Comparative evaluation of clinical efficacy and volumetric changes in pulpectomized primary molars using hand K-file, ProTaper rotary file, and Kedo-SG blue file: an in-vitro cone beam computed tomography analysis.

The accomplishment of a successful pulpectomy depends on multiple factors that involve targeted removal of the causative irritants and soft and hard tissue debris by mechanical and chemical means. Compare and evaluate the efficacy of canal preparation and volumetric filling using conventional files and two rotary file systems using cone beam computed tomography (CBCT). Thirty freshly extracted human primary second molars were randomly divided into three groups of 10 teeth each. After access opening and working length determination, pre-operative volume analysis was done using CBCT. The canals were then instrumented by either hand K-files, ProTaper rotary files or Kedo-SG Blue rotary files. Post-operative volume analysis was performed using CBCT. All the canals were obturated using Metapex and scanned again using CBCT. Mean values of the pre- and post-operative canal volumes were analyzed using one-way Analysis of Variance (ANOVA). Inter- and intra-group volumetric changes were analyzed statistically using a post hoc test. The mean difference in volume after canal preparation and obturation was the highest in the Kedo-SG Blue group, followed by the ProTaper group and the least in the hand K group (p = 0.001). Inter-group comparison showed statistically significant differences between the hand K group and ProTaper group (p = 0.001), the ProTaper group and Kedo-SG Blue group (p = 0.001), and the hand-K group and Kedo-SG Blue group (p = 0.02). The volume of preparation and obturation was the highest using Kedo-SG Blue, followed by the ProTaper file systems.

A Comparison of Preparation Times between Manual, Rotary, and Reciprocating Files in Primary Molar Pulpectomy.

AIM: To compare preparation times using manual, rotary, and reciprocating files during pulpectomy treatment of primary molars. SETTINGS AND DESIGN: This study was an in vitro, randomised, cross-sectional study. METHODS: The study was performed on 60 extracted human primary mandibular second molars. Only mesiobuccal canals were prepared using one of three preparation techniques; each preparation technique group comprised 20 canals. Canal preparations were performed by a single, skilled operator using stainless-steel (ss) K-files (ISO size 20-35), a ProTaper Gold SX file, and a WaveOne Gold Medium file following glide path preparation. Preparation times were recorded in second (s) with a digital stopwatch. STATISTICAL ANALYSIS: Preparation times were compared using analysis of variance and the Kruskal-Wallis analysis of variance, where appropriate. The level of significance was set at P ≤ 0.05. RESULTS: The mean preparation time using the ss K-files was significantly longer (186.4 s) than when using the ProTaper Gold SX (29.6 s) or WaveOne Gold Medium files (30.5 s) (P < 0.001). Similar preparation times were recorded when using the ProTaper Gold SX and WaveOne Gold Medium files (P = 0.939). CONCLUSION: Preparation times with the ProTaper Gold SX and WaveOne Gold Medium files were significantly faster than when using the ss K-files to prepare primary tooth root canals for pulpectomy. Similar preparation times were noted when using the rotary and reciprocation instrumentation groups (P > 0.05).

Has children's oral health-related quality of life improved more following necrotic primary molars pulpectomy or extraction?

STUDY DESIGN: A randomised parallel controlled clinical trial was conducted between 2013 and 2015 at the University of Sao Paulo, Brazil, to assess the impact of pulpectomy or extraction on the oral health-related quality of life (OHRQoL) of children with pulp necrosis in primary molars. STUDY SELECTION: Children between the ages of 3 and 5 who were in good health but had extensive caries in at least one primary molar with signs of pulpal necrosis (also as seen radiographically, caries reaching the pulp with no signs of internal or external resorption) were considered for inclusion. Additionally, teeth with sufficient structure for rubber dam placement were also included. Children with any systemic, neurological, or other conditions that negatively impacted their growth were excluded. CLINICAL PROCEDURES AND SUCCESS CRITERIA: After computer-generated randomisation, 100 children were assigned randomly into two groups: 50 in the pulpectomy group and 50 in the dental extraction group. A paediatric dentist performed all procedures under local anaesthesia without sedation or general anaesthesia, and a rubber dam was used for pulpectomy with composite restoration in a single session. The OHRQoL scores were evaluated at baseline, 4, 8, and 12 months using the Brazilian version of the Early Childhood Oral Health Impact Scale (B-ECOHIS) via face-to-face interviews with parents conducted by a researcher trained in a single-blinded fashion. Additionally, the child's self-reported dental anxiety was measured using the Facial Image Scale (FIS), and dental pain was assessed using the Wong-Baker Faces Pain Scale (WBFPS) immediately after the treatment as secondary outcomes. RESULTS: The mean difference (SD) in the total B-ECOHIS score between baseline and after 12 months was 12.66 (6.79) for the pulpectomy group and 10.94 (9.28) for the extraction group, with effect sizes of 3.2 (95% CI: 2.42-4.20) and 1.4 (95% CI: 0.84-2.11), respectively. While both treatments significantly improved the children's OHRQoL after 12 months, the pulpectomy group showed greater long-term improvement compared to the extraction group, with mean differences (SD) of 4.86 (6.13) and effect sizes of 0.8 (0.46-1.13; p < 0.001). Moreover, children in the extraction group showed higher levels of anxiety compared with those in the pulpectomy group at 12-month follow-up (OR = 2.52; 95% CI = 1.30-4.89), and they reported 93% more odds of 'dental pain with high level' immediately after treatment than those in the pulpectomy group (OR = 1.93; 95% CI = 0.83-4.49). CONCLUSION: Children treated with pulpectomy in their necrotic primary molars were found to have better OHRQoL than those who had their primary molars extracted.

Treatment outcomes of pulpotomy versus pulpectomy in vital primary molars diagnosed with symptomatic irreversible pulpitis: protocol for a non-inferiority randomised controlled trial.

BACKGROUND: Pulpectomy continues to be the standard treatment recommendation for management of vital primary molars diagnosed with symptomatic irreversible pulpitis. The recent decade has seen a paradigm shift in the treatment concepts of how vital mature permanent molars diagnosed with irreversible pulpitis can be more conservatively managed using vital pulp therapy techniques like pulpotomy. However, despite emerging evidence indicating similarities between primary and permanent tooth pulp response to dental caries, there is limited research on whether pulpotomy can be similarly used as a definitive treatment modality for vital primary teeth with irreversible pulpitis. This randomised controlled trial (RCT) aims to compare the treatment effectiveness of pulpotomy versus pulpectomy in management of vital primary molars diagnosed with symptomatic irreversible pulpitis over a two-year period. METHODS/DESIGN: This clinical study is a parallel, two-armed, open label, non-inferiority RCT with a 1:1 allocation ratio between the experimental intervention arm (pulpotomy) and the active comparator arm (pulpectomy). Healthy cooperative children, between 4-9 years of age, who have painful primary molars with clinical symptoms typical of irreversible pulpitis will be recruited after obtaining informed consent from their parents/legal guardians. 50 vital primary molars clinically diagnosed with symptomatic irreversible pulpitis will be randomly distributed between the two treatment arms. The primary outcomes that will be assessed are clinical and radiographic success after six-months, one-year and two-years of the trial interventions. The influence of baseline pre-operative variables (age; gender; tooth type; site of caries; pre-operative furcal radiolucency; pre-operative pain intensity) and intra-operative factors (time taken to achieve haemostasis) on treatment outcomes will also be assessed. The secondary outcome evaluated will be the immediate (24 h and 7 d) post-operative pain relief afforded by the two treatment interventions. DISCUSSION: This trial seeks to provide evidence on whether pulpotomy treatment can be no worse than the standard pulpectomy treatment for the management of symptomatic irreversible pulpitis in vital primary molars. TRIAL REGISTRATION: ClinicalTrials.gov (NCT06183203). Registered on 30 January 2024.

[The results of vital pulpotomy in primary teeth in children with negative behavior]. / Rezul'taty vital'noi pul'potomii vo vremennykh zubakh u detei s negativnym povedeniem.

OBJECTIVE: The aim of the study. Comparative assessment of the results of vital pulpotomy in primary teeth in children with negative behavior when using non-drug behavior correction or sedation with preserved consciousness. MATERIALS AND METHODS: The proportions (%), 95% Confidence Interval (CI), the Student's criterion and χ2 for assessment of the difference between indicators were calculated. After 24 months, the pulpotomy efficiency in the 1st group was lower than in the 2nd group: 81.7% (95% CI 74.7-88.6%) and 89.2% (95% CI 83.6-94.7%), respectively, p>0.05. RESULTS: The proportions (%), 95% Confidence Interval (CI), the Student's criterion and χ2 for assessment of the difference between indicators were calculated. After 24 months, the pulpotomy efficiency in the 1st group was lower than in the 2nd group: 81.7% (95% CI 74.7-88.6%) and 89.2% (95% CI 83.6-94.7%), respectively, p>0.05. CONCLUSION: The treatment of the children aged 3-6 years with negative behavior under sedation with preserved consciousness increased the results of pulpotomy in primary teeth mainly due to the improvement of the quality of restorations.

Comparative evaluation of hand and rotary file systems on dentinal microcrack formation during pulpectomy procedure in primary teeth: an in vitro study.

PURPOSE: Pulpectomy can be used for the management of deep dentinal carious lesions in primary teeth which can be restored. Mechanical preparation of root canals can be performed using hand or NiTi rotary files. However, this may cause dentinal stress and consequently dentinal microcracks. Hence, the aim was comparative evaluation of hand and rotary file systems on dentinal microcrack formation during pulpectomy procedure in primary teeth. METHODS: 60 extracted primary molar teeth were selected comprising of 80 root canals. Simple random sampling was used to divide root canals into four groups (n = 20): Group A-Hedstrom file, Group B-Pro AF Baby Gold rotary, Group C-ProTaper Next rotary, and Group D-unprepared group. Assessment was conducted on presence or absence of microcracks using Chi square test (p < 0.05). RESULTS: The total number of microcracks in Group A: one (5%), Group B: four (20%), Group C: nine (45%) and Group D: zero (0%) which was statistically significant (p = 0.002). At cervical third, the number of microcracks seen with Group A: one (5%), Group B: zero (0%), Group C: five (25%) and Group D: zero (0%) (p = 0.005). At the middle third, the number of microcracks seen in Group A: zero (0%), Group B: four (20%), Group C: four (20%) and Group D: zero (0%) (p = 0.029). CONCLUSION: The study concluded that dentinal microcracks are formed with both hand and rotary file systems in primary teeth. ProTaper Next showed significantly higher number of microcracks, followed by ProAF Baby Gold and H files.

Teaching pulpectomy in paediatric dentistry: A national cross-sectional survey of dental schools in Brazil.

BACKGROUND: Pulpectomy is used to treat primary teeth with irreversibly inflamed or necrotic pulp tissue. There is, however, a lack of consensus on clinical protocols for teaching pulpectomy at dental schools. AIM: To determine what faculty members at Brazilian dental schools are teaching about pulpectomy in primary teeth. DESIGN: A cross-sectional, observational study was conducted using a 39-question survey available via the Google Forms® platform. A snowball sampling strategy was used for recruitment. Invitations to participate were sent via e-mail, WhatsApp® and Instagram®. The data were analysed descriptively. RESULTS: A total of 177 (58.4%) responses were obtained. Most faculty members recommended the use of Kerr hand files (66.1%), and 1% sodium hypochlorite was the most common choice for the irrigating solution (35.3%). Iodoform pastes were the first choice of faculty members (41.6%), and 60.5% of the faculty members recommended composite resin as the definitive restoration. CONCLUSION: Similarities were found in the teaching of pulpectomy for primary teeth among faculty members at dental schools in Brazil.

Complications following replantation of primary teeth: a case report / Complicações após reimplante de dentes decíduos: um relato de caso clínico

Abstract Introduction: the avulsion of primary teeth is a disturbing and unexpected event. Description: this report describes the clinical case of a three-year-old child who suffered an avulsion and replantation of the primary upper central incisors at the site of the injury. The guardians sought treatment for the child at the Federal University of Minas Gerais after the replantation. Four months later, the child suffered a new trauma and the replanted teeth presented advanced mobility, root resorption and fistula. The clinical conduct was extraction and rehabilitation with a fixed esthetic maintainer. Discussion: the literature describes two treatment options for avulsion of primary incisors: replantation and non-replantation. According to a recent systematic review, the difficulty in obtaining a consensus regarding the best clinical conduct is due, in part, to the scarcity of publications that present not only follow-ups with clinical success, but also with failures. The outcomes of replantation can be influenced by several factors. The time elapsed between replantation and splinting, and the new episode of trauma, negatively influenced the prognosis in the present case, leading to failure. Replantation of primary incisors is not yet evidence-based treatment. Therefore, this option must be chosen with caution and in ideal situations. It requires constant clinical and radiographic monitoring for evaluation of outcomes.

Resumo Introdução: a avulsão de dentes decíduos é um evento perturbador e inesperado. Descrição: o presente relato descreve o caso clínico de uma criança de três anos que sofreu avulsão e reimplante dos incisivos centrais superiores decíduos no local do acidente. Os responsáveis procuraram atendimento para a criança na Universidade Federal de Minas Gerais após reimplante. Quatro meses depois, a criança sofreu novo trauma e os dentes reimplantados apresentavam mobilidade avançada, reabsorção radicular e fístula. A conduta clínica foi extração e reabilitação com mantenedor estético fixo. Discussão: a literatura descreve duas opções de tratamento para avulsão de incisivos decíduos: o reimplante e o não reimplante. De acordo com revisão sistemática recente, a dificuldade de se obter um consenso sobre a melhor conduta clínica se deve, em parte, à escassez de publicações que apresentem não apenas acompanhamentos com sucesso clínico, mas também com falhas. O reimplante pode ser influenciado por vários fatores. O tempo decorrido entre o reimplante e a contenção, e o novo episódio de trauma, influenciaram negativamente o prognóstico do presente caso, levando ao insucesso. O reimplante de incisivos decí- duos ainda não é um tratamento baseado em evidências. Portanto, essa opção deve ser escolhida com cautela e em situações ideais. Requer monitoramento clínico e radiográfico para constante avaliação do desfecho.

Microdont Developing Outside the Alveolar Process and Within Oral Diffuse and Plexiform Neurofibroma in Neurofibromatosis Type 1.

BACKGROUND/AIM: Numerical aberrations of permanent dentition and dystopic tooth eruption are part of the phenotype of the tumor predisposition syndrome neurofibromatosis type 1 (NF1). In these cases, surplus tooth germs usually develop in the alveolar processes of the jaw. This report attests to the dystopic development of a dysplastic supernumerary tooth in NF1 arising outside the jaw. CASE REPORT: The 8-year-old male patient developed a microdont outside the bone and above the occlusal plane of the retained maxillary right second molar. The supernumerary tooth was completely embedded in oral soft tissue. Hyperplastic oral soft tissue in the molar region and microdont were excised. Specimen of the mucosa surrounding the teeth was interspersed with diffuse and plexiform neurofibroma. The retained upper right first molar emerged spontaneously within a few months after surgery. The upper right second molar did not change position. CONCLUSION: Odontogenesis can take place within tumorous oral mucosa in NF1. Surgical removal of the tumorous mucous membrane facilitates tooth eruption in some cases.

Apical debris extrusion during instrumentation of oval root canals in primary teeth using manual versus motorized files: an ex vivo study.

This study aimed to assess the apical extrusion of debris during instrumentation of primary canines using three endodontic file types. Forty-five extracted primary canines were randomly assigned to three instrumentation groups (n = 15): Hand K-files; and the motorized Kedo-S files and XP-endo Shaper files. The apically extruded debris produced during the procedure was collected and dried in pre-weighed Eppendorf tubes, and the mass of debris was calculated. The time required for the endodontic procedure was also recorded. Analysis of variance (ANOVA) and Tukey's post hoc test were used with a significance level set at 5%. XP-endo Shaper and Kedo-S files extruded significantly less debris compared with hand K-files with means of 0.84 ± 0.31 and 1.20 ± 0.67 mg respectively, compared to 2.13 ± 0.31 mg (p < 0.0001). No significant difference was found between the two motorized files. Less time was required to complete the procedure with the XP-endo Shaper compared to the hand K-files (p < 0.0001) and Kedo-S files (p < 0.0001). Within the limitations of the present study, it may be concluded that motorized files extruded less debris and required less instrumentation time compared to traditional K-files, which could benefit paediatric patients with root canal treatment needs.

The Use of Hall's Technique Preformed Metal Crown (HTPMC) by Pediatric Dentists in Malaysia.

INTRODUCTION: Hall's technique preformed metal crown (HTPMC) has been used widely by pediatric dentists in developed countries as a new approach for managing decayed primary molars without local anesthesia, caries removal, and tooth preparation. Currently, inadequate information is available regarding the implementation of this technique (HTPMC) in Malaysia. This study is aimed at evaluating the implementation of HTPMC by Malaysia's pediatric dentists and identify the co-occurrence frequencies of the HTPMC implementation with the respondents' demographic profile. MATERIALS AND METHODS: A cross-sectional questionnaire-based research was conducted among 65 pediatric dentists in Malaysia. Online questionnaires were distributed to the pediatric dentists employed at public hospitals (MOH) and universities in Malaysia. RESULT: It was found that over half of the respondents (65.6%) employed HTPMC. The analysis of the co-occurrence network frequency revealed that a high frequency of female pediatric dentists who were within the age group of 31-40 years old had fulfilled their postgraduation overseas and was employed in the university mainly applied HTPMC. CONCLUSION: The application of HTPMC among respondent pediatric dentists in Malaysia was high. However, most respondents considered HTPMC a treatment option only to manage carious primary molar rather than a treatment of choice.

Post-operative discomforts in children after extraction of primary teeth.

OBJECTIVES: This prospective observational study aimed to evaluate discomfort after extraction of deciduous teeth under local anesthesia. The primary objective was to describe the prevalence of post-extraction pain (PEP), post-extraction bleeding (PEB), post-extraction biting injury (PEBI), and analgesic usage in children. The secondary objective was to define whether it is possible to determine a profile of patients or a type of extraction procedure predictive to PEP, administration of analgesics, PEB, or PEBI. METHODS: One hundred and twenty-five children, aged 3-13 years, with indications of at least one deciduous tooth extraction, were included. Immediately after extraction, information concerning the patient and the extraction were collected. Eighteen to 32 hr after extraction, parents were called by phone to request reports concerning the onset and intensity of PEP assessed using the Wong-Baker Faces (WBF) scale, the administration of paracetamol (acetaminophen) to their children, and the appearance of PEB and/or PEBI. RESULTS: Of the children, 37.3% reported PEP (WBF ≥2), but 23.3% of these children did not receive any analgesic drugs to help relieve pain. Pain appeared before 3 hr after extraction in 69% of the children. Higher incidences of PEP and usage of analgesics were found both in the group of children with unfavorable socioeconomic level compared to favorable level and in the group with pre-operative pain compared to no pre-operative pain (p < .05). CONCLUSIONS: About a third of the children reported pain after extraction, but the instructions for pain relief were not followed by all parents. The socioeconomic level of the young patient and the pain felt during the extraction were important predictors of discomfort. Therefore, our study could help the dentist to provide information on predicted post-operative discomfort and to allow suitable care depending on the patient's profile or procedure.

Clinical and radiographic comparative study to evaluate the efficacy of restoring destroyed primary incisors using two different techniques-A pilot study.

OBJECTIVE: The restoration of destroyed maxillary primary incisors is difficult because of the insufficient amount of coronal structure. This pilot study aimed to compare the efficacy of composite posts technique and glass fiber posts technique in restoring destroyed primary incisors. MATERIALS AND METHODS: Thirty-six destroyed maxillary primary incisors in 11 children with early childhood caries were randomly assigned after endodontic treatment into two groups: glass fiber posts (n = 18) and composite resin posts (n = 18). Blinded clinical evaluation was made at 3, 6, 9, and 12 months and Blinded radiographic evaluation was made at 6 and 12 months. The evaluation was according to the FDI criteria. Data were analyzed with Fisher's exact test (α = .05). RESULT: After 12 months post-treatment, the success rates were 88.2% in glass fiber posts group and 70.6% in composite resin posts group. There was no statistically significant difference between the two groups according to the evaluation criteria (p-value >.05). CONCLUSION: Glass fiber posts technique and Composite posts technique may be used in the restoration of destroyed primary incisors.

Treatment of severely decayed anterior primary teeth with short-post technique (Mushroom Restorations) under general anesthesia.

AIMS: The aim of this study was to evaluation the treatment success of the short post technique (mushroom restoration) using a composite resin in severely decayed primary anterior teeth after 6, 12, and 18 months after treatment. METHODS: Eighteen children aged 3-5 years with severely decayed primary maxillary anterior teeth (60 anterior maxillary primary teeth in total) were included. Patients were treated under general anesthesia (GA). After pulpectomy, a "mushroom shape" was formed in the root canals for the purpose of retention, and the root canals were filled with zinc oxide-eugenol (ZOE), and the teeth were restored with composite resin. The status of treatment was evaluated clinically and radiographically for periapical radiolucency, pathological root resorption, marginal fracture, and loss of restoration for each treated tooth. All findings were recorded. RESULTS: As a result of the evaluation criteria, the success rates at 6, 12 and 18 months were 86%, 80%, and 71%, respectively. None of the teeth showed apical radiolucency or pathological root resorption at the end of the 18th month period. CONCLUSION: The short-post (mushroom restorations) technique is a clinically acceptable alternative method for restoration of severely decayed primary teeth. This study supports the feasibility of treatment with this technique for pediatric patients treated under GA.

Mirror image: an unusual case of prolonged tooth retention in twins

Introduction: Studies of twins are important because environmental and genetic factors seem to be related to the phenotypic alterations. Objective: This paper presents a unique case of monozygotic twins with mirror image of a retained primary central incisor. Case report: Twin male brothers, 9-years-old, presented prolonged retention of the primary central upper incisor. The over-retained teeth in one twin were a mirror image of those in the other twin. The first twin presented a prolonged retention of the tooth 51 whereas the other twin presented a prolonged retention of tooth 61. After radiographic exams the over-retained teeth were extracted. Conclusion: Twins may show similarity in pattern of dental anomalies supporting the influence of genetic factors. In identical twins the location of diagnosed anomalies can be mirror imaged. This fact should lead the professional to examine the pair of twins in order to diagnose any dental anomaly that may be present.

Introdução: Estudos feitos em gêmeos são importantes porque fatores ambientais e genéticos parecem estar relacionados às alterações fenotípicas. Objetivo: Este artigo apresenta um caso raro de gêmeos monozigóticos apresentando imagem em espelho de retenção prolongada de incisivos centrais decíduos superiores homólogos. Relato do caso: Os irmãos gêmeos, com 9 anos de idade, não apresentavam história de trauma orofacial ou doença comum da infância. Após exames clínicos e radiográficos foram identificados a retenção do dente 51 no gêmeo 1 e do dente 61 no gêmeo 2. Em ambos os pacientes, os dentes 11 e o 21 estavam em erupção. O tratamento proposto foi a exodontia dos dentes decíduos com anestesia local e acompanhamento. Conclusão: Gêmeos podem apresentar semelhança no padrão de anomalias dentárias devido à influência de fatores genéticos. Adicionalmente, em gêmeos monozigóticos, a localização das anomalias diagnosticadas pode se apresentar invertidas ou imagem em espelho. Esse fato deve estimular o profissional a examinar o par de gêmeos para diagnosticar qualquer anomalia dentária que possa estar presente. O diagnóstico precoce e tratamento adequados devem ser realizados para evitar danos funcionais e estéticos em pacientes com retenções dentárias.

Success rate of proximal tooth-coloured direct restorations in primary teeth at 24 months: a meta-analysis.

The aim was to determine the survival of tooth-coloured restorative materials in proximal restorations of primary teeth at 24 months of follow-up and the influence of the following variables: use of coating, use of cavity conditioner, use of rubber dam isolation, the cavity form, the dentist's experience and the methodological characteristics of the studies. We conducted a search until May 2019, obtaining 16 articles from which 30 independent studies were extracted, which were considered as units of analysis. Four outcome measures were extracted from each study: retention, marginal integrity, anatomic form, and absence of recurrent caries. Separate meta-analyses were carried for each outcome and multiple meta-regression model was applied. The outcomes with the highest mean success rates were absence of recurrent caries and anatomic form. The type of material significantly influenced success rates. The best materials were resin-based material plus total-etching adhesion and resin-modified glass ionomer cement (RMGIC), and the worst high viscosity glass ionomer cement (HVGIC). Atraumatic restorative treatment (ART) had a lower success rate than the conventional cavity form. RMGIC had the best clinical performance and HVGIC the worst. The form of the cavity, blinding and the experience of the operator were the variables that influenced success rates. Proximal primary molar restorations should be performed with RMGIC as it combines good mechanical performance of the resins together with the prevention of secondary caries of glass ionomers.

Application of Quality Control Circle in Promoting the Use of Rubber Dams in the Root Canal Treatment of Primary Teeth.

OBJECTIVE: Study the effect of quality control circle (QCC) in promoting the usage of rubber dams (RD) in root canal treatment of chronic pulpitis in primary teeth. METHODS: Set up a quality control group to increase the amount of rubber dams used in the treatment of chronic pulpitis in primary teeth. Monthly monitoring results of the usage amount were counted by the outpatient computer system. Relevant data were collected through questionnaires, and causes of low utilization were analyzed, and the improvement measurements were formulated and implemented. Quality control circle activity was evaluated. RESULTS: Through the quality control circle activity, the consumption of rubber dams in the root canal treatment of chronic pulpitis was significantly improved, children in treatment became more cooperative, and operation time of root canal treatment has also been shortened. CONCLUSION: The quality control circle activities played a significant role in promoting the use of rubber dams in the root canal treatment of primary teeth, and it can be used as a method to promote new clinical treatment programs.

Preformed pediatric zirconia crown versus preformed pediatric metal crown: study protocol for a randomized clinical trial.

BACKGROUND: Guidelines in pediatric restorative dentistry recommend the use of preformed pediatric stainless steel crowns (SSCs) in cases of severe tooth decay of at least two surfaces. This clinically effective and safe restorative option is frequently refused by parents for esthetic reasons; they prefer conventional restorations using esthetic filling materials (composites, glass ionomer) if lesion severity limited to two surfaces permits. Recently, manufacturers have proposed esthetic preformed pediatric zirconia crowns (ZCs) but these have been assessed in only two randomized clinical trials (RCT) with follow-ups of 6 and 12 months. Only one of these RCTs was carried out on primary molars to test ZCs (NuSmile ZR) without a groove in its inner surface. The primary objective of this proposed RCT is to assess the effectiveness of ZCs compared with SSCs. Our hypothesis is that the effectiveness of ZCs will be equivalent to that of SSCs. METHODS: In this split-mouth, 2-year RCT, pairs of primary molars in 101 child participants will be randomized and restored with SSCs (ESPE, 3M) and ZCs (EZCrowns, Sprig Oral Health Technologies) characterized by grooves on their inner surface. Primary molars will first be allocated to SSCs, and 1 to 2 weeks later the other primary molar of the same pair will be restored by ZC. The primary outcome is the success defined by the "absence of major clinical and radiographic failure" (e.g., pain, pulp infection, dental abscess or periradicular pathology visible on radiographs). The secondary outcomes include the retention and fracture rates, the gingival condition, the wear of the antagonist of the treated teeth, as well as both parental and child satisfaction. DISCUSSION: This study will investigate two types of preformed pediatric crowns for the management of severe decay on primary molars. The results may help practitioners choose the better therapeutic option and to explain to parents the advantages and disadvantages of these two therapies. TRIAL REGISTRATION: NCT03296709 . Registered on  27 September 2017.

Comparison between calcium hydroxide mixtures and mineral trioxide aggregate in primary teeth pulpotomy: a randomized controlled trial.

OBJECTIVES: To evaluate the effect of calcium hydroxide (CH) associated with two different vehicles as a capping material for pulp tissue in primary molars, compared with mineral trioxide aggregate (MTA). METHODOLOGY: Forty-five primary mandibular molars with dental caries were treated by conventional pulpotomy using one of the following materials: MTA only (MTA group), CH with saline (CH+saline group) and CH with polyethylene glycol (CH+PEG group) (15 teeth/group). Clinical and periapical radiographic examinations of the pulpotomized teeth were performed 3, 6, and 12 months after treatment. Data were tested by chi-squared analysis and a multiple comparison post-test. RESULTS: The MTA group showed both clinical and radiographic treatment success in 14/14 teeth (100%), at all follow-up appointments. By clinical evaluation, no teeth in the CH+saline and CH+PEG groups had signs of mobility, fistula, swelling or inflammation of the surrounding gingival tissue. However, in the CH+saline group, radiographic analysis detected internal resorption in up to 9/15 teeth (67%), and inter-radicular bone resorption and furcation radiolucency in up to 5/15 teeth (36%), from 3 to 12 months of follow-up. In the CH+PEG group, 2/11 teeth (18%) had internal resorption and 1/11 teeth (9%) presented bone resorption and furcation radiolucency at all follow-up appointments. CONCLUSION: CH with PEG performed better than CH with saline as capping material for pulpotomy of primary teeth. However, both combinations yielded clinical and radiographic results inferior to those of MTA alone.