THREE-YEAR OUTCOME OF DIODE LASER PULPOTOMY OF PRIMARY MOLARS USING THREE PULP CAPPING AGENTS: A SPLIT-MOUTH RANDOMIZED CLINICAL TRIAL.

OBJECTIVES: Pulpotomy is the most commonly performed treatment for asymptomatic primary molars with exposed dental pulp. This study aimed to assess the clinical /radiographic success of diode laser pulpotomy with mineral trioxide aggregate (MTA), calcium hydroxide (CH), and calcium-enriched mixture (CEM) cement as pulp capping agents. METHODS: This split-mouth randomized clinical trial was conducted initially on 34 children aged 3-8 years but 4 patients left the study before the first follow-up visit and the study was accomplished and analyzed with 30 cases. The patients had at least 3 first/second molars with deep caries that in radiographic evaluation revealed that they required pulpotomy. Following pulpotomy, the pulp stump was irradiated with diode laser (noncontact mode, 632 nm, 30 mW power) as photobiomodulation mode. Pulp tissue was then capped with MTA, CH, or CEM cement (n = 30 in each group). Reinforced zinc oxide eugenol was applied over the capping agent, and the teeth were restored with stainless steel crowns. Teeth were clinically/radiographically assessed at 6, 12, 18, and 36 months, after treatment. Data were analyzed by Cochran and McNemar tests. RESULTS: All 30 patients showed up for clinical/radiographic follow-ups for up to 36 months. Regarding clinical outcomes, the 6-, 12-, 18-, and 36-month success rates of all experimental groups were nearly similar with no significant difference (p > .05). Regarding radiographic outcomes, the 6-month success rates were similar among the groups (p > .05); however, the 12-, 18-, and 36-month outcomes of CEM and MTA groups were similar but significantly superior to that of CH group (p < .05). CONCLUSION: Diode laser irradiation and subsequent capping of pulp tissue with MTA or CEM cement can be employed for pulpotomy of primary molars.

The clinical and radiographic evaluation of Allium sativum oil (garlic oil) in comparison with mineral trioxide aggregate in primary molar pulpotomy.

BACKGROUND: Mineral trioxide aggregate (MTA) is known as a common biomaterial for pulpotomy of primary molars, with limitation including high cost, difficult handling, and long setting time. This study was conducted to compare the clinical and radiographic success rate of Allium sativum oil and MTA in pulpotomy of primary molar teeth. MATERIALS AND METHODS: This randomized, controlled, clinical trial was performed on a group of children with at least two symptom-free primary molars requiring pulpotomy. A total of 90 teeth were randomly assigned into two groups: After pulp amputation and hemostasis, Group I received MTA as medication in the pulp chamber and Group II received Allium sativum oil over the pulp stumps. Pulp chamber was then filled with reinforced ZOE paste (zinc oxide eugenol) and teeth were restored using stainless steel crowns. The follow-up scheme of 6, 12, and 18 months was set, and teeth evaluation was conducted by a calibrated pediatric dentist based on the modified criteria proposed by Zurn and Seale. The results were analyzed using the generalized estimating equation analysis with the P = 0.05 as the level of significance. RESULTS: The clinical success rate was 100% in both groups after all follow-ups. The radiographic success rate was, however, 91.1% after 6.75. 6% after 12 and 18 months in Group II while it was 95.6% after 6, 91.1% after 12 and 18 months in Group I in those follow-up points. The difference between the two groups was not statistically significant. CONCLUSION: According to the results, Allium sativum oil has a high clinical and radiographic success rate comparable to those of MTA.

Effect of coping thickness and background type on the masking ability of a zirconia ceramic.

STATEMENT OF PROBLEM: The masking ability of zirconia ceramics as copings is unclear. PURPOSE: The purpose of this in vitro study was to evaluate the effect of coping thickness and background type on the masking ability of a zirconia ceramic and to determine zirconia coping thickness cut offs for masking the backgrounds investigated. MATERIAL AND METHODS: Thirty zirconia disks in 3 thickness groups of 0.4, 0.6, and 0.8 mm were placed on 9 backgrounds to measure CIELab color attributes using a spectrophotometer. The backgrounds included A1, A2, and A3.5 shade composite resin, A3 shade zirconia, nickel-chromium alloy, nonprecious gold-colored alloy, amalgam, black, and white. ΔE values were measured to determine color differences between the specimens on the A2 shade composite resin background and the same specimens on the other backgrounds. The color change (ΔE) values were compared with threshold values for acceptability (ΔE=5.5) and perceptibility (ΔE=2.6). Repeated measures ANOVA, the Bonferroni test, and 1-sample t tests were used to analyze data (α=.05). RESULTS: Mean ΔE values ranged between 1.44 and 7.88. The zirconia coping thickness, the background type, and their interaction affected the CIELab and ΔE values (P<.001). CONCLUSIONS: To achieve ideal masking, the minimum thickness of a zirconia coping should be 0.4 mm for A1 and A3.5 shade composite resin, A3 shade zirconia, and nonprecious gold-colored alloy, 0.6 mm for amalgam, and 0.8 mm for nickel-chromium alloy.