Clinical and Radiographic Evaluation of Four Different Pulpotomy Agents in Primary Molars: A Longitudinal Study

Clinical Success of Pulpotomies Using Intermediate Restorations and Preformed Metal Crowns in the Context of a Developing Country: A Retrospective Questionnaire-Based Investigation

Background: Dental caries is one of the most prevalent dental illnesses in children. Untreated severe caries can damage teeth, requiring pulpotomy to save them. Objective: To evaluate the clinical success rate of treatments involving pulpotomies + IRM (Intermediate Restorative Material, composed of reinforced zinc oxide-eugenol polymers) + preformed metal crowns (PMCs) in primary teeth of children treated at a public university in Mexico. Materials and Methods: A cross-sectional ambispective study was conducted on children aged 10 years or younger, treated at a public university in Mexico. A total of 1281 medical records from February 2018 to June 2023 were reviewed, yielding a sample of 199 children treated with pulpotomy + IRM + PMC. Information was collected via telephone interviews with parents/caregivers to inquire about any symptoms following the pulpotomy and metal crown treatments. Success was defined as the absence of pain, inflammation, or infection. Results: During the study period, the number of teeth treated with pulpotomy + IRM + PMC was 414, with follow-ups ranging from 6 to 69 months. Most participants were girls (54.3%), while 45.7% were boys. Out of the 167 pulpotomy + IRM + PMC treatments included in the study, the clinical success rate was 98.2%. Conclusions: The clinical success rate of primary teeth treated with pulpotomy + IRM + PMCs was high, close to 100%, based on evidence and symptom reports from parents/caregivers. It would be beneficial to implement its use in public health institutions in countries such as Mexico.

Different Pulp Dressing Materials for the Pulpotomy of Primary Teeth: A Systematic Review of the Literature

Background: Pulpotomy of primary teeth provides favorable clinical results over time; however, to date, there is still not a consensus on an ideal pulp dressing material. Therefore, the aim of the present systematic review was to compare pulpotomy agents to establish a preferred material to use. Methods: After raising a PICO question, the PRISMA guideline was adopted to carry out an electronic search through the MEDLINE database to identify comparative studies on several pulp dressing agents, published up to October 2019. Results: The search resulted in 4274 records; after exclusion, a total of 41 papers were included in the present review. Mineral trioxide aggregate (MTA), Biodentine and ferric sulphate yielded good clinical results over time and might be safely used in the pulpotomies of primary molars. Among agents, MTA seemed to be the material of choice. On the contrary, calcium hydroxide showed the worst clinical performance. Although clinically successful, formocreosol should be replaced by other materials, due to its potential cytotoxicity and carcinogenicity. Conclusion: MTA seemed to be the gold standard material in the pulpotomy of primary teeth. Promising results were also provided by calcium silicate-based cements. Further randomized clinical trials (RCTs) with adequate sample sizes and long follow-ups are encouraged to support these outcomes.

Clinical and Radiographic Evaluation of Formocresol and Chloramphenicol, Tetracycline and Zinc Oxide-Eugenol Antibiotic Paste in Primary Teeth Pulpotomies: 24 month follow up

OBJECTIVE

The purpose of the present study was to evaluate clinically and radiographically the effectiveness of formocresol and the antibiotic paste CTZ (chloramphenicol, tetracycline and zinc oxide-eugenol) in primary teeth pulpotomies, during a 6, 12 and 24 month period.

STUDY DESIGN

A total of 80 pulpotomies were performed in 58 patients between three and six years of age. The patients were selected and assigned to two groups: Group I Formocresol (FC, n=40), Group II chloramphenicol-tetracycline-zinc oxide eugenol (CTZ, n=40). The teeth were restored with glass ionomer and pre-formed stainless steel crowns. The treated teeth were evaluated clinically and radiographically at 6, 12 and 24 months.

RESULTS

After 24 months of follow up a 100% and 94.3% clinical success was obtained, in the CTZ and formocresol groups respectively (x²= 0.450, p>0.05). The radiographic success was of 97.4% and 94.3% respectively (x²= 0.920, p>0.05).

CONCLUSION

The performance of the antibiotic paste CTZ was superior to formocresol. No statistically significant differences were observed between the treatment groups either clinically or radiographically. More randomized clinical trials should be performed before it can be indicated safely.

Evaluation of the Clinical and Radiological Outcomes of Pulpotomized Primary Molars Treated with Three Different Materials: Mineral Trioxide Aggregate, Biodentine, and Pulpotec. An In-vivo Study

Introduction

The main treatment objective of pediatric dentistry lies in maintaining the integrity of the arches. The loss of primary teeth at an early age causes malocclusion. Primary teeth are considered the best space maintainers in the arch. Hence, every effort should be directed to preserve these teeth as far as possible. One of the most important goals of pediatric dentistry is the restoration of carious primary teeth and the maintenance of optimal oral health.

Aim

The aim of this study is to compare and evaluate different pulpotomy materials like mineral trioxide aggregate (MTA), Biodentine, and Pulpotec in primary molars.

Materials and methods

In the present study, 84 primary molars were selected for the pulpotomy procedure and randomly assigned to one of the three groups of MTA, Biodentine, and Pulpotec, allocating 28 primary molars to each group. The pulpotomy procedure was performed on all selected teeth and followed by permanent restoration with stainless steel crowns. All the molars were evaluated, both clinically and radiographically, at an interval of one, three, and six months.

Results

At the end of the first month, there were no adverse clinical and radiographical findings observed in all three groups. At the end of the third month, Group I showed 96% clinical and radiographical success, Group II showed 100% clinical and 96% radiographical success, and Group III showed 100% clinical and radiographical success. At the end of the sixth month, Group I showed 96% clinical and radiographical success, Group II showed 100% clinical and 90% radiographical success and Group III showed 100% clinical and radiographical success. The observations were subjected to statistical analysis using Fisher’s exact test and the Chi-square test.

Conclusion

MTA, Biodentine, and Pulpotec can be used as materials of choice for pulpotomy. Furthermore, Pulpotec appeared to be clinically and radiographically more successful than MTA and Biodentine.