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Sabbagh S, Bahrololoomi Z, Sarraf Shirazi A, Zarebidoki F, Salajegheh S, Fotouhi F, Akbarzadeh Baghban A, Asgary S. Comparative evaluation of cervical pulpotomy and pulpectomy for primary molars with irreversible pulpitis: a multicentre randomised controlled trial. Eur Arch Paediatr Dent 2024; 25:255-265. [PMID: 38488954 DOI: 10.1007/s40368-024-00880-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Accepted: 02/02/2024] [Indexed: 03/17/2024]
Abstract
PURPOSE The objective of this multicentre randomised controlled trial was to compare the clinical/radiographic outcomes of cervical pulpotomy using calcium-enriched mixture cement (PCEM) and pulpectomy using Metapex (PM) in primary molars with irreversible pulpitis (IP). METHODS A total of 134 primary molars from 94 children were randomly assigned to two intervention groups: the PCEM group (n = 74) and the PM group (n = 60). Baseline characteristics including age/gender/molar type/tooth type/jaw were recorded. The primary outcome measures were clinical/radiographic success rates assessed at the first and second follow-up appointments. Secondary outcomes included reasons for clinical/radiographic failures. Multiple logistic regression analysis was performed to determine the impact of various factors on the success rates. RESULTS The mean age of the participants in both groups was similar (PCEM group: 5.4 years, PM group: 5.5 years). Gender distribution, molar type, tooth type, jaw, and number of practitioners were comparable between the groups. The clinical success rate at the first follow-up was 98.6% in the PCEM group and 96.4% in the PM group. At the second follow-up, the clinical success rate was 97.1% in the PCEM group and 91.1% in the PM group. The radiographic success rates at the first and second follow-up were 98.6% and 96.4% in the PCEM group and 96.4% and 91.1% in the PM group, respectively. Multiple logistic regression analysis did not reveal any significant association between the success rates and age/gender/molar type/jaw, or treatment groups (P > 0.05). CONCLUSION In primary molars with IP, both simple/conservative cervical pulpotomy using calcium-enriched mixture cement and pulpectomy using Metapex demonstrated high clinical/radiographic success rates. No significant differences were observed between the two treatment modalities. These findings suggest that both techniques can be considered effective treatment options for managing primary molars with IP. TRIAL REGISTRATION NUMBER Trial registration number: IRCT20201226049838N1, retrospectively registered on 12 January 2021.
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Affiliation(s)
- S Sabbagh
- Department of Pediatric Dentistry & Dental Materials Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Z Bahrololoomi
- Department of Pedodontics & Social Determinants of Oral Health Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - A Sarraf Shirazi
- Department of Pediatric Dentistry, Faculty of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran
| | - F Zarebidoki
- Department of Pedodontics, Faculty of Dentistry, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - S Salajegheh
- Department of Pedodontics, Faculty of Dentistry, Hormozgan University of Medical Sciences, Hormozgan, Iran
| | - F Fotouhi
- Pediatric Dentist, Private Practice, Yazd, Iran
| | - A Akbarzadeh Baghban
- Proteomics Research Center, Department of Biostatistics, School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - S Asgary
- Iranian Center for Endodontic Research, Research Institute of Dental Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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Hu X, Liang Z, Wang Q, Liu L. A retrospective study of iRoot BP Plus pulpotomy compared with Vitapex pulpectomy for irreversible pulpitis of primary molars with the presence of coronal pulp tissue. Int J Paediatr Dent 2023; 33:216-226. [PMID: 36453980 DOI: 10.1111/ipd.13037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 11/20/2022] [Accepted: 11/24/2022] [Indexed: 12/02/2022]
Abstract
BACKGROUND Pulpotomy has been successfully performed in immature and mature permanent teeth with irreversible pulpitis but rarely in primary teeth. AIM To evaluate the outcomes of iRoot BP Plus pulpotomy and Vitapex pulpectomy in primary molars with irreversible pulpitis. DESIGN We selected 130 primary molars of 99 patients, aged 3-7 years, diagnosed with irreversible pulpitis with coronal pulp tissue and treated with iRoot BP Plus pulpotomy or Vitapex pulpectomy (median follow-up period: 18 months). They were divided into the pulpotomy (n = 88) and pulpectomy (n = 42) groups according to treatment procedure. The pulpotomy group was further divided into asymptomatic (n = 46) and symptomatic (n = 42) subgroups according to preoperative symptoms. The chi-squared test and Cox regression were performed to analyze the outcomes. RESULTS Clinical and radiographic success rates were significantly higher in the pulpotomy group (98.9% and 95.5%) than in the pulpectomy group (88.1% and 54.8%) and did not differ significantly between asymptomatic and symptomatic pulpotomy subgroups. CONCLUSION Irreversible pulpitis of primary molars with coronal pulp tissue can be successfully treated with iRoot BP Plus pulpotomy. Early intraradicular resorption of materials is the main adverse outcome of Vitapex pulpectomy.
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Affiliation(s)
- Xiaoyan Hu
- Jiangsu Province Key Laboratory of Oral Diseases, Department of Basic Science of Stomatology, Jiangsu Province Engineering Research Center of Stomatological Translational, The Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing, China.,Key Laboratory of Oral Diseases Research of Anhui Province, Department of Pediatric Dentistry, College & Hospital of Stomatology, Anhui Medical University, Hefei, China
| | - Zhaojia Liang
- Key Laboratory of Oral Diseases Research of Anhui Province, Department of Pediatric Dentistry, College & Hospital of Stomatology, Anhui Medical University, Hefei, China
| | - Qun Wang
- Key Laboratory of Oral Diseases Research of Anhui Province, Department of Pediatric Dentistry, College & Hospital of Stomatology, Anhui Medical University, Hefei, China
| | - Laikui Liu
- Jiangsu Province Key Laboratory of Oral Diseases, Department of Basic Science of Stomatology, Jiangsu Province Engineering Research Center of Stomatological Translational, The Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing, China
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Zhang D, Zheng C, Zhu T, Yang F, Zhou Y. Identification of key module and hub genes in pulpitis using weighted gene co-expression network analysis. BMC Oral Health 2023; 23:2. [PMID: 36593446 PMCID: PMC9808982 DOI: 10.1186/s12903-022-02638-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Accepted: 11/30/2022] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Pulpitis is a common disease mainly caused by bacteria. Conventional approaches of diagnosing the state of dental pulp are mainly based on clinical symptoms, thereby harbor deficiencies. The accurate and rapid diagnosis of pulpitis is important for choosing the suitable therapy. The study aimed to identify pulpits related key genes by integrating micro-array data analysis and systems biology network-based methods such as weighted gene co-expression network analysis (WGCNA). METHODS The micro-array data of 13 inflamed pulp and 11 normal pulp were acquired from Gene Expression Omnibus (GEO). WGCNA was utilized to establish a genetic network and categorize genes into diverse modules. Hub genes in the most associated module to pulpitis were screened out using high module group members (MM) methods. Pulpitis model in rat was constructed and iRoot BP plus was applied to cap pulp. Reverse transcription-quantitative polymerase chain reaction (RT-qPCR) was used for validation of hub genes. RESULTS WGCNA was established and genes were categorized into 22 modules. The darkgrey module had the highest correlation with pulpitis among them. A total of 5 hub genes (HMOX1, LOX, ACTG1, STAT3, GNB5) were identified. RT-qPCR proved the differences in expression levels of HMOX1, LOX, ACTG1, STAT3, GNB5 in inflamed dental pulp. Pulp capping reversed the expression level of HMOX1, LOX, ACTG1. CONCLUSION The study was the first to produce a holistic view of pulpitis, screen out and validate hub genes involved in pulpitis using WGCNA method. Pulp capping using iRoot BP plus could reverse partial hub genes.
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Affiliation(s)
- Denghui Zhang
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, 310006, China
| | - Chen Zheng
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, 310006, China
| | - Tianer Zhu
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, 310006, China
| | - Fan Yang
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, 310006, China
| | - Yiqun Zhou
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, 310006, China.
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Nassif N, Noueiri B. Antibiotic Prescription for Dental Procedures in Type 1 Diabetic Children. Int J Clin Pediatr Dent 2023; 16:60-63. [PMID: 37020756 PMCID: PMC10067975 DOI: 10.5005/jp-journals-10005-2464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/07/2023] Open
Abstract
In diabetic patients, maintaining blood glucose levels as close to normal as possible is an objective in dental management especially in pediatric ones. Patients with poorly controlled diabetes are at greater risk of developing infections. Therefore, the prescription of antibiotics may be necessary for some dental procedures. Aim The aim is to optimize the benefit and minimize the risk of antibiotics in dental treatments performed in diabetic children. Materials and methods A cross-sectional approach was conducted on 155 type 1 diabetic children (72 controlled and 83 uncontrolled). The types of dental acts held for the study were pulpotomies, pulpectomies, pediatric crowns, scaling, and extraction. For the balanced diabetic patients, no antibiotics were prescribed except for infected teeth. In the unbalanced diabetic group, for the acts causing bleeding, prophylactic antibiotics were administered. In presence of dental infection, antibiotics were administered for at least 5 days. Results The analysis of data was carried out using Statistical Package for the Social Sciences Computer Software (SPSS 21.0, Inc., Chicago, Illinois, USA). A probability value of <0.05 was regarded as statistically significant. Around 126 acts in the balanced group and 145 in the unbalanced ones were performed. In balanced diabetic children, 125 successes and one failure were noted. In the unbalanced group, 142 successes and three failures were recorded. The comparison between variables did not show any statistical significance (p-value = 0.382). Conclusion This study demonstrated that working with diabetic young patients is possible and safe as long as some measures are considered. It is crucial to identify the dental acts that necessitate antibiotics administration and to differentiate between balanced and unbalanced diabetic children for the same dental procedure. How to cite this article Nassif N, Noueiri B. Antibiotic Prescription for Dental Procedures in Type 1 Diabetic Children. Int J Clin Pediatr Dent 2023;16(1):60-63.
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Affiliation(s)
- Nahla Nassif
- Department of Pediatric Dentistry and Public Dental Health, Faculty of Dental Medicine, Lebanese University, Beirut, Lebanon
| | - Balsam Noueiri
- Department of Pediatric Dentistry and Public Dental Health, Faculty of Dental Medicine, Lebanese University, Beirut, Lebanon
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Amorim AC, Caldeira AV, Sampaio SC, Lourenço Neto N, Oliveira TM, Nogueira DA, Moretti ABDS, Sakai VT. Comparison between the rotary (Hyflex EDM®) and manual (k-file) technique for instrumentation of primary molars: a 12-month randomized clinical follow-up study. J Appl Oral Sci 2022; 30:e20210527. [PMID: 35319604 PMCID: PMC8963391 DOI: 10.1590/1678-7757-2021-0527] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 12/14/2021] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVES Rotational instrumentation is an alternative for the clinical practice of pediatric dentists. However, there are few records in the literature on the clinical and radiographic aspects of treated teeth over time. Compare instrumentation time and filling quality between manual (k-file) and rotary (Hyflex EDM®) files, and clinically and radiographically follow-up the treated teeth for 12 months. Moreover, the characteristics of glass ionomer restorations and their interference in the treatment prognosis over time were evaluated. METHODOLOGY In total, 40 children with pulp involvement in primary molars received treatment with Hyflex EDM® or manual rotary files, performed by an operator. Clinical and radiographic aspects were observed at different times to determine the effectiveness of each technique. RESULTS The rotary system reduced instrumentation time when compared to the use of manual files (p≤0.05), but there was no difference in filling quality between the groups (p≥0.05). Moreover, both types of instrumentation were effective for 12 months (p≥0.05), and restoration retention influenced the emergence of periapical lesions (p≤0.05). CONCLUSION Although rotary files reduce clinical time, the clinical and radiographic aspects of both techniques were similar over 12 months. Moreover, restoration retention has been shown to be related to treatment prognosis.
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Affiliation(s)
- Andressa Cardoso Amorim
- Universidade Federal de Alfenas (UNIFAL), Faculdade de Odontologia, Departamento de Clínica e Cirurgia, Alfenas, Minas Gerais, Brasil
| | - Amanda Valentim Caldeira
- Universidade Federal de Alfenas (UNIFAL), Faculdade de Odontologia, Departamento de Clínica e Cirurgia, Alfenas, Minas Gerais, Brasil
| | - Samara Catarino Sampaio
- Universidade Federal de Alfenas (UNIFAL), Faculdade de Odontologia, Departamento de Clínica e Cirurgia, Alfenas, Minas Gerais, Brasil
| | - Natalino Lourenço Neto
- Universidade de São Paulo (USP), Faculdade de Odontologia de Bauru, Departamento de Odontopediatria, Ortodontia e Saúde Coletiva, Bauru, São Paulo, Brasil
| | - Thais Marchini Oliveira
- Universidade de São Paulo (USP), Faculdade de Odontologia de Bauru, Departamento de Odontopediatria, Ortodontia e Saúde Coletiva, Bauru, São Paulo, Brasil.,Universidade de São Paulo (USP), Hospital de Reabilitação de Anomalias Craniofaciais, Bauru, São Paulo, Brasil
| | - Denismar Alves Nogueira
- Universidade Federal de Alfenas (UNIFAL), Instituto de Ciências exatas, Alfenas, Minas Gerais, Brasil
| | - Ana Beatriz da Silveira Moretti
- Universidade Federal de Alfenas (UNIFAL), Faculdade de Odontologia, Departamento de Clínica e Cirurgia, Alfenas, Minas Gerais, Brasil
| | - Vivien Thiemy Sakai
- Universidade Federal de Alfenas (UNIFAL), Faculdade de Odontologia, Departamento de Clínica e Cirurgia, Alfenas, Minas Gerais, Brasil
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Eid A, Mancino D, Rekab MS, Haikel Y, Kharouf N. Effectiveness of Three Agents in Pulpotomy Treatment of Permanent Molars with Incomplete Root Development: A Randomized Controlled Trial. Healthcare (Basel) 2022; 10:healthcare10030431. [PMID: 35326909 PMCID: PMC8949884 DOI: 10.3390/healthcare10030431] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Revised: 02/20/2022] [Accepted: 02/23/2022] [Indexed: 02/05/2023] Open
Abstract
The aim of this study was to investigate and compare, radiographically and clinically, the impacts of calcium-silicate based-cement (CSBC), nano-hydroxyapatite and platelet-rich fibrin (PRF) as pulpotomy agents in permanent immature molars with incomplete root development. Sixty-three participants (63 permanent immature molars) were included in this study. The patients were randomly divided into three equal groups. Fast setting MTA (MM-MTA), nano-hydroxyapatite and platelet-rich fibrin were used as pulpotomy agents. The teeth were evaluated clinically and radiographically after 6 and 12 months by two blinded examiners. Apical closure and pulp canal obliteration percentages were recorded. The in vitro reaction of the tested materials after a 7-day immersion period of the different materials in phosphate-buffered solution was analyzed using scanning electron microscopy to associate the in vitro mineralization with in vivo pulp canal obliteration percentages. Data were analyzed using Chi-square and ANOVA tests (α = 0.05). No significant difference was found between the three tested groups in terms of clinical and radiographic success (p > 0.05). All cases demonstrated evidence of root growth, including complete apical closure or continued apical closure. At 12 months, complete apical closure was found among the MM-MTA group (50%), nano-hydroxyapatite group (55%) and platelet-rich fibrin group (60%) (p > 0.05). After 12 months, pulp canal obliteration was more observed in the MM-MTA and nano-hydroxyapatite groups than in the PRF group (p < 0.05). MM-MTA (auto-mixed), NHA (hand-mixed) and PRF (autologous) could be used as pulpotomy agents since they exhibit comparable high clinical and radiographic success rates. However, the fact that the groups managed with MM-MTA and NHA have a higher tendency to canal obliteration might indicate that PRF should be considered the first choice material as pulpotomy agent, as it would make retreatment considerably easier.
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Affiliation(s)
- Ammar Eid
- Department of Endodontic and Operative Dentistry, Faculty of Dentistry, Damascus University, Damascus 0100, Syria; (A.E.); (M.S.R.)
| | - Davide Mancino
- Department of Biomaterials and Bioengineering, INSERM UMR_S 1121, Strasbourg University, 67000 Strasbourg, France; (D.M.); (Y.H.)
- Department of Endodontics and Conservative Dentistry, Faculty of Dental Medicine, University Hospital of Strasbourg, 67000 Strasbourg, France
- Pôle de Médecine et Chirurgie Bucco-Dentaire, Hôpital Civil, Hôpitaux Universitaire de Strasbourg, 67000 Strasbourg, France
| | - Mohammad Salem Rekab
- Department of Endodontic and Operative Dentistry, Faculty of Dentistry, Damascus University, Damascus 0100, Syria; (A.E.); (M.S.R.)
- Department of Endodontic and Operative Dentistry, Faculty of Dentistry, International University for Science and Technology, Damascus 0100, Syria
| | - Youssef Haikel
- Department of Biomaterials and Bioengineering, INSERM UMR_S 1121, Strasbourg University, 67000 Strasbourg, France; (D.M.); (Y.H.)
- Department of Endodontics and Conservative Dentistry, Faculty of Dental Medicine, University Hospital of Strasbourg, 67000 Strasbourg, France
- Pôle de Médecine et Chirurgie Bucco-Dentaire, Hôpital Civil, Hôpitaux Universitaire de Strasbourg, 67000 Strasbourg, France
| | - Naji Kharouf
- Department of Biomaterials and Bioengineering, INSERM UMR_S 1121, Strasbourg University, 67000 Strasbourg, France; (D.M.); (Y.H.)
- Department of Endodontics and Conservative Dentistry, Faculty of Dental Medicine, University Hospital of Strasbourg, 67000 Strasbourg, France
- Correspondence: ; Tel.: +33-667-522-841
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Influence of selective immunosuppressive drug regimens on the healing of exposed dogs' dental pulp capped with a recent calcium silicate-based cement. Clin Oral Investig 2021; 26:1417-1425. [PMID: 34370099 DOI: 10.1007/s00784-021-04116-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Accepted: 07/30/2021] [Indexed: 12/22/2022]
Abstract
OBJECTIVES In the clinical medicine, immunosuppressive drugs are used for an assortment of disorders, while their effect on the pulp healing is a controversial issue. This study evaluated the effect of different immunosuppressive drugs on the healing capacity of mechanically exposed dogs' dental pulps after direct pulp capping (DPC) with calcium silicate-based cement. MATERIALS AND METHODS Twelve healthy male dogs were randomly allocated into four equal groups, 3 dogs each: group I allocated as a control group where no drugs were received; group П given prednisone (Pred); group III given a combination of Pred and cyclosporine A (CsA); and group IV given triple dose including Pred, CsA, and mycophenolate mofetil (MMF) for 45 days before the operative procedures and until the dogs were euthanized. In each dog, 16 class V cavities were prepared on the labial surfaces of anterior teeth. Following mechanical exposure, the pulps were capped with Biodentine, calcium silicate-based cement. The pulpal tissues response to Biodentine was assessed 65 days postoperatively. RESULTS The pulp healing response was inferior in the Pred-CsA- and Pred-CsA-MMF-treated groups compared with the control and Pred-treated groups (P < 0.05). Non-significant difference was found between control and Pred-treated groups (P > 0.05). CONCLUSIONS Within the limitation of this study, DPC with calcium silicate-based cement performed under strict aseptic condition for traumatically exposed dental pulp can be considered as a successful treatment option for those who receiving Pred immunosuppressive therapy. Meanwhile, DPC with those receiving a combination of Pred, CsA, and/or MMF immunosuppressive drug regimens demonstrated unfavorable results. CLINICAL RELEVANCE Direct capping of mechanically exposed pulps with calcium silicate-based cement performed with special care for preventing infection considered a suitable strategic measure for preserving pulp vitality in patients receiving corticosteroid immunosuppressive drug.
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Yong D, Cathro P. Conservative pulp therapy in the management of reversible and irreversible pulpitis. Aust Dent J 2021; 66 Suppl 1:S4-S14. [PMID: 33818812 DOI: 10.1111/adj.12841] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 03/05/2021] [Accepted: 03/30/2021] [Indexed: 11/26/2022]
Abstract
Conservative pulp therapy is an alternative treatment option to tooth removal and root canal treatment in the management of deep caries, traumatic pulp exposures and developmental anomalies. Pulp tissue preservation can extend the long-term survival of teeth through relatively simple restorative procedures. This article aims to update clinicians on the current state of research in materials, techniques and outcomes of vital pulp therapies and provide practical guidelines for their implementation into daily practice.
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Affiliation(s)
- D Yong
- Department of Oral Rehabilitation, Faculty of Dentistry, University of Otago Dental School, Dunedin, New Zealand
| | - P Cathro
- Department of Oral Rehabilitation, Faculty of Dentistry, University of Otago Dental School, Dunedin, New Zealand
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Asgary S, Sarraf Shirazi A, Sabbagh S. Management of primary molars with irreversible pulpitis employing tampon pulpotomy: Report of three cases with 34-month mean follow-up. Clin Case Rep 2021; 9:2289-2294. [PMID: 33936681 PMCID: PMC8077301 DOI: 10.1002/ccr3.4017] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2020] [Revised: 02/17/2021] [Accepted: 02/21/2021] [Indexed: 11/24/2022] Open
Abstract
This study suggests that tampon-based coronal pulpotomy using a calcium silicate-based biomaterial can be a reliable approach for the treatment of vital primary molars with irreversible pulpitis.
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Affiliation(s)
- Saeed Asgary
- Iranian Center for Endodontic ResearchResearch Institute of Dental SciencesShahid Beheshti University of Medical SciencesTehranIran
| | - Alireza Sarraf Shirazi
- Pediatric Dentistry DepartmentSchool of DentistryMashhad University of Medical SciencesMashhadIran
| | - Sedigheh Sabbagh
- Dental Materials Research CenterMashhad University of Medical SciencesMashhadIran
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Sharma R, Kumar V, Logani A, Chawla A, Mir RA, Sharma S, Kalaivani M. Association between concentration of active MMP-9 in pulpal blood and pulpotomy outcome in permanent mature teeth with irreversible pulpitis - a preliminary study. Int Endod J 2020; 54:479-489. [PMID: 33128238 DOI: 10.1111/iej.13437] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Revised: 10/26/2020] [Accepted: 10/27/2020] [Indexed: 12/11/2022]
Abstract
AIM To investigate the correlation between the concentration of active-matrix metalloproteinases-9 (aMMP-9) in pulpal blood and the outcome of pulpotomy in mature permanent teeth with symptomatic irreversible pulpitis (SIP). METHODOLOGY Forty permanent molar teeth with a clinical diagnosis of SIP and normal apical tissues with periapical index (PAI) score ≤ 2 and ten permanent teeth (8 molars and two premolars) with a diagnosis of normal pulp that required root canal treatment for prosthetic reasons from patients between the ages of 15-35 years were recruited. All clinical procedures were performed under local anaesthesia and rubber dam isolation. After access opening, the coronal pulp tissue was amputated up to the canal orifice. A 100 μL volume of the pulpal blood was collected using a micropipette and transported to the laboratory. Sodium hypochlorite (2.5 %) was used as a haemostatic agent, and mineral trioxide aggregate (MTA) was used as the pulp capping material. The tooth was restored with composite at the same visit. Teeth with normal pulps were treated with single-visit root canal treatment. Patients with pulpotomy were recalled at 6 and 12 months. Outcome assessment of teeth with pulpotomy was carried out at 12 months and was categorized as success (asymptomatic patients with PAI score ≤ 2) or failure (symptomatic patients or PAI score ≥ 3). Quantification of aMMP-9 in pulpal blood was achieved using a fluorometric assay. The following statistical analyses were performed to assess the data: t-test, Fisher's exact test, kappa coefficient, non-parametric test, Wilcoxon rank-sum test, Spearman rank correlation test and receiver operating characteristic curve (ROC). RESULT The success rate of pulpotomy was 88 % at 12-months. There was a significant difference between the median concentrations of aMMP-9 in pulpal blood of teeth with normal pulps (52 (12-96) ng mL-1 :) and SIP (193.3 (25.8-607.7) ng mL-1 :) (P = 0.0003) and successful (132.3 (25.8-548.3) ng mL-1 :) and failed cases (512.4 (334.8-607.7 ng mL-1 :) (P = 0.0015) of MTA pulpotomy. A significant association was established between aMMP-9 concentration and outcome of pulpotomy. The area under the receiver operating characteristics curve (0.9484, 95%CI) suggested excellent discriminatory power of aMMP-9 concentration in pulpal blood to predict the pulpotomy outcome. CONCLUSION The pulpal blood concentration of aMMP-9 was significantly associated with the outcome of pulpotomy in teeth with symptomatic irreversible pulpitis, where it may be used as a potential prognostic biomarker.
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Affiliation(s)
- R Sharma
- Division of Conservative Dentistry and Endodontics, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India
| | - V Kumar
- Division of Conservative Dentistry and Endodontics, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India
| | - A Logani
- Division of Conservative Dentistry and Endodontics, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India
| | - A Chawla
- Division of Conservative Dentistry and Endodontics, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India
| | - R A Mir
- Department of Biochemistry, All India Institute of Medical Sciences, New Delhi, India
| | - S Sharma
- Division of Conservative Dentistry and Endodontics, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India
| | - M Kalaivani
- Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, India
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Aminabadi NA, Asl Aminabadi N, Jamali Z, Shirazi S. Primary tooth pulpectomy overfilling by different placement techniques: A systematic review and meta-analysis. J Dent Res Dent Clin Dent Prospects 2020; 14:250-261. [PMID: 33575016 PMCID: PMC7867685 DOI: 10.34172/joddd.2020.043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Accepted: 10/12/2020] [Indexed: 11/23/2022] Open
Abstract
Background. This study was conducted to investigate root canal overfilling with different material placement techniques in primary teeth. Methods. A systematic search was undertaken by searching PubMed/MEDLINE and Scopus for English language peer-reviewed articles published until February 2018 that reported primary tooth pulpectomy overfilling. Two reviewers independently screened and identified studies in terms of the selection criteria and independently collected the data using a specially designed data extraction form. The overfilling rate was the primary summary measure. The weighted pooled overfilling rates were estimated by random-effects meta-analysis. Results. Twenty clinical and four in vitro studies met the eligibility criteria. In the clinical studies, the pooled overfilling rate for zinc oxide-eugenol (ZOE) was 23.3% with a lentulo spiral mounted on a handpiece, 22.7% with a hand-held lentulo spiral, and 17% with a plugger. The pooled overfilling rate for calcium hydroxide-based materials was 16.7% with a lentulo spiral mounted on a handpiece, 14.7% with a hand-held lentulo spiral, 19.6% with a syringe, and 25.7% with a plugger. In the in vitro studies, neither individual overfilling rates nor two-by-two comparisons were subjected to meta-analysis because of an inadequate number of studies. Conclusion. The lowest overfilling rate in the clinical studies was related to plugger and handheld lentulo spiral techniques for ZOE and calcium hydroxide-based materials, respectively.
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Affiliation(s)
- Naser Asl Aminabadi
- Department of Pediatric Dentistry, Faculty of Dentistry, Tabriz University of Medical Science, Tabriz, Iran
| | - Nahid Asl Aminabadi
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Zahra Jamali
- Department of Oral Medicine, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Sajjad Shirazi
- Department of Oral Biology, College of Dentistry, University of Illinois at Chicago, Chicago, IL, USA
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12
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Chen M, Zeng J, Yang Y, Wu B. Diagnostic biomarker candidates for pulpitis revealed by bioinformatics analysis of merged microarray gene expression datasets. BMC Oral Health 2020; 20:279. [PMID: 33046027 PMCID: PMC7552454 DOI: 10.1186/s12903-020-01266-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Accepted: 09/29/2020] [Indexed: 12/11/2022] Open
Abstract
Background Pulpitis is an inflammatory disease, the grade of which is classified according to the level of inflammation. Traditional methods of evaluating the status of dental pulp tissue in clinical practice have limitations. The rapid and accurate diagnosis of pulpitis is essential for determining the appropriate treatment. By integrating different datasets from the Gene Expression Omnibus (GEO) database, we analysed a merged expression matrix of pulpitis, aiming to identify biological pathways and diagnostic biomarkers of pulpitis. Methods By integrating two datasets (GSE77459 and GSE92681) in the GEO database using the sva and limma packages of R, differentially expressed genes (DEGs) of pulpitis were identified. Then, the DEGs were analysed to identify biological pathways of dental pulp inflammation with Gene Ontology (GO) analysis, Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analysis and Gene Set Enrichment Analysis (GSEA). Protein–protein interaction (PPI) networks and modules were constructed to identify hub genes with the Search Tool for the Retrieval of Interacting Genes/Proteins (STRING) and Cytoscape. Results A total of 470 DEGs comprising 394 upregulated and 76 downregulated genes were found in pulpitis tissue. GO analysis revealed that the DEGs were enriched in biological processes related to inflammation, and the enriched pathways in the KEGG pathway analysis were cytokine-cytokine receptor interaction, chemokine signalling pathway and NF-κB signalling pathway. The GSEA results provided further functional annotations, including complement system, IL6/JAK/STAT3 signalling pathway and inflammatory response pathways. According to the degrees of nodes in the PPI network, 10 hub genes were identified, and 8 diagnostic biomarker candidates were screened: PTPRC, CD86, CCL2, IL6, TLR8, MMP9, CXCL8 and ICAM1. Conclusions With bioinformatics analysis of merged datasets, biomarker candidates of pulpitis were screened and the findings may be as reference to develop a new method of pulpitis diagnosis.
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Affiliation(s)
- Ming Chen
- Stomatological Hospital, Southern Medical University, Guangzhou, China.,School of Stomatology, Southern Medical University, Guangzhou, China
| | - Junkai Zeng
- School of Stomatology, Southern Medical University, Guangzhou, China.,Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Yeqing Yang
- Stomatological Hospital, Southern Medical University, Guangzhou, China.,School of Stomatology, Southern Medical University, Guangzhou, China
| | - Buling Wu
- School of Stomatology, Southern Medical University, Guangzhou, China. .,Shenzhen Stomatology Hospital (Pingshan), Southern Medical University, Shenzhen, Guangdong, 510515, P.R. China.
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13
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Ghaderi F, Jowkar Z, Tadayon A. Caries Color, Extent, and Preoperative Pain as Predictors of Pulp Status in Primary Teeth. Clin Cosmet Investig Dent 2020; 12:263-269. [PMID: 32694920 PMCID: PMC7340361 DOI: 10.2147/ccide.s261108] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Accepted: 06/25/2020] [Indexed: 11/23/2022] Open
Abstract
Aim This study aimed to assess the relationship between preoperative pain status, caries extent, and caries color and the ability to achieve hemostasis at the canal orifices during pulp therapy access in primary teeth. Study Design Eighty primary molar teeth with extremely deep caries extending to the pulp (based on bitewing radiography) were investigated in 66 children. The teeth with clear radiographic and clinical signs indicating the involvement of the radicular pulp were excluded. The history of preoperative pain status, the color of dental caries by visual inspection, and the extent of caries lesion measured in bitewing radiographs were recorded. After preparing the access cavities, the hemostasis achievement at the canal orifices was assessed and considered as the final factor in determining the type of treatment (pulpotomy or pulpectomy). The data were analyzed using Fisher’s exact test, the independent t-test, and Cohen’s unweighted kappa statistic. P<0.05 was considered statistically significant. Results Hemostasis was achieved in 78.1% of the teeth with black dental caries, whereas in most of the teeth with light brown dental caries (64.3%), hemostasis was not achieved (p=0.015). The extent of dental caries in the teeth needing pulpotomy was statistically significantly lower than that of those needing pulpectomy (p=0.024). Mesial side dental caries was more related to the irreversible pulpitis compared to the distal one (p=0.01). In 78.1% of the teeth without pain, hemostasis was achieved, and in most of the teeth with nocturnal pain (64.3%), hemostasis did not occur (p=0.034). Conclusion The caries color, caries extent, and preoperative pain have the potential to be used as clinical diagnostic tools to determine the pulpal status in primary teeth.
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Affiliation(s)
- Faezeh Ghaderi
- Oral and Dental Disease Research Center, Department of Pediatric Dentistry, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Zahra Jowkar
- Oral and Dental Disease Research Center, Department of Operative Dentistry, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Alireza Tadayon
- Department of Operative Dentistry, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
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14
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Chen Y, Li H, Li M, Yang L, Sun Q, Chen K. Analysis of survival and factors associated with failure of primary tooth pulpectomies performed under general anaesthesia in children from South China. Int J Paediatr Dent 2020; 30:225-233. [PMID: 31663231 DOI: 10.1111/ipd.12589] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Revised: 08/24/2019] [Accepted: 10/15/2019] [Indexed: 12/19/2022]
Abstract
BACKGROUND Pulpectomy is a technique recommended for treatment of irreversible pulp inflammation or necrosis. Treatment-related variables and patient factors may affect the prognosis of pulpectomy. AIM To investigate the survival and related predictors associated with failure of pulpectomies performed under general anaesthesia for early childhood caries. DESIGN Dental records of 124 patients, who underwent pulpectomy as part of comprehensive dental treatment under general anaesthesia, were reviewed and assessed. Relapse of pulpitis and periodontal periodontitis were evaluated by clinical examination and periapical film assessment at each follow-up appointment after original treatment. RESULTS A total of 389 teeth of 124 children were evaluated. By the end of the fourth year, 45% of teeth with pulpitis and 46% of teeth with periapical periodontitis were estimated to relapse; the median (interquartile range) number of years to relapse was 3.5 (3.4-3.8) and 3.0 (1.8-3.0) years, respectively. The follow-up frequency, number of teeth extracted, plaque index, tooth position, type of restoration, pulp status, and quality of root canal filling were observed to have independent effects on relapse. CONCLUSION Recurrence came earlier in teeth diagnosed with periapical periodontitis than those with pulpitis. Both treatment-related variables and patient factors could affect the prognosis of pulpectomy.
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Affiliation(s)
- Yu Chen
- Department of Stomatology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Huixian Li
- Institute of Paediatrics, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Mianxiang Li
- Department of Stomatology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Liuqing Yang
- Department of Stomatology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Qiyin Sun
- Department of Stomatology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Ke Chen
- Department of Stomatology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China.,Stomatological Hospital, Southern Medical University, Guangzhou, China
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15
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Park JS, Jasani B, Patel J, Anthonappa RP, King NM. Efficacy of Alternative Medicaments for Pulp Treatment in Primary Teeth in the Short Term: A Meta-analysis. J Evid Based Dent Pract 2019; 19:101309. [PMID: 31843186 DOI: 10.1016/j.jebdp.2019.01.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2018] [Revised: 12/21/2018] [Accepted: 01/20/2019] [Indexed: 10/27/2022]
Abstract
OBJECTIVE This systematic review and meta-analysis aimed to evaluate the overall, clinical, and radiographical success rates of alternative pulpotomy medicaments in primary teeth. METHODS A systematic search of five databases was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Prospective clinical trials using alternative pulpotomy medicaments in children were included. The outcome measures were overall, clinical, and radiographic success, expressed in percentages and converted to odds ratios. Fifteen articles were included in the meta-analysis. RESULTS Combined odds ratios for overall, clinical, and radiographic success was 0.55 (95% confidence interval [CI]: 0.12-2.41; P = .42; I2 = 76%), 1.03 (95% CI: 0.57-1.86; P = .92; I2 = 0%), and 0.84 (95% CI: 0.54-1.47; P = .66; I2 = 34%), respectively. The results suggest an inconclusive outcome in the success rate of alternative medicaments. CONCLUSIONS There is insufficient evidence to support the efficacy of alternative pulpotomy medicaments for use in primary teeth. Further robust studies are required before such alternative medicaments should be used in clinical practice.
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Affiliation(s)
- Joon Soo Park
- Paediatric Oral Health Research Group, UWA Dental School, The University of Western Australia, Nedlands, Western Australia, Australia
| | - Bosky Jasani
- Paediatric Oral Health Research Group, UWA Dental School, The University of Western Australia, Nedlands, Western Australia, Australia
| | - Jilen Patel
- Paediatric Oral Health Research Group, UWA Dental School, The University of Western Australia, Nedlands, Western Australia, Australia
| | - Robert P Anthonappa
- Paediatric Oral Health Research Group, UWA Dental School, The University of Western Australia, Nedlands, Western Australia, Australia.
| | - Nigel M King
- Paediatric Oral Health Research Group, UWA Dental School, The University of Western Australia, Nedlands, Western Australia, Australia
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16
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Al-Saudi KW, Nabih SM, Farghaly AM, AboHager EAA. Pulpal repair after direct pulp capping with new bioceramic materials: A comparative histological study. Saudi Dent J 2019; 31:469-475. [PMID: 31695296 PMCID: PMC6823775 DOI: 10.1016/j.sdentj.2019.05.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2018] [Revised: 05/08/2019] [Accepted: 05/13/2019] [Indexed: 12/22/2022] Open
Abstract
Aim To histopathologically evaluate the pulpal healing after direct pulp capping with TotalFill and compared it with Neo MTA Plus in human tooth cultures. Methods Forty sound human premolars freshly extracted for orthodontic reasons were randomly assigned to two experimental groups; group I: TotalFill and group II: Neo MTA Plus. Standardized Class V cavities were prepared on the buccal surface of each tooth where the pulp exposure was performed with a dental explorer. The pulp-exposed teeth were immediately capped with one of the tested materials. The prepared cavities were then finally restored with glass-ionomer cement. Teeth were cultured for three weeks and three months. Then, the cultured teeth were demineralized, sectioned and stained for histopathological evaluation. Data collected and statistically analyzed by using Fisher's exact test. The significance level was set at P ≤ 0.05. Results Histopathological analysis showed complete dentin bridge formation and an absence of inflammatory pulp response. Statistical analysis showed no significant differences between the TotalFill and Neo MTA Plus groups during the observation periods. However, a significantly higher thickness of the dentin bridge was found in the group of teeth treated with TotalFill at three months. Conclusions TotalFill produced similar favorable pulp healing and repair, and were comparable to Neo MTA Plus. Furthermore, TotalFill can form a thicker dentin bridge compared with Neo MTA Plus.
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Affiliation(s)
- Khaled Wagih Al-Saudi
- Operative Dentistry Department, Faculty of Oral and Dental Medicine, Misr University for Science and Technology, Cairo, Egypt
| | - Sameh Mahmoud Nabih
- Operative Dentistry Department, Faculty of Oral and Dental Medicine, Al-Azhar University, Cairo, Egypt
| | - Ahmed Mustafa Farghaly
- Department of Endodontics, Faculty of Oral and Dental Medicine, Al-Azhar University, Cairo, Egypt
| | - Eman Abdul-Aziz AboHager
- Oral Pathology Department, Faculty of Oral and Dental Medicine, Al-Azhar University, Cairo, Egypt
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17
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Uesrichai N, Nirunsittirat A, Chuveera P, Srisuwan T, Sastraruji T, Chompu-Inwai P. Partial pulpotomy with two bioactive cements in permanent teeth of 6- to 18-year-old patients with signs and symptoms indicative of irreversible pulpitis: a noninferiority randomized controlled trial. Int Endod J 2019; 52:749-759. [PMID: 30638262 DOI: 10.1111/iej.13071] [Citation(s) in RCA: 54] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2018] [Accepted: 01/01/2019] [Indexed: 12/20/2022]
Abstract
AIM To compare the outcome of partial pulpotomy using two cements, ProRoot MTA (Dentsply, Tulsa Dental Specialties, Tulsa, OK, USA) and Biodentine (Septodont, Saint-Maur-des-Fossés, France), in permanent teeth of 6- to 18-year-old patients with signs and symptoms indicative of irreversible pulpitis. Furthermore, the frequencies of perceptible grey discoloration caused by the cements were compared. METHODOLOGY Sixty-nine permanent first molars with signs and symptoms indicative of irreversible pulpitis, from 69 patients, were included. All operators performed partial pulpotomy under a standardized protocol. Teeth were allocated, using a website-generated number of simple randomization, to partial pulpotomy with either ProRoot MTA (37 teeth) or Biodentine (32 teeth) and were restored with composite resin or stainless steel crowns. Patients were recalled every 6 months. To be categorized as having success, the evaluated tooth must have had both clinical and radiographic success. In addition, photographs of treated teeth were evaluated for frequency of perceptible grey discoloration. Success rates between the two cements were compared using the Fisher exact test. The frequencies of perceptible grey discoloration were compared using the chi-square test. The percentage difference was estimated by 95% confidence interval, and the level of significant difference was P < 0.05. RESULTS At a mean follow-up of 32.2 ± 17.9 months, a total of 67 teeth, 37 with ProRoot MTA and 30 with Biodentine, were available for evaluation. The mean age of participants was 10 ± 2.1 years and, there were no differences in the baseline variables (gender, age, tooth type, periapical status, stage of root development, final restoration and follow-up period) between the groups. The overall success in both groups was 90%, with 92% for ProRoot MTA and 87% for Biodentine (difference, 5%; 95% confidence interval, -9% to 19%, P = 0.487), suggesting that Biodentine was noninferior to ProRoot MTA. Perceptible grey discoloration was observed in both groups, 80% for teeth treated with ProRoot MTA and 27% for teeth treated with Biodentine, with a significant difference between the materials (P < 0.001). CONCLUSIONS Permanent teeth with signs and symptoms indicative of irreversible pulpitis in 6- to 18-year-old patients were successfully treated with partial pulpotomy using both cements. Biodentine exhibited significantly less frequency of discoloration than did ProRoot MTA.
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Affiliation(s)
- N Uesrichai
- Faculty of Dentistry, Chiang Mai University, Chiang Mai, Thailand
| | - A Nirunsittirat
- Faculty of Dentistry, Chiang Mai University, Chiang Mai, Thailand
| | - P Chuveera
- Faculty of Dentistry, Chiang Mai University, Chiang Mai, Thailand
| | - T Srisuwan
- Faculty of Dentistry, Chiang Mai University, Chiang Mai, Thailand
| | - T Sastraruji
- Faculty of Dentistry, Chiang Mai University, Chiang Mai, Thailand
| | - P Chompu-Inwai
- Faculty of Dentistry, Chiang Mai University, Chiang Mai, Thailand
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Randomized Controlled Trial of Pulpotomy in Primary Molars using MTA and Formocresol Compared to 3Mixtatin: A Novel Biomaterial. J Clin Pediatr Dent 2018; 42:361-366. [PMID: 29763354 DOI: 10.17796/1053-4625-42.5.7] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE This study was conducted to compare the efficacy of 3Mixtatin (a combination of simvastatin and 3Mix antibiotic) with MTA and Formocresol for the pulpotomy of primary molars. STUDY DESIGN 114 children aged 3-6 years old with 150 primary molars were randomly allocated to three groups. MTA, Formocresol or 3Mixtatin were used for Pulpotomies. Hard setting zinc oxide eugenol was used to cover these materials. The teeth were restored with amalgam. Blinded radiographic and clinical examinations were conducted at 6, 12 and 24 months after treatment for the presence of pain, tenderness to palpation and percussion, sinus tract, swelling, presence of internal or external root resorption, inter-radicular radiolucency, and periapical lesion. RESULTS 122 teeth were available for 24-month follow-up study. The overall success rate was 78.9% for FC, 90.5% for 3Mixtatin and 88.1% for MTA group. There was no significant difference in overall success rate among the groups after 24-month follow-up (X2=2.43, df = 2, P =0.27). CONCLUSION Our findings demonstrated remarkable results of 3Mixtatin in pulpotomy of primary teeth at the 24-month follow-up. Therefore, 3Mixtatin may be considered as an effective material in pulpotomy of primary teeth because of its successful results.
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Direct pulp capping in primary molars using a resin-modified Portland cement-based material (TheraCal) compared to MTA with 12-month follow-up: a randomised clinical trial. Eur Arch Paediatr Dent 2018; 19:197-203. [PMID: 29767382 DOI: 10.1007/s40368-018-0348-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2017] [Accepted: 04/17/2018] [Indexed: 01/07/2023]
Abstract
AIM This study was to compare the success of resin-modified Portland cement-based material (TheraCal) with MTA in direct pulp capping (DPC) of primary molars. METHODS Symmetrical bilateral primary molars (92) from 46 healthy subjects aged 5-7 years were included in this split-mouth randomised clinical trial. DPC for small non-contaminated pulp exposures using either TheraCal or MTA were randomly performed in symmetrical molars. Thereafter, teeth were restored with amalgam. Clinical and radiographic evaluations were performed at 6 and 12 month follow-ups. Data were analysed using Chi square test at a significance level of 0.05. RESULTS At the final follow-up session 74 teeth were available. After 12 months, the overall success rates for MTA and TheraCal were 94.5 and 91.8%, respectively. The difference between outcomes of the two groups was not statistically significant (P > 0.05). CONCLUSION Within the limitations of the current study, radiographic and clinical findings revealed that TheraCal exhibited a comparable outcome to MTA in DPC of primary molars after 12 months.
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