A Partial Pulpotomy in Traumatized Permanent Incisors With Pulp Exposure

A complicated crown fracture in a permanent incisor is one of the most difficult traumatic dental injuries to deal with. Treatment involves multiple visits and invasive intraoperative interventions and this is a very costly procedure. However, progress in vital pulp therapy and adhesive dentistry may allow practitioners to treat these injuries with a conservative method. Correct diagnosis of the pulp is important as it forms the basis for the establishment of an appropriate management strategy. A partial pulpotomy is indicated if the patient has significant pulp exposure or if it is reported after a considerable delay. It has been reported that partial pulpotomies after complicated crown fractures have a 96% success rate. Other studies have reported that partial pulpotomy is a treatment of choice after a complicated traumatic crown fracture, with a very high success record. Traditionally, calcium hydroxide has been applied as a dressing agent. However, research has recently focused on other calcium silicate cements (CSC), such as Biodentine (BD). This study aimed to illustrate the successful management of a vital permanent incisor with complicated crown fractures, which were treated by partial pulpotomy using Biodentine material and evaluated for healing clinically and radiographically. No radiographic signs of failure or clinical symptoms were detected over a one-year period.

Apical Extrusion: Is It an Inherent Occurrence During Every Endodontic Treatment?

The aim of this literature review was to analyze all available scientific data on apical extrusion and to identify and associate the possible factors influencing the occurrence of apical extrusion, ranging from the choice of the canal shaping system, the irrigation technique, to the choice of diameter and the apical limit of preparation. A bibliographic search for relevant articles on apical extrusion of debris, irrigants, and bacteria was performed using the following databases: PubMed, Cochrane Library, and ScienceDirect. This search identified articles published between 2010 and 2023 in two languages (French and English). After selective sorting, 25 relevant documents were included. All the studies retained clearly agree on the inherent nature of apical extrusion during endodontic treatment. At the same time, we also understand that the amount of extrusion can be influenced by a number of parameters throughout endodontic therapy. According to this review, despite the undeniable nature of apical extrusion during endodontic therapy, studies with relatable experimental models that approach in vivo conditions are required to establish exploitable conclusions regarding apical extrusion and its prevention.

Evaluation of Direct and Indirect Pulp Capping With Biodentine in Vital Permanent Teeth With Deep Caries Lesions

INTRODUCTION

Pulp capping is a procedural method of preserving pulp vitality following deep caries damage or accidental pulp exposure. Biodentine is a calcium silicate material that has been promoted for use in pulp capping among various clinical applications. This study evaluated the outcome of pulp capping with Biodentine following curettage of deep caries in the case series of permanent mature teeth.

MATERIALS AND METHODS

The study was carried out on 40 teeth with advanced caries treated by direct and indirect pulp capping using Biodentine, within a follow-up of six months. This was carried out at the Department of Conservative Dentistry-Endodontics of the CCTD Ibn Rochd-Casablanca.  Results: In this study, 43 teeth from 37 patients were treated with direct pulp capping and indirect pulp capping using Biodentine. The success rate of pulp capping was 90% at one month, 85% at three months, and 80% at six months.

CONCLUSION

The results of the studies conducted using Biodentine indicate that it is a suitable material for direct and indirect pulp capping, due to its bioactivity and ability to form a dentinal bridge.