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1.
Pediatr Dent ; 42(4): 288-292, 2020 Jul 15.
Artigo em Inglês | MEDLINE | ID: mdl-32847668

RESUMO

Purpose: The purpose of this study was to examine if there are differences in the success rate of primary teeth treated with pulpotomies performed by general dentists (GDs) versus pediatric dentists (PDs), using submitted paid insurance dental claims. The extraction time after pulpotomy was examined. Methods: Data for this study were obtained from a private dental insurance claims warehouse. The insurance claims data were retrieved, and a retrospective analysis was performed over seven years (2008 to 2015). The survival rate was estimated using proportional hazard survival analysis. Results: The total number of paid dental claims that used the CDT code for pulpotomy was 401,638. For teeth that received pulpotomy, the average time between pulpotomy and extraction was 1.1 years if the pulpotomies were performed by GDs. The average time was 1.3 years if the pulpotomies were performed by PDs (P<0.0001). GDs had an extraction rate of 7.83 percent after pulpotomies and the placement of stainless steel crowns, while PDs had an extraction rate of 4.09 percent. Conclusions: There is a significant difference in the success rate of teeth treated with pulpotomies performed by pediatric dentists versus general dentists, with pulpotomies performed by the former having a longer survival rate.


Assuntos
Análise de Dados , Pulpotomia , Criança , Coroas , Odontólogos , Humanos , Dente Molar , Estudos Retrospectivos , Dente Decíduo , Resultado do Tratamento
2.
Pediatr Dent ; 42(4): 293-299, 2020 Jul 15.
Artigo em Inglês | MEDLINE | ID: mdl-32847669

RESUMO

Purpose: The purpose of this study was to evaluate the clinical and radiographic effectiveness of Biodentine® as a pulpotomy medicament for use in primary molars. Methods: A retrospective chart review was conducted on children who had received full-mouth dental rehabilitation under general anesthesia between January 1, 2013, and May 1, 2018. Three clinical outcomes (pain, pathologic mobility, and soft tissue pathology) and two radiographic outcomes (pathologic radiolucency and pathologic root resorption) defined a composite outcome of pulp therapy failure. Results: The final study sample consisted of 208 children with a mean age of 4.9 years. The total number of primary molars that received a Biodentine® pulpotomy over the 30-month posttreatment period was 608. Survival analyses determined that the cumulative probability of clinical survival at 30 months was 93.7 percent (95 percent confidence interval [95% CI] equals 83.7 percent to 99.2 percent) and radiographic survival probability was 85.6 percent (95% CI equals 76.3 percent to 93.7 percent). The majority (n equals 14 out of 20; 70 percent) of failed Biodentine® pulpotomies occurred before 18 months. Conclusions: Primary molar pulpotomies utilizing Biodentine® as the pulpal medicament had favorable clinical and radiographic results after 30 months. Biodentine® can be considered an alternative to other commonly used primary tooth pulpotomy medicaments.


Assuntos
Compostos de Cálcio , Pulpotomia , Criança , Pré-Escolar , Combinação de Medicamentos , Humanos , Dente Molar , Óxidos , Estudos Retrospectivos , Silicatos , Dente Decíduo , Resultado do Tratamento
3.
J Clin Pediatr Dent ; 44(3): 142-147, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32644897

RESUMO

Introduction: Bioceramic materials, gray and white mineral trioxide aggregate (GMTA, WMTA), have been shown to have high rates of success in various endodontic applications. A major drawback is their tendency to discolor teeth. Biodentine (BD), a recenlty developed bioceramic material, has been claimed not to discolor teeth. The aim of this study was to compare tooth discoloration after applying different pulpotomy base materials (BD, GMTA and WMTA). Methods: Forty human fully developed primary incisors teeth were used in this study. Coronal access was achieved by a Tungsten Carbide drill, and the pulp chambers were accessed and chemo-mechanically debrided. Each material was placed in the pulp chamber, up to the cervical sectioning level. All specimens were incubated at 37°C and 100% humidity for 14 weeks and have been evaluated before the study and weekly. Color was assessed according to the CIE L*a*b* color space system. Results: The ΔE (delta E) of all experimental groups (GMTA, WMTA and BD) were significantly different from the control group at all time points. Color changes in the GMTA and WMTA groups showed significantly higher discoloration compared to BD group in the cervical part of the crown, since week 1. WMTA group showed significant discoloration in the cervical part as of week 1, and gradually increased over time. BD group showed no significant discoloration over time. GMTA group showed the most significant discoloration at week 1 and week 14 (P<0.05). Conclusions: both GMTA and WMTA pulpotomy materials may discolor tooth structure over time in an extracted primary anterior tooth model. When choosing bioceramic pulpotomy material, BD may be preferable, mainly in esthetic area.


Assuntos
Materiais Restauradores do Canal Radicular , Descoloração de Dente , Compostos de Alumínio , Compostos de Cálcio , Combinação de Medicamentos , Estética Dentária , Humanos , Óxidos , Pulpotomia , Silicatos , Coroa do Dente , Dente Decíduo
4.
J Endod ; 46(8): 1085-1090, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32553418

RESUMO

INTRODUCTION: This report describes the treatment of an immature mandibular molar by combining vital pulp therapy (VPT) and regenerative endodontic procedures (REPs). It details the use of REP to regain functionality and continued root development of an immature root with pulp necrosis and VPT for an immature root containing vital pulpal tissues. METHODS: An 8-year old male presented for evaluation of a mandibular first right molar with mild buccal swelling and a nontraceable sinus tract. He recently had received a restoration. After intraoral and radiographic examination, a diagnosis of pulp necrosis and chronic apical abscess was made. After access, pulp necrosis was confirmed in the distal root; however, vital pulp tissues were present in the mesial canals. It was decided on pulpotomy (VPT) in the mesial and REP in the distal root. At the initial visit, pulpotomy was completed in the mesial root, and REP was initiated in the distal root. Three weeks later, the patient was asymptomatic and the sinus tract absent. REP was completed in the distal root, and the tooth was restored. RESULTS: At the 6-, 12-, and 18-month follow-up, the patient presented without symptoms, and the tooth responded positively to pulp sensibility tests. Radiographic examinations showed resolution of the apical radiolucency and completed root development. CONCLUSIONS: Combined treatment using both VPT and REP for immature molars with different pulpal status in individual roots may be a preferable treatment option because preservation of vital pulp tissues and regeneration of new vital tissues allow for continued root development and functionality.


Assuntos
Dente Molar , Criança , Necrose da Polpa Dentária , Humanos , Masculino , Pulpotomia , Endodontia Regenerativa , Raiz Dentária
5.
J Evid Based Dent Pract ; 20(1): 101341, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-32381418

RESUMO

ARTICLE TITLE AND BIBLIOGRAPHIC INFORMATION: Partial Pulpotomy in Mature Permanent Teeth with Clinical Signs Indicative of Irreversible Pulpitis: A Randomized Clinical Trial. Taha NA, Khazali MA. J Endod 2017;43(9):1417-21. SOURCE OF FUNDING: Information not available. TYPE OF STUDY/DESIGN: Randomized clinical trial.


Assuntos
Pulpite , Pulpotomia , Compostos de Alumínio , Compostos de Cálcio , Hidróxido de Cálcio , Combinação de Medicamentos , Humanos , Dente Molar , Óxidos , Silicatos
6.
J Clin Pediatr Dent ; 44(2): 84-89, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32271667

RESUMO

Introduction: the study aimed to evaluate Enterococcus Faecalis colonization in the pulp chamber in pulpotomized extracted human teeth filled by different pulpotomy base materials (PBMs), using confocal laser scanning microscopy (CLSM). Study design: Cavity preparations were made in 70 extracted primary molars. The pulp chambers were filled using either Intermediate restorative material (IRM), Mineral Trioxide Aggregate (MTA) or Glass ionomer (GI). Twenty-five teeth served controls. The specimens were sterilized, and coronally filled with bacterial suspension for 21 days. The specimens were cut through the furcation area, stained using LIVE/DEAD BacLight Bacterial Viability Kit and evaluated using CLSM. Results: The extent of fluorescent staining was larger in the GI group, compared to the IRM and MTA groups, and larger in the IRM group compared to the MTA group (P<0.05). The minimal and maximal bacterial penetration depths into the dentinal tubules were 55 and 695μm, respectively (mean 310μm), without differences between the materials (GI, IRM, MTA, p>0.05). The ratio of live bacteria to dead bacteria within the evaluated areas was higher in the GI group compared to the IRM and the MTA groups, and higher in the IRM group compared to the MTA group (P<0.05). There were no differences between the mesial, distal and apical parts in any of the evaluations (p>0.05). Conclusions: bacteria colonize the interface between the PBM and dentin and penetrate deeply into the dentinal tubules. The extent and the vitality of the colonized bacteria may be affected by the type of PBM.


Assuntos
Compostos de Cálcio , Pulpotomia , Compostos de Alumínio , Proliferação de Células , Combinação de Medicamentos , Humanos , Microscopia Confocal , Dente Molar , Óxidos , Silicatos , Dente Decíduo
8.
J Endod ; 46(3): 352-357, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32035640

RESUMO

INTRODUCTION: Calcium hydroxide has been used as a traditional pulpotomy agent for a long time but has some disadvantages. iRoot BP Plus (Innovative Bioceramix Inc, Vancouver, Canada) is a newly developed, ready-to-use calcium silicate-based bioactive ceramic with excellent bioactivity and sealing ability. However, whether iRoot BP Plus shows superiority over calcium hydroxide as a pulpotomy material on permanent incisors with complicated crown fractures remains unknown. METHODS: This research included 205 permanent incisors with complicated crown fractures. These teeth were treated with pulpotomy and divided into 2 groups according to the pulpotomy material (105 treated with iRoot BP Plus and 100 with calcium hydroxide). Clinical and radiographic information was collected during the 12- to 24-month follow-up period. The formation of reparative dentin bridges and pulp canal obliteration were analyzed using radiographs in both groups. RESULTS: The success rates for recall in the average follow-up period of 17.5 ± 4.4 months (12-24 months) after pulpotomy treatment were significantly different between the 2 groups, with 99% for the iRoot BP Plus group and 93% for the calcium hydroxide group. Reparative dentin bridges were observed in 92.4% of the iRoot BP Plus group and 90% of the calcium hydroxide group, but the difference was not significant. Pulp canal obliteration was observed in 2 teeth (2%) in each group. CONCLUSIONS: The success rates obtained in our study indicate that iRoot BP Plus as a pulpotomy agent can be a suitable alternative to calcium hydroxide to manage complicated crown fractures.


Assuntos
Hidróxido de Cálcio , Pulpotomia , Canadá , Coroas , Humanos , Incisivo , Estudos Retrospectivos , Silicatos
9.
Int J Paediatr Dent ; 30(5): 536-546, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32078201

RESUMO

OBJECTIVE: To summarize the clinical/radiographic outcomes from the evidence of studies published since 1988 on different DPC agents applied on vital pulp-exposed primary teeth. METHODS: The following electronic databases were searched: PubMed, Embase, Cochrane Library, Dentistry and Oral Science Source, and Google Scholar. Inclusion criteria were randomized controlled trials (RCTs) published between January 1988 and December 2019, with at least 6 months of follow-up, comparing the clinical and radiographic success rates of two or more DPC agents applied in primary teeth with cariously and non-cariously exposed pulp. RESULTS: Initial searches identified 83 potentially relevant studies on DPC in primary teeth. Sixty-four of these studies were excluded, whereas 19 articles satisfied the inclusion criteria and were retrieved in full text for data extraction and a methodological quality assessment. Finally, 12 of these articles were included in the systematic review. Low and moderate risks of bias were observed. Overall, DPC clinical and radiographic success rates among the selected studies ranged between 53% and 100%. CONCLUSIONS: For DPC in primary teeth, this systematic review found that diverse new biologically and compatible agents with promising success rates are currently available for paediatric dentistry practitioners. There is no evidence that justifies discarding the judicious use of DPC procedures in primary teeth.


Assuntos
Cárie Dentária , Pulpotomia , Criança , Capeamento da Polpa Dentária , Humanos , Tratamento do Canal Radicular , Dente Decíduo
10.
J Endod ; 46(3): 383-390, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31902641

RESUMO

INTRODUCTION: Pulpotomy in mature permanent cariously exposed teeth preserves the remaining pulp tissues, but long-term outcomes of the pulp and the restoration are unknown. This prospective study examined the immediate and long-term status of the pulp and the restored tooth and identified potential predictors of early and late failures in teeth that were asymptomatic or experiencing only mild symptoms at the time of treatment. METHODS: Pulpotomy was performed using the aseptic technique and a tricalcium silicate cement under local anesthesia. Teeth were assessed for up to 5 years for pulpal and apical signs and symptoms, restorative marginal integrity, and periodontal health. RESULTS: Fifty-two patients (61 teeth) with a median age of 40 years (range, 21-75 years) were included in this study; 17 (32.7%) men and 35 (67.3%) women were treated and reviewed. Overall pulp survival was 90.2% (95% confidence interval, 79.8%-96.3%); 6 teeth developed irreversible pulpitis or pulp necrosis when the restoration was intact. Preoperative pain was a potential predictor (P < .05) for early failure. Eleven late failures occurred between 2 and 4 years: 1 tooth with intact coronal restoration had pulp necrosis and asymptomatic apical periodontitis, 4 had recurrent caries resulting in asymptomatic apical periodontitis, 4 remained vital and only needed new restorations, 1 was unrestorable, and 1 was extracted for periodontal reasons. The type of definitive restoration was a potential predictor for late failure (P < .05). CONCLUSIONS: Carious pulp exposures in asymptomatic mature permanent teeth can be predictably managed by pulpotomy using a tricalcium silicate cement. Short-term failures were few and managed by pulpectomy. Appropriate coronal restoration is critical to long-term success.


Assuntos
Cárie Dentária , Dentição Permanente , Pulpotomia , Adulto , Idoso , Polpa Dentária , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Óxidos , Estudos Prospectivos , Resultado do Tratamento , Adulto Jovem
11.
J Endod ; 46(1): 81-88, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31767340

RESUMO

INTRODUCTION: Pulp capping materials allow healing of injured pulp with a layer of reparative dentin. Glucose is needed to cure the injured area. Glucose is transported by glucose transporter (Glut) 2 and Glut4, which are transmembrane proteins that act as gatekeepers. We hypothesized that the transport of glucose via Glut2/Glut4 might contribute to the production of a dentin bridge during wound healing. Therefore, we explored Glut2 and Glut4 expression during reparative dentinogenesis after mineral trioxide aggregate capping. METHODS: The upper left first molar of 8-week-old Wistar rats underwent pulpotomy with mineral trioxide aggregate. At 1, 3, 5, 7, and 14 days after treatment, localization and colocalization of Glut2, Glut4, nestin (odontoblast marker), and antiendothelial cell antigen 1 (RECA-1; endothelial cell marker) were analyzed with immunohistochemical staining. Messenger RNA expression levels of Slc2a2 (encoding Glut2), Slc2a4 (encoding Glut4), Igf-1r (encoding insulinlike growth factor 1 receptor), and nestin were analyzed in the extracted teeth using real-time polymerase chain reaction. RESULTS: Glut2 and Glut4 were localized within odontoblasts and endothelial cells in normal control teeth. Three days after pulpotomy, Glut2- and Glut4-positive cells were detected; 7 days after pulpotomy, immunoreactivity for Glut2 and Glut4 was confined to newly differentiated odontoblastlike cells arranged beneath reparative dentin. Messenger RNA expression levels of Slc2a2 and Slc2a4 were significantly up-regulated after pulpotomy. CONCLUSIONS: Glut2 and Glut4 regulate glucose transport during wound healing beneath the injured area. This may contribute to the development of new vital pulp therapy for patients with deep caries.


Assuntos
Transportador de Glucose Tipo 2 , Transportador de Glucose Tipo 4 , Glucose , Pulpotomia , Cicatrização , Compostos de Alumínio , Animais , Compostos de Cálcio , Polpa Dentária , Capeamento da Polpa Dentária , Combinação de Medicamentos , Células Endoteliais , Glucose/metabolismo , Transportador de Glucose Tipo 2/fisiologia , Transportador de Glucose Tipo 4/fisiologia , Humanos , Dente Molar , Óxidos , Ratos , Ratos Wistar , Silicatos
12.
Int J Paediatr Dent ; 30(3): 370-380, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-31778237

RESUMO

BACKGROUND: Endodontic therapies may be required in the management of compromised first permanent molar teeth; their success in children, however, is unknown. AIM: To determine the success of endodontic therapies used on first permanent molar teeth in children aged sixteen and under. DESIGN: MEDLINE, Embase, Cochrane library, CENTRAL, Clinicaltrials.gov, and the ISRCTN registry as well as relevant paediatric, endodontic, and traumatology journal were searched using a detailed search strategy. References of included studies were hand-searched. A PICOS question was formulated: (P): children aged sixteen and under; (I): endodontic therapies (not pulp capping) on a first permanent molar tooth; (C): no treatment; (O): clinical success of endodontic therapy; and (S): all study types included. Bias was assessed using the Cochrane and Robins-I risk tools. Quality of evidence was assessed using the GRADE approach. Significant heterogeneity precluded meta-analysis. RESULTS: 4172 studies were retrieved and eleven were included in the narrative review. Partial and coronal pulpotomies have high success rates in the short term and long term. Limited evidence is available for conventional pulpectomy or regenerative techniques. CONCLUSIONS: Partial and coronal pulpotomies are successful endodontic therapies for use in a compromised child's first permanent molar.


Assuntos
Cárie Dentária , Criança , Humanos , Dente Molar , Pulpectomia , Pulpotomia
13.
Oral Dis ; 26(2): 341-349, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31710760

RESUMO

OBJECTIVES: To determine glucose transporter 1 (GLUT1) and runt-related transcription factor 2 (RUNX2) expression during reparative dentinogenesis after pulpotomy with mineral trioxide aggregate (MTA) capping. SUBJECTS AND METHODS: Eight-week-old male Wistar rats were used. Pulp of the upper left first molar was exposed and capped with MTA. The upper right first molar of the same animal was used as a control. After collecting molars at various time points, GLUT1, RUNX2 and mammalian target of rapamycin (MTOR) were examined by immunohistochemistry. mRNA levels of Slc2a1 (encoding GLUT1), Runx2, Nestin and Mtor were determined by real-time PCR. RESULTS: Pulp exhibited progressive formation of reparative dentine lined with GLUT1- and MTOR-immunoreactive odontoblast-like cells at 5 days after pulpotomy. RUNX2 was detected in nuclei of most pulp tissue cells at day 5 after pulpotomy. Double immunofluorescence staining revealed GLUT1 immunoreactivity on odontoblast-like cells positive for Nestin or RUNX2, 5 days after pulpotomy. Slc2a1, Runx2, Nestin and Mtor mRNA levels were significantly upregulated on days 3-5 after pulpotomy. CONCLUSIONS: After rat molar pulpotomy, dental pulp induced formation of reparative dentine with colocalization of GLUT1 and Nestin or RUNX2. Moreover, mRNA levels of Slc2a1, Runx2, Nestin and Mtor were significantly upregulated in pulpotomized dental pulp.


Assuntos
Compostos de Alumínio/administração & dosagem , Compostos de Cálcio/administração & dosagem , Subunidade alfa 1 de Fator de Ligação ao Core/genética , Capeamento da Polpa Dentária/métodos , Polpa Dentária/fisiologia , Dentinogênese/genética , Transportador de Glucose Tipo 1/genética , Óxidos/administração & dosagem , Pulpotomia , Silicatos/administração & dosagem , Serina-Treonina Quinases TOR/genética , Animais , Combinação de Medicamentos , Expressão Gênica , Imunoquímica , Masculino , Dente Molar/cirurgia , Nestina/genética , Odontoblastos/fisiologia , Ratos , Ratos Wistar
14.
Quintessence Int ; 51(1): 38-48, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31781690

RESUMO

OBJECTIVES: This study aims to evaluate the success rate of formocresol and ferric sulfate through meta-analysis with trial sequential analysis (TSA). METHOD AND MATERIALS: The protocol of the review was registered in the PROSPERO database (CRD 42018090044). Two independent reviewers used PubMed, Scopus and EBSCOhost databases to identify randomized clinical trials published from inception to June 2019. Patients undergoing pulpotomy therapy in vital primary molars with pulp exposure due to caries treated with formocresol and ferric sulfate were evaluated for clinical and radiographic success. Meta-analysis was conducted to evaluate the success at 6, 12, 18, and 24 months and TSA was performed for success at 24 months. Quality of evidence was determined by Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) analysis. RESULTS: Eight clinical trials were included in meta-analysis. No difference was observed in the clinical and radiographic success rate between formocresol and ferric sulfate at 6, 12, 18, and 24 months. TSA identified required information size of 687 teeth for clinical success and 568 teeth for radiographic success. In addition, it demonstrated evidence for radiographic success rate at an anticipated intervention effect of 10% for formocresol over ferric sulfate. CONCLUSION: Formocresol and ferric sulfate show comparable clinical and radiographic success rates as pulpotomy material in primary molars at 24 months based on the studies with low to moderate quality of evidence.


Assuntos
Formocresóis , Pulpotomia , Compostos Férricos , Humanos , Dente Molar , Ensaios Clínicos Controlados Aleatórios como Assunto , Dente Decíduo , Resultado do Tratamento
15.
Pediatr Dent ; 41(6): 446-450, 2019 Nov 15.
Artigo em Inglês | MEDLINE | ID: mdl-31882030

RESUMO

Purpose: Tricalcium silicate (Biodentine), a new synthetic inorganic restorative cement, has shown a high rate of success in pulpotomy treatments, with few side effects. The purpose of the present randomized clinical control trial was to evaluate the long-term success of pulpotomies in human primary molars using tricalcium silicate versus formocresol. Methods: Healthy two- to 10-year-olds were treated with pulpotomies on primary molars as part of their scheduled regular dental treatment. Pulp dressing alternated randomly between tricalcium silicate and formocresol. Data were analyzed at follow-up periods up to 48 months. Results: Thirty-seven (51.4 percent) teeth with tricalcium silicate and 35 (48.6 percent) teeth with formocresol in 58 healthy children (31 boys and 27 girls) were studied. The overall success rate of the pulpotomies in this study was 94.4 percent. Tricalcium silicate was successful in 97.3 percent (36 out of 37) of the cases, and formocresol in 91.4 percent (32 out of 35). No association was found between success and type of tooth or time range from treatment to last follow-up. Conclusion: Tricalcium silicate shows a higher (though not statistically significant) success rate than formocresol in human primary molars pulpotomies followed for two to four years.


Assuntos
Formocresóis , Pulpotomia , Compostos de Cálcio , Criança , Feminino , Humanos , Masculino , Silicatos , Dente Decíduo , Resultado do Tratamento
16.
Evid Based Dent ; 20(4): 117-118, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31863048

RESUMO

Data sources Embase, MEDLINE, Web of Science, Trip Pro, Cochrane Library, the International Clinical Trials Registry Platform and ClinicaTrials.gov, including a grey literature search.Study selection Randomised or quasi-randomised clinical trials (RCT).Data extraction and synthesis Two reviewers screened independently and extracted data separately with focus on study and population characteristics, treatment, pulp capping materials and clinical and radiographical outcome measures. Incremental cost effective ratios were collated.Results Seventeen studies reported in 21 articles were included. Three were completed trials and one ongoing trial comparing (partial/full) pulpotomy with other interventions for vital pulp therapy. The remaining 13 studies compared hydraulic calcium silicate cements with calcium hydroxide. Only three studies were considered as low risk of bias, except for performance bias (the inherent impossible task of blinding the clinician). Five trials comparing the capping materials were the basis of a quantitative synthesis. No cost-effectiveness studies were found.Conclusions Firm evidence has not been reached with respect to pulpotomy being the preferred intervention substituting root canal treatment; however better pulpotomy outcomes were reported when hydraulic calcium silicate cements are used, when compared to procedures where calcium hydroxide was used.


Assuntos
Capeamento da Polpa Dentária , Pulpotomia , Hidróxido de Cálcio , Tratamento do Canal Radicular
17.
J Evid Based Dent Pract ; 19(4): 101309, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31843186

RESUMO

OBJECTIVE: This systematic review and meta-analysis aimed to evaluate the overall, clinical, and radiographical success rates of alternative pulpotomy medicaments in primary teeth. METHODS: A systematic search of five databases was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Prospective clinical trials using alternative pulpotomy medicaments in children were included. The outcome measures were overall, clinical, and radiographic success, expressed in percentages and converted to odds ratios. Fifteen articles were included in the meta-analysis. RESULTS: Combined odds ratios for overall, clinical, and radiographic success was 0.55 (95% confidence interval [CI]: 0.12-2.41; P = .42; I2 = 76%), 1.03 (95% CI: 0.57-1.86; P = .92; I2 = 0%), and 0.84 (95% CI: 0.54-1.47; P = .66; I2 = 34%), respectively. The results suggest an inconclusive outcome in the success rate of alternative medicaments. CONCLUSIONS: There is insufficient evidence to support the efficacy of alternative pulpotomy medicaments for use in primary teeth. Further robust studies are required before such alternative medicaments should be used in clinical practice.


Assuntos
Pulpotomia , Dente Decíduo , Criança , Assistência Odontológica , Humanos , Avaliação de Resultados em Cuidados de Saúde , Estudos Prospectivos , Resultado do Tratamento
18.
J Indian Soc Pedod Prev Dent ; 37(4): 399-404, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31710016

RESUMO

Aim: The purpose of this study was to evaluate and compare clinically and radiographically PRF, MTA and Ca(OH)2 as a pulp dressing material in primary molars. Material and Methods: The study was conducted on 30 children between 6-9 years of age. Pulpotomy was performed using MTA(Gp I), PRF + MTA(Gp II) and PRF +Ca(OH)2(Group III). The teeth were evaluated clinically and radiographically after 1,3 and 6 months and were subjected to statistics analysis. Results: After 6 months follow-up the overall success rate was found to be highest in Gp I with success rate of 97% followed by Gp II 95% and Gp III 78.3%. The results were found to be statistically insignificant (P ≤ 0.05). Conclusion: All materials used in the present study were equally effective as the success rates are statistically insignificant.


Assuntos
Polpa Dentária , Fibrina Rica em Plaquetas , Compostos de Alumínio , Compostos de Cálcio , Criança , Combinação de Medicamentos , Seguimentos , Humanos , Dente Molar , Óxidos , Pulpotomia , Silicatos
19.
BMC Oral Health ; 19(1): 227, 2019 10 23.
Artigo em Inglês | MEDLINE | ID: mdl-31647004

RESUMO

BACKGROUND: Pulpotomy is one of the most widely used methods in preserving vital pulp in teeth, which is of great significance in achieving continue root formation in immature permanent teeth suffering from dental caries or trauma. The aim of this meta-analysis and systemic review is to synthesize the available evidences to compare different pulpotomy dressing agents for pulpotomy treatment in immature permanent teeth. METHODS: Electronic databases including MEDLINE (via Pubmed), EMBASE, the Cochrane library (CENTRAL) and the clinicaltrials.gov database were searched. The references of all included articles or relevant reviews were cross-checked. Only randomized controlled trials (RCTs) comparing two or more pulp dressing agent in permanent teeth with open apex would be included. Also, the studies should have at least 6 months of follow-up, report clinical and radiographic success in detail and publish in English. RESULTS: Five RCTs were included for a systematic review, and all of them had a high risk of bias. There is little difference in success rate between mineral trioxide aggregate (MTA) and calcium hydroxide (CH) at 6-month follow-up (risk ratio (RR) 1; 95% confidence interval (CI) 0.94 to 1.06) and 12-month follow-up (RR 1.04; 95% CI 0.96 to 1.13). There is no difference between MTA versus platelet-rich fibrin and MTA versus calcium-enriched mixture (CEM). There is only weak evidence of increased success rate in using MTA and triple antibiotic paste (TAP) rather than abscess remedy. CONCLUSIONS: Based on the present evidence, similar success rates with MTA were found between the dressing agents CH, CEM, RPF and TAP as pulpotomy-dressing agents in the treatment of immature permanent teeth. More high-quality RCTs are needed in this field in future studies.


Assuntos
Compostos de Alumínio/uso terapêutico , Compostos de Cálcio/uso terapêutico , Hidróxido de Cálcio/uso terapêutico , Dentição Permanente , Pulpotomia/métodos , Silicatos/uso terapêutico , Cárie Dentária/terapia , Capeamento da Polpa Dentária/métodos , Exposição da Polpa Dentária/terapia , Combinação de Medicamentos , Humanos , Óxidos/uso terapêutico , Ensaios Clínicos Controlados Aleatórios como Assunto , Resultado do Tratamento
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