group with a mean value of 0.080 ± 0.033. The mean value of MTA Plus™ was 0.031 ± 0.026 and Biodentine™ was 0.024 ± 0.031.Conclusion:The mean value of dye absorption of MTA Plus™ was greater than Biodentine™ but it was statistically insignificant.

Clinical and radiographic outcomes of the use of capping materials in vital pulp therapy of human primary teeth

Objective: The aim of this study was to compare the clinical and radiographic outcomes of Calcium Hydroxide (CH), Calcium Hydroxide preceded by corticosteroid/antibiotic solution (O+CH) and diluted formocresol (FC) in the vital pulp therapy of human primary teeth. Material and methods: Forty-five mandibular primary molars of children aged between 5-9 years were randomly assigned in the three study groups, FC, CH and O+CH and received conventional pulpotomy treatment. Clinical and radiographic follow-up was made at 3, 6 and 12-months. Results: No sign of clinical failure was observed in the three study groups during all the periods of evaluation. Radiographic analysis showed a total of six cases of internal root resorption in CH and O+CH groups after the 12 months follow-up, with statistically significant difference as compared with FC group. FC group did not show hard tissue barrier formation, that was observed in CH and O+CH groups in all the follow-up periods. Conclusion: All employed materials showed acceptable clinical and radiographic success rates. The results showed that the use of an anti-inflammatory solution prior the dressing material has therapeutic properties that help with pulpal healing. Continued clinical investigations using these medicaments as vital pulpotomy treatment in primary molars are recommended.

Clinical and radiographic success of mineral trioxide aggregate compared with formocresol as a pulpotomy treatment in primary molars: A systematic review and meta-analysis

The authors conducted a systematic review and meta-analysis to compare the long-term clinical and radiographic success of using mineral trioxide aggregate (MTA) and formocresol (FC) as a pulp-dressing material in pulpotomy treatment in primary molars. The authors searched MEDLINE, Thomson Reuters Web of Science and the Cochrane Central Register of Controlled Trials for randomized controlled trials (RCTs) published from Jan. 1, 1990, to May 9, 2013. For an RCT to be included, the authors required that the primary molars treated with a pulpotomy procedure must have received stainless steel crowns as a final restoration and that rubber dam isolation was used during treatment; that the pulp must have been vital as determined clinically by means of hemorrhage control with a cotton pellet; and that the RCT must have included a follow-up period of at least two years. For each included RCT, two authors assessed the risk of bias independently. The authors identified 20 trials and included five of them. A total of 377 primary molars were treated. The authors judged that none of the included RCTs had a low risk of bias. They noted no significant differences in clinical success (relative risk [RR] = 1.01; 95 percent confidence interval [CI], 0.98-1.05) and radiographic success (RR = 1.09; 95 percent CI, 0.97-1.21) for primary molars treated with MTA versus those treated with FC. On the basis of the limited evidence, pulpotomy procedures performed in primary molars involving the use of MTA or FC showed comparable clinical success rates.

A retrospective review of outcomes of dental treatment performed for special needs patients under general anaesthesia: 2-year follow-up.

Objective. The purpose of the study was to evaluate the follow-up pattern of special needs patients (SNP) treated under general anaesthesia (GA) and the failure rates of different treatment procedures and restorative materials. Study Design. The treatment records of the patients who received dental treatment under GA during 2005 to 2009 were reviewed. The duration of follow-up periods, the outcomes of different treatment procedures, and the quality of different restorative materials were recorded and evaluated. Statistics were used for the comparison (SPSS 20.0). Pearson's chi-square test and post hoc analysis were used to evaluate the attendance of postoperative appointments and the associations of failure rates of different treatment procedures and restorative materials. Cohen kappa statistics was used for intraexaminer reliability. Results. A total of 177 patients were included in the study. The attendance of postoperative appointments showed a gradual decrease from 96% to 36% within 24 months (P < 0.05). Restorative procedures had the highest failure rates among all treatment procedures (P < 0.05). Stainless steel crowns showed higher survival rates among different restorative materials (P < 0.05). Pulp treatment in primary molars has higher success rate than primary incisors and canines. Composite restorations placed in primary canines have low survival rates. The intraexaminer reliability was good (k = 0.94). Conclusion. The attendance for postoperative follow-up appointments declined within two years. Restorative treatment was less successful when compared to preventive and pulp treatments. Stainless steel crowns were more reliable restorations with higher survival rates and composite restorations were less durable.

Anatomical challenges, electronic working length determination and current developments in root canal preparation of primary molar teeth

Paediatric endodontics is an integral part of dental practice that aims to preserve fully functional primary teeth in the dental arch. Pulpectomy of primary molars presents a unique challenge for dental practitioners. Negotiation and thorough instrumentation of bizarre and tortuous canals encased in roots programmed for physiological resorption are the main challenges for this treatment approach. Consequently, numerous in vitro and in vivo studies have been conducted to validate the application of some contemporary endodontic armamentarium for effective treatment in primary molars whilst maintaining favourable clinical outcomes. Electronic apex locators, rotary nickel-titanium files and irrigation techniques are at the forefront of endodontic armamentarium in paediatric dentistry. Hence, this review aims to map out the root and root canal morphology of primary molars, to discuss the application of electronic apex locators in primary molars and to provide an update on the preparation of their root canal systems.