Vital and Nonvital Pulp Therapy in Primary Dentition: An Umbrella Review

An approach of preserving a mandibular primary second molar by a hemisection procedure: A case report with 36-month follow up

Primary teeth play a crucial role in functional, aesthetic and speech tasks. They are also responsible for maintaining the jaw space for successor permanent teeth. Thus, dentists should understand that extraction might be the easiest decision but not always the correct one, especially, in the case of multiple loss of primary molars. On the other hand, endodontic treatments should be accurately diagnosed - necrotic and irreversibly inflamed teeth - and performed with suitable dental tools and materials. Then it is important to provide a good sealing with a suitable final restoration. This case report discusses an approach for preserving a mandibular primary second molar which had a radiographic lesion in the mesial root and the furcation area with multiple loss of primary molars (before eruption of first permanent molar). This treatment was done by performing a root canal treatment (pulpectomy) just for the distal root and a hemisection procedure by extracting the mesial root, followed by applying SSC crown and space maintainer (band and loop). To conclude, this type of treatment should be temporary until the eruption of the first permanent molar and then changed to be a lingual arch appliance. Moreover, hemisection was a suitable alternative approach to extraction over 36 months of following up.

Clinical Effectiveness of Restorative Materials for the Restoration of Carious Primary Teeth: An Umbrella Review

Since untreated dental caries remain a worldwide burden, this umbrella review aimed to assess the quality of evidence on the clinical effectiveness of different restorative materials for the treatment of carious primary teeth. A literature search in electronic bibliographic databases was performed to find systematic reviews with at least two-arm comparisons between restorative materials and a follow-up period ≥12 months. Reviews retrieved were screened; those eligible were selected, and the degree of overlap was calculated using the 'corrected covered area' (CCA). Data were extracted and the risk of bias was assessed using the ROBIS tool. Fourteen systematic reviews with a moderate overlap (6% CCA) were included. All materials studied performed similarly and were equally efficient for the restoration of carious primary teeth. Amalgam and resin composite had the lowest mean failure rate at 24 months while high-viscosity and metal-reinforced glass ionomer cements had the highest. At 36 months, high-viscosity glass ionomer cements showed the highest failure rate with compomer showing the lowest. Most reviews had an unclear risk of bias. Within the limitations of the review, all materials have acceptable mean failure rates and could be recommended for the restoration of carious primary teeth.