Clinical and radiographic evaluation of white MTA versus formocresol pulpotomy: A 48-month follow-up study.

PURPOSE: To determine whether there were differences between formocresol (FC) and white mineral trioxide aggregate (MTA) pulpotomy in terms of clinical and radiographic signs or effects upon the permanent successor over a long term. METHODS: A total of 212 molars (74 treated with FC and 138 with white MTA) corresponding to 129 subjects [66 females (51.1%) and 63 males (48.8%)] were evaluated. The coronal pulp was carefully amputated up to the entrance of the root canals using a sharp spoon excavator. Post-amputation bleeding was confirmed to be bright red and was seen to subside after applying 2-3 minutes of gentle pressure with a sterile cotton pellet. One group was treated with a 1:5 dilution of formocresol (20% Buckley's formocresol solution), while a second group was treated using white MTA powder (ProRoot). RESULTS: There were no significant differences in clinical success rate between the two groups (89.9% in the white MTA group versus 82.5% if the FC group). However, the radiographic success rate was significantly greater for white MTA versus FC. The radiographic failure rate in the molars treated with MTA was 7.9% versus 18.9% with FC. Regarding alterations in the timing of eruption, early and delayed eruption were respectively recorded in 7.24% and 8.69% of the cases in the MTA group, versus 9.45% and 4.05% of the cases in the FC group. Thus, neither group showed relevant alterations in the timing of eruption. CLINICAL SIGNIFICANCE: Mineral trioxide aggregate showed a significantly greater radiographic success rate than formocresol in pulpotomy in primary teeth over 6 to 48 months of follow-up. MTA may be indicated as a substitute of formocresol in pulpotomy treatments of temporary molars, with no pathological consequences of any kind to the permanent successor premolar.

Effect of mineral trioxide aggregate (MTA) pulpotomies in primary molars on their permanent tooth successors.

PURPOSE: To determine the long-term success rate of white MTA pulpotomies in primary teeth and its influence upon eruption and calcification of the permanent successor, as well as other key clinical and radiographic parameters. METHODS: A total of 138 molars from participants between 2-10 years of age were included. Clinical and radiographic parameters were monitored in the primary and/or permanent successor at 6, 12, 18, 24, 30, 36, 42, and 48 months or until eruption of the permanent successor, using the contralateral tooth as control. Chi-squared test and the Spearman correlation coefficient (r) were used to evaluate potential associations and distributions between radiographic/clinical parameters (P < 0.05; 95% CI). RESULTS: Clinical alterations were observed in 1.4% of the primary molars. Unfavorable radiographic pulp responses (furcation radiolucency, internal root resorption with perforation, or external root resorption) were observed in 6.5% of the cases. Dentin bridge formation in the roots was observed in a range as low as 71.2% to a maximum of 89.9% of the cases. The presence or absence of dentin bridge formation in any of the roots was not associated or correlated with the age of the patient (P > 0.05). Reparative dentin formation in any of the the root canals was recorded in 37.3 to a 68.1% of the canals (P > 0.05). The 50 permanent successors recorded after exfoliation of the treated molars showed no alterations in color, mineralization, structure or position, and no alterations in the timing of eruption were noted.

Longevity of Aesthetic Fixed Space Maintainers in the Anterior Area of the Pediatric Dental Patient.

Space maintenance for children at very early ages in primary molars or posterior sectors is widely used and the scientific evidence is clear as to its indications. In the anterior sectors there are doubts as to whether there is a loss of space and its use is usually accompanied by aesthetic, phonatory requirements or the completion of certain habits. In this type of aesthetic anterior maintainer, there are many medium and long-term complications that can occur. PURPOSE: To evaluate the factors determining possible complications capable of reducing the longevity of aesthetic fixed space maintainers placed due to premature loss of temporary upper anterior teeth. METHODS: Data were collected on 100 patients of 1-5 years of age requiring fixed space maintainer placement in the upper anterior area due to caries or traumatisms. RESULTS: Complications were recorded in the form of resin tooth fracture (in 41% of the cases), welding fracture (16%), detachments (28%), gingivitis (26%) and root resorptions (8%). Space maintainer placement in younger children (12-24 months of age) was associated with a significantly greater incidence of root resorptions (p < 0.05). CONCLUSIONS: Within the limits of the present study, it is concluded that fixed space maintainers would be a good treatment option in patients with prematurely missing anterior teeth, though the use of temporary first molars as abutments could imply a greater risk of failure, with a lesser incidence of root resorptions. Periodic checks and adequate measures of hygiene are essential.