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PubMed1991

The effect of pulp capping and pulpotomy on hard tissue bridges of contaminated pulps.

The pulp and dentine of permanent incisors in 13 young monkeys were exposed by grinding. The pulpal perforations were treated by partial pulpotomy with a tungsten carbide fissure bur after exposure for 4, 48, or 168 hours in nine animals, and by direct pulp capping after exposure for 4 or 48 hours in the remaining four animals. After haemostasis, the pulpal wounds were covered with calcium hydroxide (Dycal), followed by conventional amalgam (Revalloy). Initial and subsequent formation of hard tissue bridges over the wounds was studied by conventional histology after 1-6 months. Screening showed three categories of initial bridging development, differing in nature and rate of formation. A significant difference in the distribution of the two main categories was found between the two methods of treatment (P less than 0.02). A similar difference was observed when partial pulpotomy was performed after 168 hours compared with that performed after 4 hours (P = 0.055). No relationship was found between the initial bridging category and the eventual development of complete dentine bridges.

Animals↗
PubMed1993

Success of pulpotomy in the management of hyperplastic pulpitis.

Hyperplastic pulpitis is a variety of chronic open pulpitis which is regarded as irreversible. This condition is usually treated by root canal treatment, unless coronal damage does not permit restoration, in which case extraction is indicated. In the present study, 24 permanent teeth of individuals, aged 10-22 years and diagnosed as hyperplastic pulpitis were treated by pulpotomy using an atraumatic surgical technique with calcium hydroxide alone. The treatment was successful in 22 teeth, according to the following criteria: absence of clinical symptoms, absence of any intraradicular or periradicular radiographic pathological changes, presence of dentine bridge detected by clinical examination and sometimes observed radiographically, and sensitivity to electrical stimulation. The follow-up examination ranged from 12 to 48 months. The high frequency of clinical healing in this study appears to justify recommending pulpotomy as the treatment regime in selected cases of chronic hyperplastic pulpitis.

Adolescent↗
PubMed1994

Clinical reliability of the dentine bridge formed after pulpotomy: a case report.

An exposed pulp in a crown-fractured vital young tooth may be treated with either pulp capping or pulpotomy, using a calcium hydroxide dressing. Calcium hydroxide stimulates dentine bridge formation, which is a good indicator of pulp vitality. In this case it is reported that, although seriously contaminated for a long period with debris from the oral environment, the dentine bridge which formed after pulpotomy was able to function as a protective pulpal barrier. The tooth responded to an electrical pulp tester within normal limits and the periapical radiographic appearance was normal at review after 7 years.

Adolescent↗
PubMed1995

Pulpotomy of carious vital teeth with periapical involvement.

Twenty-six permanent vital molars with carious pulp exposures and periapical involvement presenting as radiolucencies or radiopacities on radiographic examination, in patients aged between 10-24 years, were treated using an atraumatic surgical technique with calcium hydroxide alone. The healing was evaluated using clinical and radiographic criteria: absence of clinical symptoms, sensitivity of the radicular pulp, formation of a hard tissue barrier in the exposed area, resolution of periapical involvement and no intraradicular pathosis radiographically. Assessed by these criteria, successful results were achieved in 24 teeth. The observation period following pulpotomy treatment was 16-72 months. The favourable results of this study demonstrate that pulpotomy treatment in teeth with cariously exposed vital pulps and with periapical involvement may be an alternative treatment to root canal therapy.

Adolescent↗
PubMed1993

Partial pulpotomy in young permanent teeth with deep carious lesions.

The material comprised 37 young posterior teeth with deep carious lesions and exposed pulps, treated with partial pulpotomy and dressed with calcium hydroxide. The teeth were divided into two groups. Group 1 consisted of 31 teeth with no clinical or radiographic symptoms before treatment, Group 2 of 6 teeth with temporary pain, widened periodontal space periapically and/or productive osteitis, i.e. increased density of the surrounding alveolar bone. After an observation time of 24 to 140 months (mean = 56 months), healing had occurred in 29 of 31 teeth in Group 1 (93.5%) and in 4 of 6 teeth in Group 2. It was concluded that the present, as well as previously reported results indicate that partial pulpotomy may be an adequate treatment for young permanent molars with a carious exposure, although more studies are needed before the treatment can be recommended for routine clinical use.

Adolescent↗
PubMed2005

Effectiveness of 4 pulpotomy techniques--randomized controlled trial.

Pulpotomy is the accepted therapy for the management of cariously exposed pulps in symptom-free primary molars; however, evidence is lacking about the most appropriate technique. The aim of this study was to compare the relative effectiveness of the Er:YAG laser, calcium hydroxide, and ferric sulfate techniques with that of dilute formocresol in retaining such molars symptom-free. Two hundred primary molars in 107 healthy children were included and randomly allocated to one of the techniques. The treated teeth were blindly re-evaluated after 6, 12, 18, and 24 months. Descriptive data analysis and logistic regression analysis, accounting for each patient's effect by a generalized estimating equation (GEE), were used. After 24 months, the following total and clinical success rates were determined (%): formocresol 85 (96), laser 78 (93), calcium hydroxide 53 (87), and ferric sulfate 86 (100). Only calcium hydroxide performed significantly worse than formocresol (p = 0.001, odds ratio = 5.6, 95% confidence interval 2.0-15.5). In conclusion, calcium hydroxide is less appropriate for pulpotomies than is formocresol.

Calcium Hydroxide↗
PubMedDate not supplied

Histologic evaluation of pulpotomy performed with ethyl-cyanoacrylate and calcium hydroxide.

The aim of this study was to evaluate histological aspects of the pulp-dentin complex of dogs submitted to pulpotomy and capped with ethyl-cyanoacrylate and calcium hydroxide. Thirty dog teeth were divided into 2 groups of 15 as follows: Group 1 - ethyl-cyanoacrylate; Group 2 - calcium hydroxide. The pulpotomies were carried out following all of the treatment precautions recommended for dogs. After 30 days the specimens were submitted to histological preparation and were then blindly evaluated by a histologist. Data were analyzed statistically by the Fisher exact test, comparing the two groups. After 30 days, the presence of a hard tissue barrier was observed in 83.3% of Group 1, and in 100% of Group 2 (p = 0.478). A continuous hard tissue barrier was observed in 50% of the ethyl-cyanoacrylate group and 75% of the calcium hydroxide group (p = 0.652). It can be concluded that both materials induced hard tissue barrier formation, but Group 2 had a higher percentage than Group 1, with no significant statistical differences; the differences observed between the different barriers (continuous/non-continuous) were not significant between groups and there was no pulpal necrosis in either group.

Animals↗
PubMedDate not supplied

Stainless steel crown and pulpotomy: procedure and technique for primary molars.

The purpose of this article is to facilitate performance of the stainless steel crown and pulpotomy procedures in order to save chair time and provide a more durable and reliable final restoration for primary molars. The rationale and methods for preparing the tooth, crown selection, and placement of a stainless steel crown are included, along with alternatives for selection and technique for fabrication of more esthetic options. Medicament and tips for the pulpotomy procedure also are discussed. Information for patient education and consent regarding the procedures and their limitations is provided to complete this step-by-step guide for the clinician.

Child, Preschool↗
PubMedDate not supplied

The success of emergency pulpotomies in primary molars.

PURPOSE: The purpose of this retrospective study was to assess the success of pulpotomies performed on an emergency basis and restored with a temporary zinc-oxide eugenol restorative material. METHODS: Records were collected from 216 pulpotomies in primary molars performed on an emergency basis by pediatric dental residents at the University of Florida pediatric dental clinic between July 1999 and June 2001. The selection criteria include teeth with a positive history of pain but with absence of clinical and radiographic signs of pulp degeneration. Formocresol was the medicament used and the teeth were restored temporarily with a reinforced zinc-oxide eugenol material. Treatment success or failure was determined, at the definitive restorative appointment, by the presence or absence of clinical and/or radiographic pathology. The time interval between emergency and definitive treatment appointments, tooth-type, arch, age, and gender were the variables analyzed in this study. Chi-square analysis was used to assess the effect of the different variables on the outcome of the treatment. RESULTS: Sixty-four teeth were available for assessment in the two-year period. A 53% success rate was observed, if the tooth was evaluated and restored with the definitive restoration, within the first 90 days post-emergency treatment. A 31% success rate was observed after 365 days. These results were statistically significant (P=0.016). Patients younger than six years old showed statistically significant higher chances for success than older children did (P=0.018). No significant differences were found for gender, type of tooth, or arch. CONCLUSIONS: The low success rate found during the first three months post emergency treatment may be attributed to undiagnosed, subclinical inflamed pulp, while long-term failure may be associated with microleakage of the temporary restorative material.

Chi-Square Distribution↗
PubMed1992

A clinical evaluation of root resorption by formocresol treatment in 120 cases of pulpotomy in permanent molars.

The effect of a formocresol pulpotomy of a 120 permanent molar showed external and internal resorption on distal root in lower molar, and palatal root in the upper molar. In this study 33.3% were male and 66.7% were female. The age distribution of patients was 16 to 20 years of age and 21 to 25 years of age. The rate of resorption for chronic pulpitis was more than acute pulpitis. The success of formocresol pulpotomy treatment at the end of the 10th year for acute pulpitis was 92.26% in contrast to 84% for chronic pulpitis.

Acute Disease↗
PubMed2004

Comparative evaluation of lyophilized freeze dried platelet derived preparation with calcium hydroxide as pulpotomy agents in primary molars.

The aim of this study was to compare the efficacy of lyophilized freeze dried platelet derived preparation with calcium hydroxide as pulpotomy agents in primary molars. Fifty six primary molars in 28 children were treated by a conventional pulpotomy technique. 28 teeth were treated by lyophilized freeze-dried platelet derived preparation and another 28 by calcium hydroxide. Clinical evaluation was carried out out at 1, 3, and 6-months interval and the radiographic evaluation was carried out at 1 and 6-months. The success rate of lyophilized freeze-dried platelet derived preparation proved better than calcium hydroxide.

Blood Platelets↗
PubMed2005

Dentin bridge formation after mineral trioxide aggregate (MTA) pulpotomies in primary teeth.

PURPOSE: To evaluate the results of using mineral trioxide aggregate (MTA) in pulpotomy procedures in primary teeth. METHODS: Seven patients were selected and a total of 20 molars and two canines were treated with pulpotomy procedures using MTA instead of formocresol. RESULTS: After 6 months, 55% of the molars and 100% of the canines treated showed radiographic signs of dentin bridge formation. Also, 6 months after treatment, 60% of the molars showed root canal calcification (obliteration). Color change of the crown of the canines treated was noticeable. No clinical or radiographic signs of pathology was observed.

Aluminum Compounds↗
PubMed2005

Apexogenesis of a symptomatic mandibular first permanent molar with calcium hydroxide pulpotomy.

Vital pulp therapy of immature, symptomatic permanent posterior teeth presents a challenge in pediatric endodontics. A case report is presented in which cervical pulpotomy with calcium hydroxide was performed on a cariously exposed mandibular first permanent molar. The patient was seen every 3 months for a total of 18 months for a clinical and radiographic follow up. During the follow-up period, root development, as evidenced by root lengthening, was observed. Apical closure was evident at the end of 19 months. As the root canals showed a tendency toward calcification, root canal treatment was carried out, followed by restoration of the tooth with a stainless-steel crown. The success of this single-visit apexogenesis procedure supports the contention that young pulp possesses remarkable reparative capacity, as well as resistance to bacterial infection due to greater vascularity, and that apexogenesis with calcium hydroxide apical closure pulpotomy can be attempted for continued root development of symptomatic, vital, permanent teeth.

Calcium Hydroxide↗
PubMed2006

Dentin bridge formation after white mineral trioxide aggregate (white MTA) pulpotomies in primary molars.

PURPOSE: To evaluate, clinically and radiographically, the dentin bridge formation potential of white mineral trioxide aggregate (white MTA) when used in pulpotomy treatments in primary molars. METHODS: A total of 23 primary molars received a pulpotomy treatment using white MTA followed by stainless steel crown restoration and controlled 6 months after treatment. RESULTS: Clinical and radiographic success was 100% as none of the molars showed any clinical or radiographic pathological signs. Reparative dentin deposition was found in some of the cases: stenosis was present in 69.2% of the pulp canals from mandibular molars and formation of dentin bridges was seen in 11.5% of the pulp canals from mandibular molars 6 months after treatment with white MTA.

Aluminum Compounds↗
PubMed1990

[A study on the application of Ga-As semiconductor laser to endodontics. The effects of laser irradiation on the activation of inflammatory cells and the vital pulpotomy].

The effects of laser irradiation on the activation of macrophage and fibroblast were examined by determining the rate of glucose utilization into the cell and the activity of lactate dehydrogenase (LDH) in culture supernatant. The laser irradiated macrophages that had been prepared from the peritoneal exudate cells, did not show any enhancement of activity, whereas fibroblast cell line (Gin 1 cell) were activated by laser irradiation. These findings suggest that laser irradiation was effective for the growth of fibroblast and induced suppressive effects for macrophage. In addition, effects of laser irradiation on the vital pulpotomy were investigated. It was observed that laser irradiation induced enhancement of calcification in wound surface and stimulated formation of calcified tissue. These observations indicate that laser irradiation is a useful method for the vital pulpotomy.

Calcification, Physiologic↗
PubMed1989

[Radiographic follow up examination on pulpotomy in primary teeth. Treatment with formocresol paste].

We conducted a radiographic follow up and discussion concerning 125 primary teeth (46 boys and 24 girls), which were random samplings from all primary teeth which had been treated by pulpotomy with Formocresol (Pulpac V) during the period from January 1980 to December 1985 at the Pediatric Dentistry Clinic of the School of Dentistry, Hiroshima University. For the follow up examination, we used only the radiograms which were radiographically available. The results obtained were as follows: 1) At the time of final follow up examination for each treated tooth, the number of teeth judged as being successful were 50 (40.0%) and 75 (60.0%) as being unsuccessful. In particular we observed especially many teeth judged as being unsuccessful during the period from 6 to 12 months and from 30 to 36 months after treatment. 2) In this investigation, we observed all the radiograms which had been taken at the recall after treatment, and therefore the number of cases examined was 247. According to the results at the time of each follow up examination, unsuccessful cases were more numerous during the period from 30 to 36 months. 3) According to the location of the treated teeth and the age at the time of treatment, abnormal findings appeared in the majority of the unsuccessful cases within 18 months after treatment. Unsuccessful cases were more numerous for the lower first deciduous molars. Successful cases of patients aged 6 years, when pulpotomy had been performed, were more numerous. 4) Of 75 teeth judged as being unsuccessful, 24 showed internal root resorption, 24 abnormal root resorption, 51 loss of lamina dura integrity and 53 alveolar bone resorption in the periapical and/or furcation areas.

Child↗
PubMed1989

Assessment of the systemic distribution and toxicity of glutaraldehyde as a pulpotomy agent.

The systemic distribution of glutaraldehyde (GA) from a pulpotomized tooth of a rat was estimated to be 40 nanomoles or 25% of the applied dose. Metabolic studies disclosed that GA was eliminated in urine and expired gases; 90% was cleared from body tissues in 3 days. To evaluate the toxicity of GA, doses 500x greater than that systemically distributed from a pulpotomy site were infused into the jugular veins of rats. Twenty-four hours postinfusion the rats were evaluated in vivo for physiologic changes or sacrificed for biochemical and histologic evaluation of harvested tissues. Only one of the assays, a physiologic parameter, was altered by the 500x dose. Considering the relatively large dose administered and the limited effects, we conclude that GA would not be toxic when used as a pulpotomy agent.

Aldehydes↗