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PubMed1991

[A study concerning radiographic diagnosis in dental caries of primary teeth. 1. The investigation on the indications for pulpotomy with formocresol].

The prognosis in the pulpotomy procedure with Formocresol during primary teeth has an excellent clinical results. On the other hand, some reports of a poor prognosis in radiographic findings were found. To obtain valuable information about the indications for pulpotomy procedures is quite difficult in the case of children concerning. In 1972, Kurihara reported radiographic findings the indications for the pulpotomy procedure in primary molars with a stable stage having no root absorption. The authors investigated the clinical and radiographic changes 6 months after the pulpotomy procedure with Formocresol. 26 primary lower molars having four criteria obtained from 3 to 7 year old patients were treated, and 4 primary lower molars were used as controls without the criteria. We found that the dental lamina dura were an especially important finding to judge the indications for pulpotomy with Formocresol in primary molars.

Child↗
PubMedDate not supplied

Consequences of endodontic treatment in primary teeth. Part I: A clinical and radiographic study of the influence of formocresol pulpotomy on the life-span of primary molars.

In the context of a study of the life-spans of primary teeth subjected to formocresol pulpotomy, 152 such teeth were compared with the corresponding teeth on the contralateral sides. The life-span of each tooth was determined by registration of the time of exfoliation or extraction. In addition, data were collected concerning factors which may influence the life-spans of teeth. The principal conclusions are: There was no significant difference in life-spans between primary teeth with or without pulpotomy. Premature loss due to extraction exerted virtually no influence on the mean life-span of primary teeth, regardless of whether a pulpotomy had been performed. There was no significant difference in the number of extractions of primary teeth with or without a formocresol pulpotomy. There was no significant difference in the mean life-span between primary teeth with vital and those with nonvital pulp at the time of formocresol pulpotomy.

Child↗
PubMedDate not supplied

Electrosurgical pulpotomy: a retrospective human study.

While the formocresol pulpotomy has enjoyed long-term clinical use and success, concerns over its toxicity and mutagenicity have prompted research into other pulpotomy techniques. The purpose of this study was to observe retrospectively the results of the electrosurgical pulpotomy technique used on primary molar teeth requiring pulp therapy, secondary to carious involvement. The mean age at the time of treatment was 5 years, 11 months and the mean postoperative observation time was 2 years, 3 months. Of the 164 teeth studied, 127 were normal at the last observation visit; 32 had undergone exfoliation; 4 had an abnormality associated with the pulpotomized tooth, but were not considered failures; and 1 was considered a failure. This is a 99.4 percent success rate. Compared to a formocresol pulpotomy study of similar design, the success rate for the electrosurgical pulpotomy procedure in this study is higher at the statistically significant level of p < 0.01.

Child↗
PubMed2006

The effect of sodium hypochlorite application on the success of calcium hydroxide pulpotomy in primary teeth.

OBJECTIVE: The aim of this study was to evaluate the effects of 3% sodium hypochlorite (NaOCl) used as a hemostatic agent on the outcome of calcium hydroxide pulpotomies of primary teeth. STUDY DESIGN: A total of 18 primary molars with advanced caries and root resorption of approximately half the root length were randomly placed into 2 groups. Conventional calcium hydroxide pulpotomies were performed on teeth in both groups; however, a cotton pellet saturated with 3% sodium hypochlorite was applied to teeth in the treatment group for 30 seconds before the pulpotomy to control hemorrhage. After the extraction of the teeth, they were examined histologically. RESULTS: In the histologic evaluation it was found that none of the specimens in the control group showed necrosis and 1 specimen in the treatment group showed partial necrosis. CONCLUSION: It was found that the use of 3% NaOCl as a hemostatic agent had no effect on the outcome of calcium hydroxide pulpotomies with the given concentration and timing of the NaOCl treatment and the given observation period.

Adolescent↗
PubMed2003

Comparison of bioactive glass, mineral trioxide aggregate, ferric sulfate, and formocresol as pulpotomy agents in rat molar.

Bioactive glass (BAG) is often used as a filler material for repair of dental bone defects. Although there is evidence of osteogenic potential of this material, it is not clear yet whether the material exhibits potential for dentinogenesis. Hence, the aim of the present study was to evaluate BAG as a pulpotomy agent and to compare it with three commercially available pulpotomy agents such as formocresol (FC), ferric sulfate (FS), and mineral trioxide aggregate (MTA). Pulpotomies were performed in 80 maxillary first molars of Sprague Dawley rats, and pulp stumps were covered with BAG, FC, FS, and MTA. Histologic analysis was performed at 2 weeks and then at 4 weeks after treatment. Experimental samples were compared with contra-lateral normal maxillary first molars. At 2 weeks, BAG showed inflammatory changes in the pulp. After 4 weeks, some samples showed normal pulp histology, with evidence of vasodilation. At 2 weeks, MTA samples showed some acute inflammatory cells around the material with evidence of macrophages in the radicular pulp. Dentine bridge formation with normal pulp histology was a consistent finding at 2 and 4 weeks with MTA. Ferric sulfate showed moderate inflammation of pulp with widespread necrosis in coronal pulp at 2 and 4 weeks. Formocresol showed zones of atrophy, inflammation, and fibrosis. Fibrosis was more extensive at 4 weeks with evidence of calcification in certain samples. Among the materials tested, MTA performed ideally as a pulpotomy agent causing dentine bridge formation while simultaneously maintaining normal pulpal histology. It appeared that BAG induced an inflammatory response at 2 weeks with resolution of inflammation at 4 weeks.

Aluminum Compounds↗
PubMed1978

Distribution of 14C-formaldehyde after pulpotomy with formocresol.

Pulpotomies were performed on rhesus monkeys with use of formocresol to determine if there was uptake of 14C-formaldehyde into the systemic circulation after formocresol pulpotomies. Five-minute exposure of pulpal tissue to the 14C-formocresol resulted in the systemic absorption of approximately 1% of the dose. Two hours of exposure of pulp tissue to the 14C-formocresol did not increase the systemic absorption. Multiple sequential pulpotomies resulted in proportionately higher systemic absorption of 14C-formaldehyde. Application of 131I to pulpotomy sites indicated that formocresol compromises the microcirculation of the dental pulp. Autoradiography disclosed extensive concentrations of 14C-formaldehyde in the pulp, dentin, periodontal ligament, and bone.

Absorption↗
PubMed1984

Calcium hydroxide pulpotomy for primary teeth: a clinical study.

Calcium hydroxide pulpotomies were performed in 17 carious primary mandibular molars. Variables in the pulpotomy procedure were recognized and controlled in an attempt to obtain a more favorable result or end product. The effects of two methods of hemorrhage control were also evaluated. The duration of treatment for the study ranged from three to nine months. Treatment was clinically successful for all 17 teeth. The radiographic evaluations were more favorable for the experimental group than for the control group. Treatment was radiographically successful for 15 teeth, questionable for one tooth, and unsuccessful for one other tooth. The results of this study suggest that the aluminum chloride-calcium hydroxide pulpotomy may be a viable alternative to formocresol pulpotomies in the primary dentition. Although these findings encourage continued research, including a long-term follow-up, a histologic study is indicated.

Aluminum↗
PubMed2005

Mineral trioxide aggregate as a pulpotomy agent in primary molars: an in vivo study.

The retention of pulpally involved deciduous tooth in a healthy state until the time of normal exfoliation remains to be one of the challenges for Pedodontists. A scientific noise has been generated about several materials some of which have been popular pulpotomy medicaments. Concerns have been raised about the toxicity and potential carcinogenicity of these materials, and alternatives have been proposed to maintain the partial pulp vitality, however to date no material has been accepted as an ideal pulpotomy agent. Mineral trioxide aggregate (MTA) is a biocompatible material which provides a biological seal. MTA has been proposed as a potential medicament for various pulpal procedures like pulp capping with reversible pulpitis, apexification, repair of root perforations, etc. Hence the present study was done to evaluate the efficacy of MTA as a pulpotomy medicament. A clinical and radiographic evaluation was done on children where MTA was used as pulpotomy medicament in primary molars for a period of 6 months and it was found to be a successful material.

Aluminum Compounds↗
PubMedDate not supplied

Outcome of formocresol/ZOE sub-base pulpotomies utilizing alternative radiographic success criteria.

PURPOSE: The purposes of this investigation were to 1) measure success of a primary tooth pulpotomy technique that applies formocresol in the sub-base without the common five-minute application of a formocresol impregnated cotton pellet; and 2) compare success rates of the pulpotomy procedure using traditional criteria found throughout the literature with new criteria recently established, excluding internal resorption as a radiographic failure. METHODS: Clinical and radiographic data were collected from a retrospective chart review of patients receiving formocresol pulpotomies with the application of formocresol in the zinc oxide-eugenol sub-base. RESULTS: Clinical and radiographic data were available for 196 primary molars in 122 children (followup=six to 103 months; mean=49 months). Traditional assessment of radiographic success and failure yielded a success rate of 79%. Alternative assessment excluding internal resorption as a failure yielded a 99% success rate. Most frequently observed pulpal responses were calcific metamorphosis and internal resorption. Overall clinical success was 99%. Two of the 196 teeth were extracted due to failure. A survival analysis demonstrated that the overall probability of survival remained high over time with a cumulative survival of over 95% after six years. CONCLUSIONS: The overall success rates in this study indicate that the formocresol pulpotomy technique incorporating formocresol in the zinc oxide-eugenol sub-base is a very successful treatment modality for primary molars requiring pulp therapy.

Chi-Square Distribution↗
PubMedDate not supplied

Concentration of formocresol used by pediatric dentists in primary tooth pulpotomy.

Diluted formocresol is the most widely recommended primary tooth pulpotomy medicament, but it is not commercially available. This investigation surveyed practicing pediatric dentists about the concentration of formocresol that they use to perform pulpotomies and, if they use diluted formocresol, where they obtain it. Eight-hundred-and-six surveys were sent to a randomly selected sample of practicing pediatric dentists, and 422 were returned for a 52% response rate. Eighty-four percent of the respondents use formocresol for their primary tooth pulpotomies. Of those, 69% use full strength, 27% use diluted and 4% don't know. Sources of diluted formocresol for those who use the diluted form include: 34% who buy it that way, 58% who dilute it themselves and 8% who have the pharmacy dilute it. The majority of pediatric dentists who use formocresol for primary tooth pulpotomies use a full strength formulation.

Chemistry, Pharmaceutical↗
PubMedDate not supplied

Clinical and radiographic evaluation of pulpotomies employing calcium hydroxide and trioxide mineral aggregate.

This study utilized clinical and radiographic examinations to compare the effectiveness of calcium hydroxide paste and mineral trioxide aggregate (MTA) for pulpotomies of primary molars in children. Ninety primary molars that showed clinical and radiographic indications for pulpotomy treatment were selected. The pulpotomies were performed in two sessions, using a corticosteroid/antibiotic solution as therapeutic dressing. The sample was divided into two groups of 45 teeth, in which the pulpal remains were protected with either calcium hydroxide paste (Group 1) or MTA (Group 2). Radiographs were taken immediately and at 3-, 6-, and 12-month follow-up appointments. Three teeth in Group 1 failed after three months, while two cases failed after six months and one more failed at one year. Two failures were found in Group 2 at the 12-month follow-up. These results indicate that both materials may be utilized for pulpotomies in primary teeth.

Aluminum Compounds↗
PubMedDate not supplied

Comparison of mineral trioxide aggregate and calcium hydroxide as pulpotomy agents in young permanent teeth (apexogenesis).

PURPOSE: The purpose of this study was to compare mineral trioxide aggregate (MTA) with calcium hydroxide (Ca(OH)2) clinically and radiographically as a pulpotomy agent in immature permanent teeth (apexogenesis). METHODS: Fifteen children, each with at least 2 immature permanent teeth requiring pulpotomy (apexogenesis), were selected for this study. All selected teeth were evenly divided into 2 test groups. In group 1, the conventional Ca(OH)2pulpotomy (control) was performed, whereas in group 2, the MTA pulpotomy (experimental) was done. The children were recalled for clinical and radiographic evaluations after 3, 6, and 12 months. RESULTS: The follow-up evaluations revealed failure due to pain and swelling detected at 6 and 12 months postoperative evaluations in only 2 teeth treated with Ca(OH)2. The remaining 28 teeth appeared to be clinically and radiographically successful 12 months postoperatively. Calcific metamorphosis was a radiographic finding in 2 teeth treated with Ca(OH)2 and 4 teeth treated with MTA. CONCLUSIONS: Mineral trioxide aggregate showed clinical and radiographic success as a pulpotomy agent in immature permanent teeth (apexogenesis) and seems to be a suitable alternative to calcium hydroxide.

Aluminum Compounds↗
PubMed1990

[Histopathologic study on the application of synthetic hydroxyapatite and alpha-tricalcium phosphate for vital pulpotomy].

Hydroxyapatite (HAp) and alpha-Tricalcium phosphate (alpha-TCP) are generally known as materials biocompatible to human tissue. In this study, the adaptation of HAp and alpha-TCP as a pulpotomy agent was studied histopathologically. In this study, HAp granules with a sintering temperature of 1,200 degrees C and sieved through a 37 micron sieve, and APATITE LINER TYPE I (Sankin CO.) as alpha-TCP were used. Calcium hydroxide served as a control. The physical properties of these experimental materials were evaluated and the reaction of pulp tissue to the materials was examined histolongically in dogs. alpha-TCP mixed with saline solution showed more homogeneous and higher viscosity than HAp mixed with saline solution. When alpha-TCP was applied on the site of exposure of a pulp following pulpotomy, the mechanically harmed pulp tissue was healed earlier than when HAp was applied. A hard tissue was formed earliest when calcium hydroxide was used, and then in the order of alpha-TCP and HAp. When HAp was applied, osteodentin was formed and when alpha-TCP was applied, dentin was formed on the site of exposure of a pulp following pulpotomy. When HAp or alpha-TCP was applied, the calcification in the initial stage was not observed. The calcification in initial stage was observed when calcium hydroxide was applied. These results suggest that alpha-TCP is useful as a pulpotomy agent.

Animals↗
PubMedDate not supplied

Long-term followup of traumatized incisors treated by partial pulpotomy.

The purpose of this study was to assess the long-term success of partial pulpotomy in traumatized permanent incisors. Seven years before this examination, 63 teeth that had been treated by partial pulpotomy six months to four years earlier were examined. At that stage, four teeth had pulp necrosis. The remaining 59 cases were recalled for re-examination. Of these, 40 were available for assessment 7.5 to 11 years after the partial pulpotomy treatment. Thirty-five of these teeth were successful, while the remaining five had root canal fillings, and three of them were restored by post and crowns. Of these, two were root treated in consequence of new trauma, and the other two for esthetic purposes. The fifth tooth has probably been root treated for similar reasons, as the patient reported not having had any pain or problem with the tooth. The high frequency of long-term success justifies recommending partial pulpotomy as the treatment of choice for traumatic pulp exposures in crown-fractured permanent incisors.

Dental Pulp Exposure↗
PubMedDate not supplied

Calcium hydroxide pulpotomy with a light-cured cavity-sealing material after two years.

In this follow-up study a light-cured glass ionomer lining cement was evaluated as a cavity-sealing material in calcium hydroxide pulpotomies in primary molars after one and two years. The pulpotomy dressing was a suspension of pure calcium hydroxide with either tap water or sterile saline. The success rate of the pulpotomies after one year was 87.7 percent and after two years 80.4 percent (clinically and radiographically). This result was only influenced by the type of restoration (amalgam versus stainless steel crown). The results of the present investigation compare favorably with those of other published studies of pulpotomy of primary molars using calcium hydroxide as the wound dressing.

Calcium Hydroxide↗
PubMed2003

Histopathological changes in dental pulp irradiated by Er:YAG laser: a preliminary report on laser pulpotomy.

OBJECTIVE: The effects of Er:YAG laser irradiation on the pulp tissue during a pulpotomy procedure were evaluated histopathologically. BACKGROUND DATA: The effects on pulp tissue during laser pulpotomy using Er:YAG laser irradiation are not clear. MATERIALS AND METHODS: Sixty mesial root canals of mandibular first molars in rats were divided into four groups. In three of these groups, root canals were irradiated using an Er:YAG laser at 2 Hz and 34, 68, and 102 mJ/pulse for 15 sec. Non-irradiated canals served as controls. The effects of laser irradiation on the remaining pulp tissue and periodontal tissues were evaluated at 0 days, 2 days, and 1 week after irradiation under light microscopy. RESULTS: At 1 week after treatment, no inflammation or resorption was observed in any cases in the control or 34 mJ/pulse-irradiated groups. However, moderate to severe inflammation was observed in 9 of 10 cases (90%) in the 68 and 102 mJ/pulse-irradiated groups. CONCLUSION: These results suggest that effects on pulp tissues during a pulpotomy procedure by Er:YAG laser irradiation are minimal, if appropriate parameters are selected, and this is a potential therapy for pulpotomy of human teeth.

Animals↗
PubMed2006

A prospective clinical study of mineral trioxide aggregate for partial pulpotomy in cariously exposed permanent teeth.

The aim of this study was to evaluate the success of using gray mineral trioxide aggregate (MTA) for partial pulpotomy in cariously exposed young permanent first molars. Thirty-one first permanent molars of 23 patients with a carious exposure were treated using a partial pulpotomy technique. The age of the patients ranged from 7.2 to 13.1 yr with an average of 10 yr. Clinical and radiographic examination revealed a pulpal response within normal limits and normal appearance of the periradicular area respectively. A diagnosis of reversible pulpitis and normal periapex was established. After isolation, caries removal and carious exposure, the exposed pulp tissue was removed with a diamond bur to a depth of 2 to 4 mm. After hemostasis, 2 to 4 mm of gray MTA paste was placed against the fresh wound. The floor of the cavity was covered with a base of glass ionomer. The teeth were restored with amalgam or stainless steel crowns. Teeth were reviewed radiographically and clinically at 3, 6, 12, and 24 month intervals. Twenty-two of the treated teeth did not show any clinical or radiographic signs of failure during the follow-up evaluation period. Six teeth did not respond to vitality testing at the final follow-up period; however, no radiographic signs of failure or clinical symptoms were detected. Gray MTA was a suitable dressing agent for parital pulpotomy in cariously exposed young permanent first molars.

Adolescent↗
PubMed2006

Evaluation of the formocresol versus mineral trioxide aggregate primary molar pulpotomy: a meta-analysis.

OBJECTIVE: To apply meta-analysis to compare the clinical and radiographic effects of mineral trioxide aggregate (MTA) with formocresol (FC) when used as wound dressing for pulpotomy of primary molars. STUDY DESIGN: The study list was obtained by searching MEDLINE, The Cochrane Library, EMBASE, and SCI. Only those papers that met the inclusion criteria were analyzed. RESULTS: Six studies met the inclusion criteria. There was significant difference between the success rates of FC- and MTA-treated pulpotomized primary molars (P < .05). Clinical assessments and radiographic findings of the MTA versus FC pulpotomy suggested that MTA was superior to FC in pulpotomy resulting in a lower failure rate, with the RR (Relative Risk) being 0.32 (95% confidence interval [CI] 0.11 to 0.90) and 0.31 (95% CI 0.13 to 0.74), respectively. Internal root resorption happened less in the MTA group with RR 0.29, 95% CI 0.11 to 0.77. CONCLUSION: MTA induces less undesirable responses and might be FC's suitable replacement.

Aluminum Compounds↗