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PubMedDate not supplied

A retrospective evaluation of pulpotomy as an alternative to extraction.

Pulpotomy was performed as an alternative to extraction on 26 teeth over a period of 88 months. Patients were recalled to evaluate the status of each tooth. Seventeen teeth were still functioning with the original pulpotomy and amalgam restoration for periods of between 14 and 88 months. Five teeth were lost after an average of 35 months because they became symptomatic and the patients were unable to afford root canal therapy. Four teeth became symptomatic after an average of 36 months but the patients' economic status had changed and they were able to afford root canal therapy and keep the teeth functioning. The data suggest that pulpotomy may be an alternative to extraction for those patients who are unable to afford conventional endodontic therapy. This procedure has the potential to postpone the loss of the tooth for up to 88 months.

Adolescent↗
PubMed1991

The floor of the pulp chamber following pulpotomy.

The purpose of this study was to investigate the incidence of pulpal floor damage caused by operator error in a standard pulpotomy exercise, and to determine if this damage produced significant changes in dentin morphology and thickness at the base of the pulp chamber. One hundred and fourteen primary molar teeth were utilized in this study, 61 having pulpotomies and the remainder untreated. The dentin thickness in the furcation was measured on all the teeth and the pulpal floor morphology was examined using both light and scanning electron microscopy. The difference in thickness of dentin in the furcation of pulpotomized and non-pulpotomized teeth was not statistically significant. Less than fourteen per cent of pulpotomized teeth showed damage to the pulpal floor and this damage was only minimal in all cases. This study therefore suggests that damage to the pulpal floor during preparation is unlikely to be a factor contributing to failure of pulpotomies.

Dental Pulp Cavity↗
PubMed1991

Root canal treatment and pulpotomy in Kenya.

This study was carried out to evaluate the practice and depth of knowledge of root canal treatment and pulpotomy by dentists in Kenya. Questionnaires were prepared and mailed to 114 dentists whose addresses were available. Sixty seven (58.8%) dentists responded. Of these, 67.2% carried out root canal treatment (RCT) and 43.3% carried out pulpotomy. The main reasons given by most dentists in the public hospitals for not carrying out these procedures routinely were lack of facilities and materials. Furthermore, it was found that amongst those who carried out these procedures, some used outdated techniques and materials. In order to reduce the large number of teeth lost through extraction, materials and equipment should be made available to enable dentists carry out root canal treatment and pulpotomies routinely. It is also necessary to have continuing dental education amongst dentists to update their knowledge of these procedures.

Dentists↗
PubMed1990

Experimental study of pulpotomy with calcium hydroxide-iodoform paste in dogs' immature permanent teeth.

To investigate the healing process and continuous root development following pulpotomy with improved calcium hydroxide-iodoform paste, the authors performed an experimental study of pulpotomy in immature permanent teeth. Thirty five incompletely formed root canals in dogs were used, and radiographical and histopathological observations were made. The results lead to the conclusion that pulpotomy with improved calcium hydroxide-iodoform paste is a very effective treatment for immature permanent teeth.

Animals↗
PubMedDate not supplied

Formocresol pulpotomy in primary molars: a long-term radiographic evaluation.

Of 137 pulpotomies with Tempophore, 13 percent failed. In comparison with pulpotomies using Ca(OH)2, in which higher failure rates occurred (Magnusson, Schröder), we can conclude that the pulpotomy with Tempophore, as well as with Buckley's formocresol, can be considered a clinically successful therapy. These therapies permit the preservation of even extensively carious primary molars, until their normal exfoliation time. The preservation of these teeth prevents the appearance of functional as well as orthodontic problems, because the arch-length is not adversely affected. The mesial tipping or drifting of the permanent molars is, furthermore, prevented.

Child↗
PubMedDate not supplied

Polycarboxylate cement as a cavity-sealing material for the calcium hydroxide pulpotomy: a retrospective study.

Polycarboxylate cement was evaluated as a cavity-sealing material in calcium hydroxide pulpotomies of primary molars. The lifespan of these teeth (N = 55) were compared with that of the corresponding teeth on the contralateral sides. The success rate for the treatment was 75.5 percent after one year and at least 61.9 percent after two years. Significant shorter life-spans were found in primary teeth with pulpotomy than in those without it. However, polycarboxylate cement can be a suitable alternative for zinc oxide-eugenol as a cavity sealing material in calcium hydroxide pulpotomies.

Calcium Hydroxide↗
PubMed1994

Comparison of electrosurgery and formocresol as pulpotomy techniques in dog primary teeth.

The primary teeth of four dogs were treated using either a conventional formocresol or electrosurgical technique following pulpotomy. Pulps of the treated teeth were evaluated histologically for the presence of inflammation, fibrosis, necrosis, resorption, and reparative dentin formation. Results indicated that conventional formocresol pulpotomy technique is histopathologically superior to electrosurgery pulpotomy technique.

Animals↗
PubMed2006

Emergency pulpotomy in relieving acute dental pain among Tanzanian patients.

BACKGROUND: In Tanzania, oral health services are mostly in the form of dental extractions aimed at alleviating acute dental pain. Conservative methods of alleviating acute dental pain are virtually non-existent. Therefore, it was the aim of this study to determine treatment success of emergency pulpotomy in relieving acute dental pain. METHODS SETTING: School of Dentistry, Muhimbili National Hospital, Dar es Salaam, Tanzania. STUDY DESIGN: Longitudinal study. PARTICIPANTS: 180 patients who presented with dental pain due to acute irreversible pulpitis during the study period between July and August 2001. Treatment and evaluation: Patients were treated by emergency pulpotomy on permanent posterior teeth and were evaluated for pain after one, three and six week's post-treatment. Pain, if present, was categorised as either mild or acute. RESULTS: Of the patients with treated premolars, 25 (13.9%) patients did not experience pain at all while 19 (10.6%) experienced mild pain. None of the patients with treated premolars experienced acute pain. Among 136 patients with treated molars 56 (31%) did not experience any pain, 76 (42.2%) experienced mild pain and the other 4 (2.2%) suffered acute pain. CONCLUSION: The short term treatment success of emergency pulpotomy was high being 100% for premolars and 97.1% for molars, suggesting that it can be recommended as a measure to alleviate acute dental pain while other conservative treatment options are being considered.

Journal Article↗
PubMed2002

Ferric sulphate and formocresol pulpotomies in baboon primary molars: histological responses.

AIM: To compare pulpal reactions to ferric sulphate and formocresol pulpotomies in primary molar teeth with inflamed pulps. STUDY DESIGN: An experimental study in 15 juvenile baboons (Papio ursinus). MATERIALS AND METHODS: Pulpitis was induced with fresh human carious dentine or Streptococcus mutans placed into occlusal cavities in 57 primary molars; after 14 days a pulpotomy was performed on the same primary molars with the two pulp medicaments randomly allocated; the pulp was covered with IRM and the cavity filled with amalgam. After 90 days specimens were harvested and examined under the light microscope with the examiner blind to the treatment. RESULTS: Reaction frequencies in the ferric sulphate-treated and formocresol-treated teeth were: recognisable pulp 52% and 50%, dentine bridges 16% and 12%, internal root resorption 12% and 4%, external resorption 28% and 31%, bacteria 12% and 23%, peri-apical abscesses 32% and 38%. STATISTICS: Fisher's exact probability test showed no statistically significant differences between reaction frequencies in the two treatment groups. CONCLUSION: A pulpotomy in a primary tooth may be clinically successful in the presence of adverse histological reactions.

Journal Article↗
PubMed2001

[Clinical evaluation of pulpotomy in the treatment of deciduous teeth with deep dentine caries].

OBJECTIVE: To study the curative effect of pulpotomy in the treatment of deciduous teeth with deep caries. METHODS: 45 deciduous molars with deep caries from 3 8 years old children were selected at random. Pulpotomy was performed on these treated teeth. Clinical examination and X-ray films for the treated teeth were taken to follow up all the teeth at 6 months, one year and two years respectively after treatment. RESULTS: At one year after treatment, 45 cases were followed up, the rate of success in clinical examination and in X-ray photographs both were 100%. While at two years after treatment, 42 cases were followed up and 3 cases were lost, the rate of success in clinical examination was 95% and the rate of success in X-ray photographs was 88%. The reasons of the failure were internal absorption and pulpitis followed by fracture and exfoliation of the obturators in the treated teeth. CONCLUSION: Pulpotomy in deciduous teeth with deep caries was a reliable and effective method. It is necessary to follow up the treated teeth by X-ray at regular intervals after treatment.

English Abstract↗
PubMed2006

Pulpotomy in primary teeth: review of the literature according to standardized criteria.

AIM: To assess the relevant literature using a modification of the criteria listed in the introductory paper to this issue [Curzon and Toumba, 2006], and to review several new publications on pulpotomies with different materials and techniques that appeared after previously published reviews. METHODS: A search of the literature on pulpotomies was identified using Medline between the years 1966-2005. The search generated 358 citations and sieving of these papers was conducted by examining the paper title and assessing its relevance [Loh et al., 2004]. Only clinical studies (non-specified) and retrospective studies were included for assessment. There were 17 criteria (considered major) weighed 2 points and 8 criteria weighed 1 point. A paper that would score between 38-42 points (90+ %) was assessed as Grade A, a score from 32 to 37 points (75-89%) was Grade B1, and between 25 to 31 points (60-74%) Graded B2. All other papers that reached 24 points or less (less than 59%) was rated Grade C. RESULTS: Of the 358 papers originally identified 48 clinical trials were evaluated according to the set of criteria. There was only one paper graded A, 5 papers graded B1, 3 graded B2 and 39 received a grade C. Formocresol or ferric sulphate medicaments were found to be likely to have similar clinical/radiographic results, and MTA seemed to be a more favourable pulp dressing. CONCLUSION: No conclusion can be made as to the optimum treatment or technique for pulpally involved primary teeth. More high quality, properly planned prospective studies are necessary to clarify these points.

Bibliometrics↗
PubMed1979

Comparison of Dycal and formocresol pulpotomies in young permanent teeth in monkeys.

This study compared Dycal and formocresol pulpotomies on young healthy permanent teeth with respect to continued dentinogenesis and root end development. Pulpotomy was performed on a total of forty permanent teeth with incompletely developed roots in three young stump-tailed monkeys (Macaca speciosa). Twenty teeth were treated with Dycal and twenty with formocresol. At the end of the experimental periods the animals were killed and the specimens were prepared and sectioned en bloc for histologic examination. The interval between treatment and death ranged between 7 and 797 days. Before each experimental procedure a Procion vital dye was administered as a marking agent for continued root development. Twelve of twenty teeth treated with Dycal and seventeen of twenty teeth treated with formocresol were judged to be successful as evidenced by continued root development, absence of periapical pathoses, and the presence of noninflamed or only mildly inflamed pulps. Brown and Brenn staining showed bacteria within the pulps of the teeth that failed. All but one of the teeth in this study showed evidence of continued root development as confirmed by Procion labeling.

Animals↗
PubMed1993

Glutaraldehyde preparations and pulpotomy in primary molars.

The study clinically and radiographically evaluated the long-term success rate of pulpotomy treatment in pulp-exposed primary molars. Five clinicians participated in this study and four glutaraldehyde preparations included 2% buffered, 2% unbuffered, 5% buffered, and 5% unbuffered glutaraldehyde solutions were used. There were 201 children, 108 boys and 93 girls, ranging in age from 4 to 7 years with 258 primary molars treated. After 36 months, 150 teeth with complete clinical records and radiographs were available for evaluation. The treatment of 98% of the patients was clinically successful, but when evaluated radiographically the overall success rate was 78.7%. The group treated with 5% buffered glutaraldehyde showed the highest success rate (87.5%) and group treated with the 5% unbuffered solution the lowest (74.1%), but no significant difference was found among the four groups. Canal obliteration was noted in 22 teeth successfully treated. Four of the teeth that were not successfully treated had canal obliteration before other pathoses became evident. The relative high failure rate in this long-term follow-up indicated that clinicians should be cautious before extensively using glutaraldehyde as a pulpotomy agent.

Chi-Square Distribution↗
PubMed2004

Histologic evaluation of pulpotomies in dog using two types of mineral trioxide aggregate and regular and white Portland cements as wound dressings.

OBJECTIVE: The purpose of this study was to investigate the pulpal response of dogs' teeth after pulpotomy and direct pulp protection with MTA Angelus, ProRoot, Portland cement and white Portland cement. STUDY DESIGN: Seventy-six teeth were treated with these materials. One hundred twenty days after treatment, the animals were sacrificed and the specimens removed and prepared for histological analysis. RESULTS: All the materials demonstrated similar results when used as pulp-capping materials. Pulp vitality was maintained in all specimens and the pulp had healed with a hard tissue bridge. CONCLUSION: The materials used in this study were equally effective as pulp protection materials following pulpotomy.

Aluminum Compounds↗
PubMed1998

Reparative hard tissue formation following calcium hydroxide application after partial pulpotomy in cariously exposed pulps of permanent teeth.

In a prospective study, partial pulpotomy was performed on six permanent molars with deep carious lesions and pulpal involvement. The bleeding pulp was irrigated with normal tap water until bleeding had stopped and the exposed pulp was covered with calcium hydroxide followed by zinc oxide eugenol, and finally covered with a semipermanent restoration. All teeth showed hard tissue barrier formation, both clinically and radiographically, within three months and were free from subjective and objective symptoms through the observation period (average observation period was 26 months). The patients also experienced the therapy positively. These findings and those of others have helped gain more recognition for partial pulpotomy as a strong possible alternative therapy when pulps are exposed by deep carious lesions and a bleeding pulp is exposed during the excavation process. The rationale for this therapy is to remove the infected and/or inflamed pulpal areas beneath the carious lesion and disintegrated tissue. A rapid and simplified procedure would allow the general practitioner to perform this procedure when necessary at dental clinics, without specialist facilities under conditions that avoid unnecessary contamination of the pulp.

Adolescent↗
PubMed2001

Clinical and radiographic evaluation of pulpotomies performed under intrapulpal injection of anaesthetic solution.

AIM: The purpose of this study was to evaluate clinically and radiographically pulpotomies carried out under intrapulpal injection of anaesthetic solution. METHODOLOGY: Forty-one permanent mandibular molar teeth presenting with deep carious lesions and/or exposed pulps, with or without periapical changes on radiographic examination, were treated with pulpotomy and dressed with calcium hydroxide. The teeth were divided into three groups. Group A consisted of 15 teeth, where intrapulpal anaesthesia was administered by a slow injection of lidocaine hydrochloride 2%. Group B, with 14 teeth, where intrapulpal anaesthesia was obtained with lidocaine hydrochloride 2% with adrenaline 1:100,000. Group C consisted of 12 teeth in which anaesthesia was performed with a mandibular block using prilocaine hydrochloride 3% with felypressin 1: 100,000. Healing was evaluated using clinical and radiographic criteria: dentine barrier formation, absence of clinical symptoms and resolution of periapical involvement. RESULTS: After an observation time of 6-8 weeks (postoperative control) and 24-32 weeks (intermediate control), healing occurred in 13 teeth from group A (87%), in 11 teeth from group B (79%) and in 10 teeth from group C (83%). No statistical difference was demonstrated between the three groups (Fisher's exact test). CONCLUSIONS: Based on the methodology adopted, intrapulpal injection of anaesthetic solution did not impair healing in pulpotomized teeth.

Adolescent↗
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↗
PubMed2003

Premature exfoliation of primary molars related to the use of formocresol in a multivisit pulpotomy technique: a case report.

Since its introduction in 1904, formocresol has become one of the most widely studied dental medicaments. In the United Kingdom, it is the preferred primary tooth pulpotomy medicament of the majority of Specialists in Paediatric Dentistry. Reports of adverse effects resulting from its clinical use are rare. This paper presents a case of premature exfoliation of primary molars that may be related to the use of formocresol in a multivisit pulpotomy technique.

Child↗