Query: Pulpotomy

title: Comparative Evaluation of Mineral Trioxide Aggregate Pulpotomy and Laser Assisted Mineral Trioxide Aggregate Pulpotomy: An Original Research Article
abstract: Formocresol has been used as the material of choice (gold standard) for pulpotomy procedures because of the ease of use but was discouraged due to its potential immune sensitization and mutagenic effects. Laser irradiation was first applied for pulpotomy procedure in the year 1985. Recently, diode lasers have been used for pulpotomy in primary teeth and have shown clinical success rates comparable to formocresol. The present in vivo study was carried out to compare the clinical and radiographic success rates of mineral trioxide aggregate (MTA) pulpotomy and diode laser assisted pulpotomy in human primary molars.  The present study was a randomized clinical trial in design wherein 40 primary teeth requiring pulpotomy treatment which met the selection criteria (clinical and radiographic) were divided into two groups, Group 1 (n 20) wherein the pulpotomy was performed with MTA alone and Group 2 (n 20) wherein laser assisted pulpotomy was performed with MTA (L MTA) The patients were recalled after 3, 6, and 9 months, respectively and evaluated clinically and radiographically.  The data were analyzed using the Statistical Package for the Social Sciences (SPSS) Version 22 (IBM corporation, Washington DC, United States) Descriptive statistics were used to analyze the data while the Pearson's correlation coefficient test was used to analyze the statistical correlation between the overall success rates observed in the clinical and radiographic findings of both the groups. P 0.05 was considered statistically significant.  The clinical success rate in the MTA group was 90% 84.21% and 88.23% at 3, 6, and 9 months, respectively, with no clinical signs or, symptoms reported at the said follow up visits while the radiographic success rate was found to be 85% 84.21% and 82.3% respectively. On the contrary, the clinical success rate in the L MTA group was found to be 95% 94.74% and 94.44% at 3, 6, and 9, months, respectively with the radiographic success rate reported being 90% 89.47% and 88.89% respectively.  The combination of diode laser and MTA yielded better clinical and radiographic success rates over the pulpotomy procedures done with the help of MTA alone, thereby, concluding that lasers may be considered as adjuvant alternatives for vital pulp therapy on human primary teeth.

title: Success of Biodentine and Ferric Sulfate as Pulpotomy Materials in Primary Molars: A Retrospective Study.
abstract: To determine the clinical and radiographic success of Biodentine(r) (BD) and Ferric Sulfate (FS) as primary molar pulpotomy materials and to compare their outcomes.  Retrospective data was obtained from the electronic health records (EHR) of a university based pediatric dental clinic. Participants were enrolled according to specified inclusion and exclusion criteria. Two trained and calibrated examiners evaluated the EHR using validated criteria for clinical and radiographic outcomes. Study data was numerically coded and analyzed. Cohen's Kappa and Chi square tests were used (p<0.05)  Eighty three participants (62.7% females, age range two to eight years, average age of 4.5 years) with 102 pulpotomies were enrolled. FS was used in 78% (n=79) and BD in 22% (n=23) of the cases. Follow up periods ranged from six to 36 months (mean of 17 months) BD showed 100% clinical and radiographic success, while FS demonstrated 84% clinical and 70% radiographic success. The two groups were compared at one year with no statistically significant differences. At 18 months, BD outperformed FS clinically (p=.012) and radiographically (p=.001) Intra rater and inter rater agreement were k>0.88.  Both materials can be recommended for clinical practice, however BD may be the preferred choice for its better outcomes at 18 months.

title: Evaluation of Mineral Trioxide Aggregate and Biodentine as pulpotomy agents in immature first permanent molars with carious pulp exposure: A randomised clinical trial.
abstract: There is insufficient evidence on the outcome of pulpotomies in carious exposed young permanent molars with newer biomaterials. This study aimed to compare Mineral Trioxide Aggregate (MTA) and Biodentine as pulpotomy materials in carious exposed vital immature mandibular first permanent molars.  Sixty immature first mandibular permanent molars, with carious exposure were randomly assigned to an MTA or Biodentine group in a split mouth design. After the amputation of the coronal pulp, the pulp stumps were covered with one of the study materials and coronal restorations placed. Blinded clinical and radiographic evaluations were performed at baseline. Following this there were evaluations at 6, 12 and 18 months where comparisons between and within the two groups were made.  A high success was observed in both groups for all outcome measures for clinical success, with no significant difference between them. The mean survival time for the Biodentine and MTA groups was (17.8 and 18 months) with 95% confidence interval (17.4 18.2) and (18 .0 18.0) months respectively. Similarly, there were no significant differences between the Biodentine and MTA groups for radiographic success (P<0.001) with an increase in root length and increasing apical closure observed in both groups.  Both materials were equally effective in the treatment of cariously exposed vital immature mandibular first permanent molars.

title: The Role of Hydraulic Silicate Cements on Long Term Properties and Biocompatibility of Partial Pulpotomy in Permanent Teeth
abstract: The use of hydraulic silicate cements (HSCs) for vital pulp therapy has been found to release calcium and hydroxyl ions promoting pulp tissue healing and mineralized tissue formation. The present study investigated whether HSCs such as mineral trioxide aggregate (MTA) affect their biological and antimicrobial properties when used as long term pulp protection materials. The effect of variables on treatment outcomes of three HSCs (ProRoot MTA, OrthoMTA, and RetroMTA) was evaluated clinically and radiographically over a 48 78 month follow up period. Survival analysis was performed using Kaplan Meier survival curves. Fisher's exact test and Cox regression analysis were used to determine hazard ratios of clinical variables. The overall success rate of MTA partial pulpotomy was 89.3% Cumulative success rates of the three HSCs were not statistically different when analyzed by Cox proportional hazard regression analysis. None of the investigated clinical variables affected success rates significantly. These HSCs showed favorable biocompatibility and antimicrobial properties in partial pulpotomy of permanent teeth in long term follow up, with no statistical differences between clinical factors.

title: Evaluation of the bond strengths of restorative materials to primary tooth dentin treated with different pulpotomy techniques
abstract: The aim of this study was to investigate the changes of different pulpotomy techniques on the primary tooth dentin and to evaluate the effects of these pulpotomy methods on the shear bond strength of restorative materials to primary tooth dentin. Two hundred and forty dentin specimens were distributed randomly to the study groups as; control, ferric sulphate, Biodentine(r) Nd:YAG laser, photobiomodulation, and atmospheric pressure cold plasma (APCP) After the application of pulpotomy methods, samples were again randomly divided to two restorative materials (glass hybrid and composite resin) (n 20) and shear bond strength (SBS) test was performed. Then, 12 new dentin specimens were prepared for all groups for surface analysis. Surface examination (n 12) and fracture analyses (n 240) were carried out with scanning electron microscope (SEM) Statistical significance range was accepted as a .05 for all data. A statistically significant difference was obtained among all study groups for glass hybrid material as well as composite material (p .05) While the highest mean SBS value was obtained with Nd:YAG laser (7.58 0.60 MPa) the lowest value was observed with Biodentine(r) (6.70 0.91 MPa; p .001) for glass hybrid material. For composite material, the highest mean SBS value was calculated for Nd:YAG laser (13.79 1.24 MPa) while the lowest value was obtained with ferric sulphate (10.17 1.45 MPa; p .001) Fracture modes were mainly adhesive and mixed type according to SEM analysis. Moreover, morphological changes were observed with SEM on the dentin surfaces of ferric sulphate, Biodentine(r) and Nd:YAG laser. Within the limitations of this study, Nd:YAG laser increased the shear bond strength values in groups of composite resin.

title: Clinical and radiographic outcomes comparison between various types of laser pulpotomy and formocresol pulpotomy on primary molars: A systematic review and meta analysis
abstract: The purpose of the present systematic review and meta analysis was to evaluate clinical and radiographic outcomes comparison between various types of laser pulpotomy and formocresol pulpotomy on primary molars.  According to the research design, we employed MEDLINE, PubMed, Cochrane Library, Embase, and ISI as the electronic databases for performing a systematic literature review between 2010 to June 2020. Therefore, a commercially accessible software program (Endnote X9) was utilized for the electronic title administration. Searches were performed with mesh terms. Log odds ratio between two groups (laser pulpotomy and formocresol pulpotomy) with a 95 confidence interval (CI) random effect model, and restricted maximum likelihood (REML) method were calculated. The Meta analysis and forest plots have been evaluated using software program available in the market (i.e. Comprehensive Meta Analysis Stata V16) Results 561 potentially relevant abstracts and topics were obtained in the course of the manual and electronic searches, and finally, nine studies were included. For 6 months follow up clinical outcome, the Odds ratio was (OR, 0.37 95 CI 1.43, 0.68. P 0.49) among 8 studies and heterogeneity found (I2 0% P 0.93) This result showed there was no statistically significant difference between Laser Pulpotomy and formocresol pulpotomy.  Diode laser is more suitable for dental pulpotomy than other lasers, and its clinical and radiographic success rate is similar and even higher than that of formocresol pulpotomy.

title: Tailored 70S30C Bioactive glass induces severe inflammation as pulpotomy agent in primary teeth: an interim analysis of a randomised controlled trial.
abstract: This study compared clinical, histologic, and inflammatory outcomes of Biodentine and Bioactive glass (70S30C BAG) as pulpotomy agents in primary teeth.  A randomised, clinical trial was performed recruiting 70 children, 5 9 years old, having 1 tooth indicated for vital pulpotomy. Participants were randomised to Biodentine or 70S30C BAG groups. Clinical evaluation was scheduled at 1, 3, 6, 9, and 12 months. Additional 16 teeth were extracted after 6 weeks to assess histologic and inflammatory response (IL 8/IL 10 ratio) using ELISA. Fisher exact, Mann Whitney U test, and t test were used to compare clinical, histologic outcomes and IL 8/IL 10 ratio.  After 3 months, 10 teeth treated with Biodentine were clinically successful, while 9 teeth treated with 70S30C BAG failed (P 0.001) necessitating trial termination. Causes of failure were analysed by assessing the pH and ionic release of 70S30C BAG. Biodentine treated teeth showed minor inflammation, normal pulp, and hard tissue formation.70S30C BAG treated teeth showed severe inflammation, abscesses, root resorption without hard tissue formation. There was a significantly greater percent reduction of IL 8/IL 10 ratio in Biodentine than 70S30C BAG (mean SD 66.39 18.56 and 40.66 0.86, P 0.02) CONCLUSIONS Biodentine showed favourable clinical, histologic, and anti inflammatory outcomes, promoting pulp healing and regeneration. 70S30C BAG resulted in pulp necrosis through persistent inflammation causing clinical failure.  Biodentine is a promising pulpotomy agent in primary teeth; it promoted healing and regeneration of the dentine pulp complex. In its current form, 70S30C BAG is not a suitable pulpotomy agent; it induced persistent inflammation, negating the pulp ability to heal and regenerate.

title: Analysis of Failures of Pulpotomy Treated Primary Teeth: A Case Series and Review
abstract: Six pulpotomy treated primary molars were examined whole and after bisection. The medicaments used in the study were formocresol, ferric sulfate. A few were primary teeth treated withlaser pulpotomies and mineral trioxide aggregate. Theteeth were either extracted due to clinical and/or radiographic failures. The reasons for failure or success were discerned with the radiographs and light microscopic inspection of different sections of the teeth.

title: Ferric Sulfate Versus Calcium Enriched Mixture Cement in Pulpotomy of Primary Molars: A Randomized Clinical Trial
abstract: To evaluate the postoperative pain and clinical and radiographic success of pulpotomized primary molars using two materials, Ferric Sulfate (FS) and Calcium Enriched Mixture (CEM) cement, over a period of 3 and 6 months.  This randomized clinical trial was conducted on a total of 38 teeth selected from 19 patients aged 3 9 years. FS 15.5% and CEM cement were used as pulpotomy agents. Permanent restorations were Stainless Steel Crowns (SSCs) in both groups. Patients were recalled for follow up at 3 and 6 months intervals for clinical and radiographic assessment. Postoperative pain was recorded by using Visual Analogue Scale up to ten days following the treatment. The data were statistically analyzed using chi square test and repeated measures ANOVA.  At 6 months, a 100% clinical success rate was observed in the FS and CEM cement groups. The radiographic success rate in the FS group was 94.7% whereas 100% in the CEM cement group at 6 months. No statistically significant difference was found between the two groups (p>0.05) There was no significant difference in postoperative pain between the teeth that received either FS or CEM cement as pulpotomy agents following the procedure (p>0.05)  There were favorable outcomes of FS and CEM cement in pulpotomy of primary molar teeth.

title: SUT DISI AMPUTASYON TEDAVISINDE GUNCEL YAKLASIMLAR
abstract: Gunumuzde dogal dentisyonu korumanin oneminin anlasilmasina ve koruyucu dis hekimligine gosterilen ilginin artmasina ragmen, pek cok sut ve daimi dis curuk nedeniyle erken kaybedilmektedir. Bu nedenle, dusme zamanlarina kadar fonksiyonlarini devam ettirebilmeleri ve daimi dislenmeye rehberlik etmelerini saglamak amaciyla, derin curuk nedeniyle pulpasi etkilenmis sut dislerinin de tedavi planlamasi icinde bulunmasi gerekmektedir. Amputasyon tedavisi, kismen veya total olarak enfekte kuronal dis pulpasinin cikarilip normal yapidaki kok pulpasinin etkili ve bakterisit bir madde ile korunmasiyla fonksiyonun surdurulmesi islemi olarak tanimlanmaktadir. Bu derlemede, cocuk dis hekimliginde uygulanan sut disi amputasyon tedavileri icin guncel tedavi yontem ve materyalleri hakkinda literaturdeki yeni gelismelerin sunulmasi amaclanmistir. Anahtar Kelimeler: Amputasyon, sut disi, curuk, dis pulpasi NEW APPROACHES IN PRIMARY TOOTH PULPOTOMY TREATMENT ABSTRACT Nowadays, although the importance of preserving natural dentition is well known and the knowledge about preventive dentistry has increased, many primary and permanent teeth can be lost early due to caries. Therefore, to maintain their function until their exfoliation time and to guide permanent dentition, pulpally involved primary teeth due to deep caries should be included in the treatment planning. Pulpotomy treatment is defined as the process of maintaining function by effective and bactericidal preservation of the healthy radicular pulp following removal of partially or totally infected coronal pulp. In this review, it was aimed to present the recent developments in the literature about the current treatment methods and materials for the treatment of primary tooth pulpotomy in pediatric dentistry.  Pulpotomy, primary teeth, caries, dental pulp