A SURVEY ON CURRENT TRENDS IN PRIMARY TOOTH PULPOTOMY IN KARACHI.

BACKGROUND: In comparison to USA and United Kingdom where Paediatric Dentistry is considered a separate specialty; there very few formal teaching programs in Pakistan for Paediatric Dentistry. Many surveys have been carried out internationally, but no survey has been carried out locally to ascertain practice of dentists when treating paediatric patients. Therefore, it appears important to map features of Paediatric Dentistry practice in our country. The purpose of this study was to assess practice regarding pulpotomy of primary teeth among dentists of Karachi and to compare difference in pulpotomy practice of primary teeth between private practitioners and teaching dentists. METHODS: Questionnaire was distributed by hand to dentists working in private clinics and teaching hospitals of Karachi, involved in treating primary teeth of children. Questions captured information on aspects related to pulpotomy procedure as carried out by dentists. Descriptive statistics and frequency distribution were computed. Chi-square test was applied to compare difference between dentists working in teaching hospitals versus private practitioners. Level of significance was kept at 0.05. RESULTS: Although majority of dentists use the preferred medicament for pulpotomy, i.e., formocresol, it was seen that only a small proportion reported frequent use of radiographs and rubber dam. There was a significant difference in selecting post pulpotomy restorations for anterior teeth by teaching dentists (Composites) compared to private practitioners (who favoured GIC). Only 20-27% of dentists reported use of stainless steel crown for definitive restoration after pulpotomy. CONCLUSIONS: Although majority of dentists use formocresol as a preferred medicament for pulpotomy, it was seen that only a small proportion of participants reported frequent use of radiographs, rubber dam and stainless steel crowns which is far below the standard of care.

El sistema rotatorio Mtwo NiTi para preparación de conductos / Mtwo Niti rotary system for root canal preparation

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Current trends in primary tooth pulp therapy.

Pulp therapy in the primary dentition remains a technique generating a tremendous amount of study. Formocresol has been and continues to be the most commonly used intrapulpal medicament despite its known ability to escape the microcirculation of the pulp. Ferric sulfate has gained significant favor as a result of formocresol's disadvantages, though at the cost of requiring a much more acute awareness of the potential for remaining disease and its ability to mask that process. Mineral trioxide aggregate perhaps offers the best immediate alternative to either of the above though at this time it is still cost-prohibitive in a practice that actively treats many children. And, as MTA has no fixative properties of its own, accurately analyzing the extent of the pulpal disease becomes even more critical to the overall success of the procedure. As with other techniques in dentistry, the debate is sure to continue for severl years to come.

Current and potential pulp therapies for primary and young permanent teeth.

OBJECTIVES: This paper aims to alert the dental practitioner to the rapidly evolving therapies for treating the pulps of primary and young permanent teeth. DATA SOURCES: Experimental research on animals, clinical studies and case reports. STUDY SELECTION: Indirect pulp capping, direct pulp capping, pulpotomies, and pulpectomies are standard procedures for treating primary teeth. However, direct pulp capping, heretofore not very successful, is being revisited. Based on studies in animals and clinical findings in humans, there has been a movement in pediatric dentistry to find alternatives to formocresol and calcium hydroxide for pulpotomy therapy. Venues range from eradication by cautery to the possibility of healing with growth factors. New studies with iodoform paste for pulpectomies are confirming the success rates of previous publications. The new dental adhesives are being tested as agents for direct pulp capping, as well as partial and complete pulpotomy protocols. CONCLUSIONS: More thought is being given by clinicians to preserving pulp, either through more ambitious indirect pulp therapy or partial pulpotomy. Formocresol and calcium hydroxide pulpotomies, while still popular, may soon be challenged by other chemical treatments, electrocautery or stimulation of reparative dentine by growth factors. Iodoform pastes are promising easier and more successful pulpectomy therapy. Total etch direct bonding materials could soon transform direct pulp capping, as well as partial and complete pulpotomy protocols.

Treatment trends during a thirteen-year period in a student pediatric dentistry clinic.

This manuscript reports the treatment trends in a pediatric dentistry clinic from 1980 to 1992 and discusses their implication in clinical teaching. Analysis of the records of the senior year pediatric dentistry students indicated: no significant change with time in the patients/student ratio, the number of preformed crowns, pulpotomies, and pulpectomies by student or by patient; a significant decrease in the number of one-surface and > or = 2-surface restorations by student and by patient; a significant increase in the number of pit-and-fissure sealants and preventive resin restorations by student and by patient. During the thirteen-year period, the students performed an average of 7.3 one-surface; 12.9 > or = 2-surface restorations; 5.5 preformed crowns; 6.4 pit-and-fissure sealants; 2.4 pulpotomies. There was a significant increase with time in the number of students who performed pit-and-fissure sealants.

Aspectos clínicos e radiográficos nas pulpotomias quando do uso de uma associação corticosteróide-antibióticos / Clinical and radiographic aspects in pulpotomies when a corticosteroid-antibiotic association was used

O objetivo deste estudo foi de avaliar, clínica e radiograficamente, o índice de sucesso das pulpotomias realizadas de duas formas: uma mediata e outra imediata. Em ambas utilizou-se uma associação corticosteróide-antibiótico para amenizar o processo inflamatório

Pulpotomia em dentes permanentes: viabilidade como tratamento definitivo em saúde pública / Pulpotomy in permenent teeth: viability as a definitive treatment in public health

A autora, através de uma revisão de literatura, discute a viabilidade da pulpotomia em dentes permanentes como um tratamento definitivo em saúde pública