BiodentineTM versus formocresol pulpotomy technique in primary molars: a 12-month randomized controlled clinical trial.

BACKGROUND: The objective of this clinical study was to prospectively compare the clinical and radiographic success rates of BiodentineTM pulpotomies versus formocresol pulpotomies in children vital primary molars. METHODS: A randomized, split-mouth study design was used with a sample of 37 healthy children aged 4- to 8-year-old. A total of 56 pairs (112 teeth) of carious primary teeth, 1 pair per child, were selected for treatment. One tooth from each pair was randomly assigned to either the BiodentineTM pulpotomy group or the formocresol pulpotomy group. Children were followed-up at 3, 6 and 12 months for clinical evaluation and at 6 and 12 months for radiographic evaluation. Data were collected, tabulated and analyzed using Fisher exact and McNemar tests. The level of significance was set at P < 0.05. RESULTS: At 12 months, the clinical success rates of both BiodentineTM and formocresol groups were 100%, while the radiographic success rates for BiodentineTM and formocresol groups were 100% and 98.1%, respectively. There was no statistically significant difference between both groups (P=1). The only observed radiographic failure was furcal radiolucency in the formocresol group at 12-month interval. Pulp canal obliteration was radiographically observed in 10/56 (17.9%) and 7/56 (12.5%) cases in the BiodentineTM and formocresol groups, respectively. CONCLUSIONS: Both BiodentineTM and formocresol pulpotomy techniques demonstrated favorable clinical and radiographic outcomes over a 12-month period without any significant difference. TRIAL REGISTRATION: Registered on NCT03779698 . Date of Registration: 18 December 2018.

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.

Existe associação entre manchas de esmalte em pré-molares e tratamento endodôntico nos seus antecessores decíduos? / Is there an association between enamel stains in premolars and endodontic treatment of their primary molar predecessors?

Objetivo: este estudo longitudinal retrospectivo objetivou avaliar se existe relação entre o surgimento de manchas de esmalte em pré-molares, após o tratamento endodôntico dos seus antecessores molares decíduos.Métodos: as crianças submetidas à pesquisa, pacientes do Instituto de Medicina Integral Professor Fernando Figueira (IMIP), desde a mais tenra idade, foram localizados, juntamente com seus prontuários, e agrupados igualmente em três grupos conforme avaliação: (1) pré-molares sucessores de dentes decíduos que foram submetidos ao tratamento endodôntico com sessão única de Formocresol; (2) pré-molares sucessores de dentes decíduos que foram submetidos ao tratamento endodôntico com CTZ; (3) pré-molares cujos molares decíduos antecessores não possuíam lesões de acometimento pulpar. Um único examinador, com o intuito de identificar manchas de esmalte, avaliou 180 pré-molares, sem conhecimento prévio do histórico clínico ao qual foram submetidos seus antecessores decíduos,utilizando inspeção visual conferindo um índice Cohen´s kappa = 0,90. O teste de Qui-quadrado de Person e o exato de Fisher foram utilizados para identificar as diferenças entre os grupos experimentais e entre os grupos experimentais e o controle, respectivamente, em relação ao surgimento de manchas. O nível de significância adotado nesse estudo foi de 5%. Resultados: foi identificado que 8,3% dos pré-molares tratados com Formocresol e 11,7% tratados com o CTZ apresentaram algum tipo de mancha no esmalte (p>0.05), no entanto, não foram detectadas manchas nos dentes do grupo controle (p<0.05). Conclusão: quando os dentes antecessores decíduos foram submetidos à terapia endodôntico com Formocresol ou CTZ, houve surgimento de manchas em pré-molares, não havendo, no entanto, diferença estatisticamente significante...

Objective: The aim of this longitudinal retrospective study was to investigate whether there is association of the presence of enamel stains in premolars after endodontic treatment of their primary molar predecessors. Method: The children of this research have been patients of the Integral Medicine Institute Professor Fernando Figueira (IMIP) since their earliest age. The children were localized, their clinical charts were retrieved, and three groups were formed according to the evaluation: (1) successor premolars of primary molars subjected to single-session endodontic treatment with formocresol; (2) successor premolars of primary molars subjected to endodontic treatment with CTZ paste; and (3) successor premolars of primary molars that had no previous pulp involvement. A single examiner blinded to the clinical history of the primary molar predecessors evaluated 180 premolars for enamel stains by visual inspection, with a Cohen?s index kappa=0.90. Pearson?s square chi and Fisher?s exact tests were used to identify the differences among the experimental groups, and between the control and experimental groups, respectively, as regards the presence of enamel stains. The significance level was set at 5%. Results: 8.3% of the premolars that had the primary molar predecessors treated with formocresol and 11.7% of those treated with CTZ had some kind of enamel stain (p>0.05). There were no enamel stains in the teeth of the control group (p less than 0.05). Conclusion: When the primary molar predecessors were subjected to endodontic treatment with both formocresol and CTZ, enamel stains developed in the premolars, though without statistically significant difference...

Biodentine used as a pulp-capping agent in primary pig teeth.

PURPOSE: The purpose of this study was to assess and compare, in primary pig teeth, the pulp response after a pulpotomy using either Biodentine (a new tricalcium-silicate cement), white mineral trioxide aggregate (WMTA), or formocresol (FC) and repeat the same after direct pulp capping using either Biodentine, WMTA, or calcium hydroxide. METHODS: A total of 180 primary teeth from 9 healthy 4-month-old female pigs were divided into 3 experimental periods (7, 28, and 90 days) for each material used for the pulpotomy and direct pulp capping treatments. Seven, 28, and 90 days later, the animals were euthanized and the specimens were prepared for histological examination and evaluation. The data collected from the histological examinations were statistically analyzed using Kruskal-Wallis and Dunn multiple comparison tests. RESULTS: In pulpotomy groups, there was a significant difference between Biodentine and WMTA vs FC in terms of inflammatory cell response and hard tissue formation. In direct pulp capping groups, there was only a significant difference between Biodentine and calcium hydroxide in terms of hard tissue formation in a 7-day period. CONCLUSIONS: Biodentine and white mineral trioxide aggregate are both suitable, biocompatible materials for pulp capping in primary teeth of pigs.

Nigella sativa oil as a pulp medicament for pulpotomized teeth: a histopathological evaluation.

PURPOSE: Concerns about the safety of formocresol (FC) as a pulpotomy agent in Pediatric Dentistry have lead to the search of new capping medicaments. Indigenous plant medicines such as Nigella Sativa (NS) have been the focus of many researches. Therefore the purpose of this study was to investigate histo-pathologically the pulp response to NS oil and FC in dogs. METHOD: Forty teeth in 4 male dogs of undefined breed aging 12-14 months were used in this study. Coronal access cavities were performed on the upper and lower premolars so that both medicaments were tested in the same animal in alternate sides of the mouth. Four weeks after treatment the animals were sacrificed, paraffin sections were prepared for histological, histochemical and immuno-histochemical staining. RESULTS: Specimens in the NS group showed mild to moderate vasodilatation. Few specimens showed scattered inflammatory cell infiltration and the odontoblastic layer was continuous. While the FC group showed moderate to severe vasodilatation with high inflammatory cell infiltrate and degenerative changes. CONCLUSIONS: NS possesses an anti-inflammatory effect and the pulp maintains its vitality after its application, which could qualify its use as a pulp medicament for pulpotomized teeth in clinical practice.

Influence of pulpotomy medicaments on the ultrastructure and shear bond strength of a self-etch adhesive to primary tooth dentin.

OBJECTIVE: To compare the effect of the pulpotomy medicaments glutaraldehyde, ferric sulfate, and formocresol on the structure and shear bond strength of a self-etch adhesive to the dentin of primary teeth. METHOD AND MATERIALS: Forty human primary molars were sectioned mesiodistally and divided into four groups: group I (control group), dentin specimens were soaked in distilled water for 48 hours; group II, dentin specimens were soaked in 2% glutaraldehyde; group III, dentin specimens were soaked in formocresol; and group IV, dentin specimens were soaked in 15.5% ferric sulfate. All specimens were rinsed with tap water and dried with air. AdheSE One (a self-etch adhesive) and Valux Plus composite resin were applied to the dentin surfaces. The molecular structure of the adhesive itself and adhesive with composite resin were tested using an FTIR spectrometer. Shear bond strength was tested with a universal testing machine. Failure modes analyses were performed with a scanning electron microscope (SEM). RESULTS: Glutaraldehyde showed little changes in the molecular structure of the adhesive itself and adhesive with composite. However, ferric sulfate and formocresol affected the molecular structure of the adhesive alone and the adhesive with composite. The highest mean value of shear bond strength was for the glutaraldehyde group (11.17 ± 4.87 MPa). Ferric sulfate and formocresol significantly reduced shear bond strength after the application of pulpotomy medicaments (7.45 ± 3.73 and 5.31 ± 3.30 MPa, respectively). SEM analysis revealed that most of the specimens failed in cohesive and mixed modes. CONCLUSION: This study revealed that formocresol and ferric sulfate adversely affect the shear bond strength and molecular structure of the adhesive system to primary dentin.

Induction of mRNA expression of osteogenesis-related genes by guaiacol in human dental pulp cells.

To investigate the stimulating effect of endodontic medications on the mRNA expression of some osteogenesis-related genes associated with reparative dentinogenesis and hard-tissue formation, human dental pulp cells (D824 cells) were treated with calcium hydroxide (Ca (OH)(2)), formocresol, or guaiacol. The effect on growth was determined by growth curves of D824 cells treated for 1-3 days with 0.03-0.3 mM Ca (OH)(2), 0.0007%-0.0014% formocresol, or 0.24-2.43 mM guaiacol. The mitotic activity of individual cells and the mRNA expression of the osteogenesis-related genes for alkaline phosphatase (ALP), type I collagen (COL-1), and bone sialoprotein (BSP) in the cells treated for 24 h with the same concentrations of the medications as described above were determined by colony-forming efficiency and by real-time quantitative reverse transcription polymerase chain reaction (qRT-PCR) analysis, respectively. Cellular growth and mitotic activity were scarcely affected by Ca (OH)(2), but were significantly reduced by formocresol or guaiacol. The mRNA expression of the osteogenesis-related genes was little affected by Ca (OH)(2) or formocresol, but was significantly enhanced by guaiacol. The results indicate that guaiacol may stimulate the mRNA expression of genes associated with reparative dentinogenesis and hard-tissue formation in human dental pulp cells, suggesting that the novel property of guaiacol provides new insights into the utilization of guaiacol in endodontic therapy.

Mineral trioxide aggregate in primary teeth pulpotomy. A systematic literature review.

UNLABELLED: Evidence-based dentistry is a critical evaluation, awareness of the available evidence to improve decision making about the care of individual patients and/or communities. OBJECTIVE: To systematically analyze the available scientific literature on clinical and radiographic results of two materials used in pulpotomy in primary teeth: formocresol and mineral trioxide aggregate. MATERIALS AND METHODS: It was identified relevant publications through a search of electronic databases such as MEDLINE (Ovid) and The Cochrane Library. To be included in the review, studies had to define the material used in child patients with pulp exposure by caries or tooth-alveolar trauma. RESULTS: Of the 21 articles obtained in the initial phase of the review, only 19 were available in full text and of these only met the requirements for inclusion 6 items, which were confronted, analyzed and discussed later. CONCLUSIONS: The clinical evidence available showed significant differences regarding the use of a material or another. In addition to the findings of clinical follow--radiographic and taking into account the potential toxicity of formocresol suggest the use of mineral trioxide aggregate pulpotomy of primary teeth.

Cytokine production from human primary teeth pulp fibroblasts stimulated by different pulpotomy agents.

PURPOSE: After exposing the pulp tissue, cytokines are produced that regulate the pulp inflammatory response. The dental literature, however, lacks information on the participation of primary tooth fibroblasts in this process. The purpose of this study was to verify the participation of human primary tooth pulp fibroblasts in the inflammatory process, evaluate the production of interleukin 1 beta (IL-l beta) and interleukin 8 (IL-8) from these cells. METHODS: Pulpotomy agents were applied as conditioned media on cell cultures in the following groups: (1) negative control; (2) positive control (Lipopolysaccharide -LPS); (3) calcium hydroxide (powder); (4) mineral trioxide aggregate (MTA); (5) adhesive resin; and (6) formocresol. After 24 hours in contact with the cells, the conditioned media were removed, the proteins were extracted from the cells and IL-l beta and IL-8 were quantified by ELISA (Enzyme linked immuno-sorbent assay). RESULTS: Data were analyzed by analysis of variance (P<0.05) and Tukey's test (P<0.05). It was observed that calcium hydroxide has stimulated the production of IL-l beta, without stimulating IL-8. Conversely, the adhesive resin and formocresol stimulated the production of IL-8, and did not stimulate IL-l beta. MTA stimulated both cytokines in an intermediate level when compared to the other materials. CONCLUSION: Primary tooth fibroblasts can respond immunologically, and different pulp capping materials can help in this process.

Histological evaluation of the effect of three medicaments; trichloracetic acid, formocresol and mineral trioxide aggregate on pulpotomised teeth of dogs.

The aim of this study was to use clinical, radiographic and histological examinations to compare the dental pulp response in 162 premolar roots of eight dogs when trichloracetic acid (TCA), formocresol, mineral trioxide aggregate (MTA) and zinc oxide eugenol were used as pulpotomy agents. The teeth were divided into four groups. Following pulpotomy, the teeth were restored with amalgam. The animals were sacrificed at 48 h, 2, 4 and 8 weeks (two dogs at each interval). Histological evaluation indicated no cases with necrosis. After 8 weeks follow up, dentine bridge formation was evident in 20%, 50% and 91.7% of formocresol, TCA and MTA cases respectively. The first signs of bridge formation were seen for MTA at 2 weeks and for TCA at 4 weeks. MTA was superior to formocresol and TCA in treating pulps in dogs. However, bridge formation was seen in 50% of TCA cases after 8 weeks which is a desirable finding in pulpotomy procedures.

The effectiveness of mineral trioxide aggregate, calcium hydroxide and formocresol for pulpotomies in primary teeth.

AIM: To compare the effectiveness of mineral trioxide aggregate (MTA), calcium hydroxide (CH) and formocresol (FC) as pulp dressing agents in carious primary teeth. METHODOLOGY: Forty-five primary mandibular molars with dental caries in 23 children [AUTHOR QUERY: How many children?] between 5 and 9 years old were treated by a conventional pulpotomy technique. The teeth were randomly assigned to the experimental (CH or MTA) or control (FC) groups. After coronal pulp removal and haemostasis, remaining pulp tissue was covered with MTA paste or CH powder in the experimental groups. In the control group, diluted FC was placed with a cotton pellet over the pulp tissue for 5 min and removed; the pulp tissue was then covered with zinc oxide-eugenol (ZOE) paste. All teeth were restored with reinforced ZOE base and resin modified glass-ionomer cement. Clinical and radiographic successes and failures were recorded at 3, 6, 12, 18 and 24 month follow-up. RESULTS: Forty-three teeth were available for follow-up. In the FC and MTA groups, 100% of the available teeth were clinically and radiographically successful at all follow-up appointments; dentine bridge formation could be detected in 29% of the teeth treated with MTA. In the CH group, 64% of the teeth presented clinical and radiographic failures detected throughout the follow-up period, and internal resorption was a frequent radiographic finding. CONCLUSIONS: Mineral trioxide aggregate was superior to CH and equally as effective as FC as a pulpotomy dressing in primary mandibular molars. Internal resorption was the most common radiographic finding up to 24 month after pulpotomies performed with CH.

Histological analysis of the association between formocresol and endotoxin in the subcutaneous tissue of mice.

This study performed a histological analysis of the effect of formocresol associated to endotoxin (LPS) in the subcutaneous connective tissue of mice. Ninety mice were randomly assigned to 3 groups (n=30). Each animal received one plastic tube implant containing endotoxin solution (10 mg/mL), formocresol (original formula) or a mixture of endotoxin and formocresol. The endotoxin and formocresol groups served as controls. The periods of analysis were 7, 15 and 30 days. At each experimental period, tissue samples were collected and submitted to routine processing for histological analysis. Endotoxin and formocresol produced necrosis and chronic inflammation at 7 and 15 days. At 30 days, the endotoxin group showed no necrosis, while in the formocresol group necrosis persisted. The formocresol-endotoxin association produced necrosis and chronic inflammation in the same way as observed with formocresol at all experimental periods. In conclusion, formocresol seems not to be able to inactive the toxic effects of endotoxin in connective tissues.

Endodontic microorganism susceptibility by direct contact test.

The aim of this study was to evaluate in vitro the duration of the antimicrobial effect of endodontic sealers by means of the Direct Contact Test. The sealers tested were: Endomethasone - Septodont, Endomethasone C-Septodont, Endion-Voco, Diaket-ESPE, Pulp Canal Sealer-SybronEndo, and AH26-Dentsply DeTrey. The endodontopathic microorganisms (MO) confronted were: Staphylococcus aureus (Sa), Candida albicans (Ca), Enterococcus faecalis (Ef), Prevotella intermedia (Pi), Porphyromonas gingivalis (Pg) and Fusobacterium nucleatum (Fn). Test specimens of each sealer were prepared and placed on the surface of agar plates that had been inoculated with each MO, and after predetermined periods, transfers were made from the contact area between the test specimen and the cultured agar and from the area that had not been in contact with the test specimens (control). The results were read as presence/absence of microbial growth and analyzed statistically using the Kruskal-Wallis test. It was concluded that the structural features and virulence of endodontopathic microorganisms determine their response to the sealers, independently of the time during which sealers act and the mechanism by which the antiseptic reaches the microorganism, which in this case was by direct contact.

Histological analysis of the association between formocresol and endotoxin in the subcutaneous tissue of mice

This study performed a histological analysis of the effect of formocresol associated to endotoxin (LPS) in the subcutaneous connective tissue of mice. Ninety mice were randomly assigned to 3 groups (n=30). Each animal received one plastic tube implant containing endotoxin solution (10 mg/mL), formocresol (original formula) or a mixture of endotoxin and formocresol. The endotoxin and formocresol groups served as controls. The periods of analysis were 7, 15 and 30 days. At each experimental period, tissue samples were collected and submitted to routine processing for histological analysis. Endotoxin and formocresol produced necrosis and chronic inflammation at 7 and 15 days. At 30 days, the endotoxin group showed no necrosis, while in the formocresol group necrosis persisted. The formocresol-endotoxin association produced necrosis and chronic inflammation in the same way as observed with formocresol at all experimental periods. In conclusion, formocresol seems not to be able to inactive the toxic effects of endotoxin in connective tissues.

O objetivo deste estudo foi avaliar histologicamente o efeito da associação do formocresol com endotoxina (LPS) em tecido conjuntivo de camundongos. Noventa camundongos foram divididos em três grupos de 30 camundongos cada. Cada camundongo recebeu um implante subcutâneo de tubo plástico contendo solução de endotoxina (10 mg/ml), formocresol (fórmula original), ou uma mistura de formocresol com endotoxina. Os grupos da endotoxina e formocresol foram considerados grupos controle. Os períodos de análise foram 7, 15 e 30 dias. Após os períodos experimentais, os tecidos foram removidos e submetidos a processamento histológico. Os resultados obtidos indicam que a endotoxina e o formocresol produzem necrose e inflamação tecidual crônica aos 7 e 15 dias e aos 30 dias o grupo da endotoxina não mostrava necrose e no grupo do formocresol a necrose persistiu. A combinação formocresol e endotoxina mostrou necrose e inflamação crônica com resultados semelhantes ao do grupo formocresol para todos os períodos experimentais. Pode-se concluir que o formocresol parece não ser capaz de inativar os efeitos tóxicos da endotoxina.

Endodontic microorganism susceptibility by direct contact test

El objetivo de este trabajo fue evaluar in vitro la duración del efecto antimicrobiano de los selladores endodónticos mediante la Prueba de Contacto Directo. Los selladores probados fueron: Endomethasone - Septodont®, Endomethasone C – Septodont®, Endion – Voco®, Diaket – ESPE®, Pulp Canal Sealer – SybronEndo® y AH26 – Dentsply DeTrey®. Los microorganismos endodontopáticos (MO) enfrentados fueron: Staphylococcus aureus (Sa), Candida albicans (Ca), Enterococcus faecalis (Ef), Prevotella intermedia (Pi), Porphyromonas gingivalis (Pg) yFusobacterium nucleatum (Fn). Se prepararon las probetas con cada uno de los selladores, se colocaron sobre la superficie de placas de agar sembradas con cada MO y luego de períodos predeterminados se realizaron repiques de las zonas de contacto probeta-agar sembrado y de la zona que no estuvo en contacto con las probetas (testigo). Se realizó la lectura de los resultados: presencia/ausencia de desarrollo microbiano y se analizaronestadísticamente mediante la Prueba de Kruskal- Wallis. Pudo concluirse que las características estructurales y la virulencia de los microorganismos endodontopáticos son determinantes de la respuesta de los mismos frente a los selladores independientemente del tiempo durante el cual estos actúen y del mecanismo por el cual el antiséptico alcance al microorganismo, en este caso por contacto directo.

Antimicrobial effect of propolis and other substances against selected endodontic pathogens.

OBJECTIVE: The aim of this study was to determine the antimicrobial effect of ethanol extract of propolis (EEP) and intracanal medicaments calcium hydroxide, camphorated paramonochlorophenol, and formocresol by means of the macrodilution method using the reinforced clostridial medium (RCM) and brucella and brain heart infusion media. STUDY DESIGN: The antimicrobial agents were sequentially diluted and tested against anaerobic bacteria Prevotella nigrescens, Fusobacterium nucleatum, Actinomyces israelii, and Clostridium perfringens and against Enterococcus faecalis, with the 5 x 10(5) CFU/mL standardized inocula. The tubes were anaerobically incubated and the minimum inhibitory concentration was detected. Blood agar RCM subcultures were performed to provide minimum bactericidal concentration. The results were analyzed by analysis of variance test. RESULTS: All drugs were effective against all tested strains, without statistical differences. E. faecalis was the less susceptible strain, and RCM broth promoted faster bacterial growth, but there were no significant differences in these results. Ethanol did not influence the antimicrobial effect of EEP.

Antimicrobial endodontic compounds do not modulate alkylation-induced genotoxicity and oxidative stress in vitro.

OBJECTIVE: To investigate if formocresol, paramonochlorophenol, or calcium hydroxide modulate the genotoxic effects induced by the oxidatively damaging agent hydrogen peroxide (H2O2) or the alkylating agent methyl methanesulfonate (MMS) in vitro by using single cell gel (comet) assay. STUDY DESIGN: Chinese hamster ovary (CHO) cells in culture were exposed directly to formocresol, paramonochlorophenol, or calcium hydroxide (adjusted to 100 microg/mL) for 1 hour at 37 degrees C. Subsequently the cultures were incubated with increasing concentrations (0-10 micromol/L) of MMS in phosphate-buffered solution (PBS) for 15 minutes at 37 degrees C or of H2O2 at increasing concentrations (0-100 micromol/L) in distilled water for 5 minutes on ice. The negative control cells were treated with PBS for 1 hour at 37 degrees C. The parameter from the comet assay (tail moment) was assessed by the Kruskal-Wallis nonparametric test followed by a post hoc analysis (Dunn test). RESULTS: Clear concentration-related effects were observed for the genotoxin-exposed CHO cells. Increase of MMS-induced DNA damage was not significantly altered by the presence of the compounds tested. Similarly, no significant changes were observed when hydrogen peroxide was used with the endodontic compounds evaluated. CONCLUSION: Formocresol, paramonochlorophenol, and calcium hydroxide are not able to modulate alkylation-induced genotoxicity or oxidative DNA damage as depicted by the single cell gel (comet) assay.

Histological comparison of alendronate, calcium hydroxide and formocresol in amputated rat molar.

The purpose of this study was to evaluate the potential of alendronate sodium (ALN), a biphosohonate to stimulate hard tissue formation in pulpotomized (amputated) rat molars. Two commonly used pulpotomy materials, calcium hydroxide (CH) and formocresol (FC) were utilized for comparisons. Histological evaluations were performed by observers blinded to treatment allocation on days 7, 15, 30 and 60, followed by statistical analysis of selected histological criteria. In all evaluation periods, hard tissue deposition was evident along the radicular dentin in ALN and CH groups. In days 30 and 60, the latter two groups showed no differences in inflammatory cell response and hard tissue deposition scores (P > 0.05). ALN appears to be capable of maintaining pulpal vitality, while promoting hard tissue formation, similar to CH.

An evidence-based analysis of the antibacterial effectiveness of intracanal medicaments.

The authors reviewed the literature evaluating the antibacterial effectiveness of intracanal medicaments used in the management of apical periodontitis. A PICO (problem, intervention, comparison, outcome) strategy was developed to identify studies dealing with calcium hydroxide, phenolic derivatives, iodine-potassium iodide, chlorhexidine, and formocresol. The final inclusion/exclusion criteria eliminated all papers except five that evaluated calcium hydroxide. The total sample size in the included studies was 164 teeth. Microbiologic sampling was performed before endodontic treatment (S1), after instrumentation and irrigation (S2), and after intracanal medication (S3). At S2, 62% of canals were positive. After medication, 27% still showed detectable growth. Of cultures that were positive at S2, 45% were still positive at S3. Most studies did not address issues of culture reversals or false positive and false negative cultures. The main component of antibacterial action appears to be associated with instrumentation and irrigation, although canals cannot be reliably rendered bacteria free. Calcium hydroxide remains the best medicament available to reduce residual microbial flora further.

The effect of formocresol on bond strength of adhesive materials to primary dentine.

The aim of this study was to evaluate the effect of formalin cresol on bonding of two compomers (Prime & Bond and Dyract, Futurabond and Glasiosite to primary dentine. Eighteen non-carious primary mandibular molar teeth were used. The two materials were placed onto the tooth surfaces before being sheared with a knife-edged blade with a crosshead speed of 1 mm min(-1). Two randomly selected teeth from each group were evaluated by scanning electron microscopy (SEM). The statistical analysis (paired t-test and Student's t-test) revealed that shear bond strength was significantly higher in the formocresol-applied group than in the group that was not applied formocresol (P < 0.05), but there was no significant difference between the restorative materials. SEM analyses also supported the results obtained. In conclusion, if compomers are used after endodontic processes which require the application of formocresol in primary teeth, dentinal bonding would not be decreased, but on the contrary, increase.