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PubMed1991

The comparative antimicrobial effect of calcium hydroxide.

The antimicrobial effectiveness of calcium hydroxide, camphorated paramonochlorophenol, and formocresol in root canals of extracted human teeth was compared. Canals in single-rooted teeth were enlarged and inoculated with Streptococcus mutans, Actinomyces viscosus, and Bacteroides gingivalis or Bacteroides fragilis. After treatment with a test agent and sealing and incubation for 1 hour, the canal contents were analyzed for the number of viable test bacteria and compared with that of inoculated teeth not treated with test agents. All test agents exhibited antimicrobial activity against all bacteria, with percent reductions in viable bacteria ranging from 64.3% to 100%. The combined data for Pulpdent paste and calcium hydroxide showed significantly higher antimicrobial activity than the combined data for camphorated paramonochlorophenol and formocresol for S. mutans and B. gingivalis or B. fragilis but showed no difference for A. viscosus.

Actinomyces↗
PubMed2006

Assessment of genotoxicity of 14 chemical agents used in dental practice: ability to induce chromosome aberrations in Syrian hamster embryo cells.

To assess the genotoxicity of 14 chemical agents used as locally applied agents in dental practice, the ability of these agents to elicit chromosome aberrations was examined using Syrian hamster embryo (SHE) cells. Chromosome aberrations in SHE cells were induced by treatment with three of eight chemical agents used as endodontic medicaments, i.e. ethylenediaminetetraacetic acid (EDTA), formocresol (a mixture of formalin and tricresol), and sodium arsenite. The other five chemical agents, i.e. chloramphenicol, p-chlorophenol, p-phenolsulfonic acid, sodium hypochlorite, and tetracycline hydrochloride exhibited a negative response for chromosome aberrations. Assessment of three dyes used for disclosing dental plaque showed chromosome aberrations induced by basic fuchsin but not by acid fuchsin and erythrosine B. Three local anesthetics, lidocaine hydrochloride, prilocaine hydrochloride, and procaine hydrochloride, were negative for chromosome aberrations. Among the ten chemical agents that exhibited a negative response in the assay, p-chlorophenol, sodium hypochlorite, and erythrosine B induced chromosome aberrations in SHE cells when treated in the presence of exogenous metabolic activation. The percentages of cells with polyploidy or endoreduplication were enhanced by formocresol, sodium arsenite, p-chlorophenol, p-phenolsulfonic acid, sodium hypochlorite, erythrosine B, prilocaine hydrochloride, and procaine hydrochloride in the absence or presence of exogenous metabolic activation. Our results indicate that the chemical agents that had a positive response in the present study are potentially genotoxic to mammalian cells.

Anesthetics↗
PubMed2005

Genotoxicity of antimicrobial endodontic compounds by single cell gel (comet) assay in Chinese hamster ovary (CHO) cells.

OBJECTIVE: In the current study, the potential DNA damage associated with exposure to a number of antimicrobial endodontic compounds was assessed by the single cell gel (comet) assay in vitro. STUDY DESIGN: Chinese hamster ovary (CHO) cells were exposed to formocresol, paramonochlorophenol, calcium hydroxide, or chlorhexidine at final concentration ranging from 0.01% to 1%. RESULTS: Formocresol, paramonochlorophenol, and calcium hydroxide, as well as chlorhexidine in all concentrations tested did not contribute to the DNA damage. CONCLUSION: These findings are clinically relevant since they represent an important contribution to the correct evaluation of the potential health risk associated with exposure to dental agents.

Animals↗
PubMed2000

Primary molar pulp therapy--histological evaluation of failure.

OBJECTIVES: Qualitative comparison of the clinical, radiographic and histological outcomes in a small sample of cariously exposed primary molars, extracted after unsuccessful pulp treatment by two vital pulpotomy methods. SUBJECTS AND METHODS: The primary molars were extracted, because of treatment failure, during a longitudinal clinical investigation of the relative efficacy of 20% Buckley's Formocresol versus calcium hydroxide powder as pulp dressings in vital pulp therapy (in press). Fifty-two child patients were sequentially enrolled in the longitudinal clinical investigation, 26 boys and 26 girls. Primary molar teeth requiring vital pulp therapy were randomly allocated to either the formocresol group (F) or the calcium hydroxide group (C). Coronal pulp amputation was prescribed only in teeth with vital, cariously-exposed pulp tissue. All cases were reviewed using predefined clinical and radiological criteria. Seventy-nine cariously-exposed primary molars required vital pulp therapy. Forty-four teeth were included in group F and 35 in group C. Five per cent (n = 2) of teeth in group F and 11 per cent of teeth (n = 4) in group C were terminated from the trial due to clinical and/or radiographic failure. Of the six teeth extracted, five were sufficiently intact to be retained for histological evaluation. RESULTS: Post-extraction radiographs taken before specimen preparation showed reactionary dentine barrier (bridge) formation in teeth treated with calcium hydroxide. However, the narrowing of root canals, indicative of appositional reactionary dentine deposition, was seen in both groups (F and C). Histological examination confirmed these findings and revealed that pus cells were evident in all specimens examined. There was also histological evidence of resorption of reactionary dentine within the root canal and that forming the calcified barrier (dentine bridge). CONCLUSION: The clinical and radiographic outcomes for the five teeth correlate well with the reported findings from decalcified histological section. Although numbers are small, the histological findings may indicate possible reasons for treatment failure. There are few reports of this sort in the literature of this under-researched treatment modality.

Calcium Hydroxide↗
PubMed2003

Vital pulpotomy in the primary dentition: attitudes and practices of Specialists in Paediatric Dentistry practising in the United Kingdom.

OBJECTIVES: This study was designed to examine the attitudes and practices of Specialists in Paediatric Dentistry practising in the United Kingdom in relation to vital pulpotomy in the primary dentition. DESIGN: Data were collected by postal questionnaire. SAMPLE AND METHODS: All dentists whose names were entered on the General Dental Council's Specialist List in Paediatric Dentistry, and who were resident and practising in the United Kingdom, were asked to complete a questionnaire consisting of nine questions. RESULTS: Questionnaires were returned by 184 (86.8%) of the eligible Specialists in Paediatric Dentistry. These yielded a sample group of 179 Specialists practising the primary vital pulpotomy technique. The most commonly used medicament was formocresol, with a 1 : 5 dilution being used by 66.5% of the sample. More than half (54.2%) of the Specialists practising the technique expressed concern regarding their preferred medicament. Without exception, their concerns related to the potential adverse effects of formocresol and formaldehyde. Seventy-five respondents (41.9% of the sample) were considering changing their technique. One hundred and thirty-seven Specialists stated that they routinely took preoperative radiographs, while postoperative radiographs were routinely taken by 107 Specialists (76.5% and 59.8% of the sample, respectively). Rubber dam isolation was used by 62.6% of the sample. CONCLUSIONS: The majority of Specialists are adhering to the UK national clinical guideline for pulp treatment of the primary dentition. However, significant numbers are considering changing their chosen technique. There is a lack of consensus on the use of pre- and postoperative radiographs; specific guidance with respect to their use is required.

Attitude of Health Personnel↗
PubMed1976

Effect of formaldehyde-containing drugs on human dental pulp evaluated by enzyme histochemical technique.

The in vivo effect of formaldehyde on pulp tissue in short-term studies cannot be established by using routine histologic techniques because the tissue is exposed to a fixative in vivo as well as during the histologic preparation. The pulps of permanent premolars were amputated and zinc oxide with 4% formaldehyde or formocresol was used as wound dressing. The observation periods varied from 1 to 16 d. After extraction the teeth were freeze-sectioned, freeze-dried and then incubated for histochemical demonstration of some oxidative and hydrolytic enzymes. A demarcated border between apically stained and cervically nonstained pulp tissue was found in sections incubated for oxidative enzymes. When formocresol, which has a high concentration of formaldehyde, was used, the border was situated closer to the apex. This was also the case when the observation period was increased. The incubation for lactate dehydrogenase gave a high staining intensity. Thus the use of frozen sections in combination with the histochemical method for the demonstration of lactate dehydrogenase appears to be suitable for the study of the penetration of formaldehyde in pulp tissue in short-term studies.

Acid Phosphatase↗
PubMed1997

Experimental apexigenesis in baboons.

Apexification with calcium hydroxide is a routine procedure. However, some clinical reports suggest that root completion can occur by controlling the infection without use of a catalyst. The present study investigated the use of tetracycline treatment (in root canals) on root growth in immature teeth, rendered non-vital experimentally. Incisors in 3 young baboons were exposed and canals were left open. After 2 months all canals were cleaned and treated with either tetracycline or formocresol. Some canals in each group were filed. Animals were sacrificed after 6 months. Bacterial evaluations were done before placing medications, one week later and six months after that. The number of bacteria were reduced in all treatment groups. Root growth almost near completion was observed in more teeth treated with tetracycline than in the formocresol group.

Animals↗
PubMed1979

Endodontic treatment of primary teeth.

Endodontic treatment of primary teeth is undertaken by indirect pulp capping, direct pulp capping, formocresol pulpotomy and pulpectomy. The same treatment principles apply to both primary and permanent teeth with infected or necrotic pulps. The main differences are the use of formocresol for root canal medication and a resorbably zinc-oxide and eugenol paste for root canal obturation.

Child↗
PubMed2000

Ferric sulfate as pulpotomy agent in primary teeth: twenty month clinical follow-up.

Seventy primary molar teeth, carious exposed, symptom free, without any sign of root resorption in children aged from 3 to 6 years (main age 4.3 yr) were treated with conventional pulpotomy procedures. Ferric sulfate 15.5% solution (applied for 15 second for 35 teeth) and formocresol solution (five minute procedure of Buckley's formula for next 35 teeth) have been used as pulpotomy agents. In both groups, pulp stumps were covered with zinc-oxide eugenol paste. Permanent restorations were stainless steel crowns. Clinical check up was every three-months and radiographic follow-up time was six and twenty months after treatment. Our results within this period revealed 100% clinical success rate in both groups. Radiographic success rate was in both groups 97.2%, while in 2.8% cases has shown internal root resorption. On the basis of these results, we can recommend ferric sulfate as a pulpotomy agent in primary teeth in substitution for formocresol at the moment.

Child↗
PubMed2005

Success of mineral trioxide aggregate in pulpotomized primary molars.

UNLABELLED: The aim of the present study was to compare, clinically and radiographically, the mineral trioxide aggregate (MTA) to formocresol (FC) when used as medicaments in pulpotomized vital human primary molars. METHODS: The sample consisted of 120 primary molars, all teeth were treated with the same conventional pulpotomy technique. Sixty molars received FC and 60 received MTA throughout a random selection technique. RESULTS: At the end of 24-month evaluation period, 74 molars (36 FC, 38 MTA) were available for clinical and radiographic evaluation. None of the MTA treated teeth showed any clinical or radiographic pathology, while the FC group showed a success rate of 86.8% radiographically and 98.6% clinically. The difference between the two groups in the radiographic outcomes was statistically significant. It was concluded that MTA treated molars demonstrated significantly greater success. MTA seems to be a suitable replacement for formocresol in pulpotomized primary teeth.

Aluminum Compounds↗
PubMedDate not supplied

Evaluation of aggressive pulp therapy in a population of vitamin D-resistant rickets patients: a follow-up of 4 cases.

This investigation collected clinical and radiographic data from a retrospective chart review of 4 patients receiving prophylactic formocresol pulpotomies and stainless steel crowns following a dental abscess associated with a medical diagnosis of vitamin-D resistant rickets (VDRR) at Texas Scottish Rite Hospital for Children in Dallas, Tex. Clinical and radiographic data were available for 29 primary teeth in 4 children, with follow-up times ranging from 2 years, 1 month to 5 years, 6 months. Based on available recalls of 29 teeth treated following the prophylactic formocresol pulpotomy, 22 failed clinically. The earliest failure occurred at 3 months; the longest time to failure was 3 years, 9 months. No trends were discernable between tooth type and failure rate, although the shorter the time between eruption of the tooth and pulpotomy treatment, the greater the chance of success. Presently, there is not enough evidence to suggest that prophylactic pulpotomy therapy in VDRR patients is beneficial in preserving their primary dentition.

Abscess↗
PubMed2005

Evaluation of three pulpotomy medicaments in primary teeth.

AIM: To examine the success of the one-appointment pulpotomy technique with three different medicaments on primary molar teeth. METHODS: The study was conducted on 104 primary molars in 104 children with an indication for pulpotomy treatment on at least one primary molar. Primary teeth were treated with either formocresol (FC) (34 teeth), calcium hydroxide (CA) (33 teeth) or ferric sulphate (FS) (37 teeth) using standardised criteria for the pulpotomy procedures. Teeth were clinically and radiographically evaluated during the examination period of 18 months. RESULTS: The clinical success rate at 18 months for the FC and FS groups was 90.9% and 89.2%, respectively. The CA showed an overall clinical success rate of 82.3%, with no statistical difference compared with either the FC or FS groups. The overall radiographic success for each technique was: FC 84.8%, CA 76.5%, and FS 81.1%. The presence of a dentine bridge above the pulp amputation site was observed radiographically for CA (47%), and FS (40.5%) pulpotomies without any statistical difference. Radiographic examination did not reveal the presence of a dentine bridge for any of the teeth treated with FC pulpotomy. CONCLUSION: Favourable clinical and radiographic success rates of ferric sulphate pulpotomy, comparable to formocresol were obtained. Therefore, ferric sulphate can be recommended as a pulpotomy medicament.

Calcium Hydroxide↗
PubMedDate not supplied

A clinical study of ferric sulfate as a pulpotomy agent in primary teeth.

Pulpotomies were performed on 83 primary molars in 62 patients. Ferric sulfate or formocresol was placed on the pulpal stumps, and teeth were followed for 3-, 6-, and 12-month periods. After the one-year follow-up, 28 of 29 teeth treated with ferric sulfate (FS group) were considered successful and 21 of 27 teeth treated with formocresol (FC group) were judged to be successful. The FS group demonstrated greater combined clinical and radiographic success than the FC group at the one-year recall (P < 0.05). Although the results of this study are promising, further study with longer observation periods is warranted before this technique can be recommended.

Chi-Square Distribution↗
PubMed1982

[Radiographic follow-up of primary molars following sclerosing amputation].

The effects of pulpotomy with the formocresol technique (Tempophore) were studied in a sample of 72 patients between 3 and 9 years of age. A total of 137 primary molars were treated and a longitudinal radiographical follow-up was executed with an interval of 4 months. Eighteen pulpotomies (13%) failed; in twelve of them an interradicular abscess was developing and 6 of them failed by internal resorption. It was striking that a rather great number of the failures occurred under 3 years of age and in patients older than 9 years. A second remarkable result was the higher frequency of failures in the mandible (18%) than in the maxilla (4%). This study reveals that the pulpotomy by formocresol is a successful therapy, by which primary molars with extensive carious lesions can be preserved until their usual time of shedding.

Age Factors↗
PubMed2005

Inhibition of cyclooxygenase activity, platelet aggregation and thromboxane B2 production by two environmental toxicants: m- and o-cresol.

Cresol is a well-known environmental pollutant, toluene metabolite, uremic toxicant and accidental poisoning product. Formocresol, a preparation of formalin and cresol, is also used as a root canal medicament and for pulpotomy of primary teeth. However, little is known about its effect on cardiovascular system. In this study, m-cresol inhibited the AA-induced platelet aggregation by 43-97% at concentrations ranging from 0.25 to 1 mM. Collagen-induced platelet aggregation was also inhibited by 0.25-1 mM of m-cresol by 47-98%. Accordingly, o-cresol (0.1-0.5 mM) also inhibited the AA-induced platelet aggregation by 46-96% and the collagen-induced platelet aggregation by 35-88% at concentrations of 0.1-1 mM. AA- and collagen-induced platelet thromboxane B(2) (TXB(2)) production was inhibited by even 0.1 mM of m-cresol with 88 and 54% of inhibition, respectively. The o-cresol (0.1 mM) also inhibited the AA- and collagen-induced platelet TXB(2) production with 91 and 97% respectively. Although m- and o-cresol (<1 mM) showed little effect on thrombin-induced platelet aggregation, they effectively inhibited the thrombin-induced platelet TXB(2) production. The m-cresol (2 and 5 mM) inhibited the COX-1 activity by 55-99%, but showed little effect on COX-2 enzyme activity. Moreover, o-cresol (0.5 and 1 mM) inhibited the COX-1 activity by 40-95%. COX-2 enzyme activity was inhibited by 68% at a concentration of 5 mM o-cresol. These results indicate that acute cresol-poisoning, direct root canal medication with formocresol or long-term occupational exposure to cresol and toluene may potentially suppress blood clot formation and lead to tissue hemorrhage via inhibition of platelet aggregation, TXB(2) production and COX enzyme activity.

Animals↗
PubMed2000

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.

Adolescent↗
PubMed1983

Effects of therapeutic and pulp protecting materials on nerve transmission in vitro.

Effects of therapeutic and pulp protecting dental materials on nervous tissue were studied in an in vitro model utilizing the isolated left rat phrenic nerve. The nerve was placed in a buffer bath between two suction electrodes, one for electrical stimulation and one for recording. Evoked compound action potentials (cAP) were monitored in an oscilloscope. Fresh mixes of six commonly used pulp-dentin materials were placed in contact with the nerve, and the cAP registered. Formocresol, zinc oxide-eugenol (ZOE), Calasept and Dycal caused a complete depression of the nerve activity within 0.5 to 5 min of contact. The depression appeared irreversible with Formocresol and Calasept, reversible with Dycal, and reversible with ZOE when applied to nerves surrounded by adherent fatty tissue. De Trey Zinc and Durelon caused only a minor depression of the cAP within 30 min of contact.

Action Potentials↗