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At least 19 recordsLinked to original sources
PubMed1996

A comparison of pulpectomy alone versus pulpectomy with trephination for the relief of pain.

Patients who when initially seen have pain of endodontic origin have a higher incidence of posttreatment pain than those who are pain-free pretreatment. The purpose of this study was to compare two methods of treatment--pulpectomy alone or pulpectomy with trephination--for the reduction of posttreatment pain in patients presenting with acute periradicular pain of pulpal origin. Seventeen patients with pretreatment pain were studied. Eleven received a pulpectomy to the radiographically determined working length. Six patients received a pulpectomy and trephination using a #4 round bur through a vertical incision. Visual analog scales were used preoperatively to measure pain intensity and unpleasantness, and postoperatively to measure intensity, unpleasantness, and pain relief at 4, 8, 16, 24, 48, 72, and 96 h. Analysis of preoperative data showed no difference between control and experimental groups. Posttreatment, at 4 h, the trephination group reported significantly more pain intensity and unpleasantness and less pain relief than the control group. Pulpectomy alone provided significantly better postoperative pain relief at 4 h compared with pulpectomy with trephination. At no time interval did the trephination group have less pain than the group without trephination.

Decompression, Surgical↗
PubMedDate not supplied

A long-term followup on the retention rate of zinc oxide eugenol filler after primary tooth pulpectomy.

A retrospective study of all the patients' records (> 6000) in a pediatric dental practice was done to assess ZOE retention after a pulpectomized primary tooth was lost and the succedaneous tooth erupted. There were 65 children with 81 ZOE pulpectomies done in 30 incisors and 51 molars. Pulpectomies were done at a mean chronologic age of 52.2 months and followed for a mean time of 90.8 months from time of placement. The initial radiograph after the pulpectomized tooth was lost, showed retained ZOE filler particles in 49.4% of the cases while 27.3% had retained ZOE a mean time of 40.2 months after pulpectomy tooth loss. Short-filled pulpectomies retained significantly less ZOE than long fills (P = 0.04). With time, retained ZOE particles either resorbed completely or showed reduction of filler size in 80% of the cases. No pathology was associated with the retained ZOE particles. Retention of ZOE was not related to pulpectomy success (P = 0.11), preoperative root resorption (P = 0.76), age of the patient (P = 0.24 incisors; P = 0.87 molars), extraction/exfoliation of the pulpectomy (P = 0.75), or timing of the pulpectomy's loss (P = 0.72).

Age Factors↗
PubMed2005

Evaluation of various root canal filling materials in primary molar pulpectomies: an in vivo study.

PURPOSE: To evaluate the clinical and radiographic success of zinc oxide-eugenol (ZOE), Calcicur, Sealapex and Vitapex in primary molar pulpectomies. METHODS: 80 primary molars, showing signs of pulpal and/or periapical involvement, with no abnormal mobility, were selected from 76 children aged between 4-9 years-old, free from systemic disease. Radiographic evaluation was done to exclude teeth showing internal or pathological external root resorption and/or inadequate bone support. The selected teeth (20 in each group) were randomly treated with ZOE, Sealapex, Calcicur and Vitapex. The procedure involved primarily a one-visit pulpectomy. The teeth were evaluated clinically and radiographically every 2 months for a period of 18 months. RESULTS: In the ZOE group, all pulpectomies were successful. In the Sealapex group, two pulpectomies and in the Calcicur group, four pulpectomies showed complete resorption of the material in the root canal. Although re-treatment was performed, those teeth had to be removed due to pathological root resorption. In the Vitapex group, although six pulpectomies showed resorption of the filling material within the canals, this had no effect on the clinical and radiographical success of the treatment.

Child↗
PubMedDate not supplied

A retrospective radiographic evaluation of primary molar pulpectomies.

Relatively few long-term studies have been performed to evaluate the clinical success of one-appointment pulpectomies in primary molar teeth. The purpose of this retrospective study was to evaluate the radiographic appearance of nonvital primary molars before and after treatment with a one-appointment formocresol pulpectomy technique. The mean length of time since pulpectomy treatment for the 62 primary molars was 40.2 months. Based upon strict radiographic criteria, the one-appointment pulpectomy procedure was considered to be successful in 82.3% (51) of the cases, with 3.2% (2) of pulpectomized primary molars needing retreatment, and 14.5% (9) of pulpectomy procedures failing. The pulpectomy procedure is indicated when inflammation of the pulpal tissue extends into the root canals, and possibly involves the periapical and/or bifurcation areas. This procedure provides an alternative to extraction and space maintenance when the pediatric dentist encounters a nonvital primary molar tooth.

Child, Preschool↗
PubMed2002

The pulpectomy in primary teeth.

BACKGROUND: The pulpectomy is an underutilized treatment modality for severely infected primary teeth. CASE DESCRIPTION: The author presents two pulpectomy cases that were filled with Vitapex. CLINICAL IMPLICATIONS: Vitapex is an excellent filling material for primary tooth pulpectomies. Its clinical characteristics and ease of use may make the pulpectomy procedure a more-attractive alternative to extraction.

Calcium Hydroxide↗
PubMedDate not supplied

Predicting pulpectomy success and its relationship to exfoliation and succedaneous dentition.

This study evaluated factors that affected pulpectomy (PE) success and its effect on the succedaneous tooth's eruption and enamel formation. Sixty-five of 250 patients with PEs met the selection criteria and yielded 81 zinc oxide-eugenol PEs (30 incisors, 51 molars) followed a mean time of 90.8 months. Overall PE success was 77.7% with no difference between molars and incisors (P = 0.53). Enamel defects were observed in 18.7% of succedaneous teeth and were related (P = 0.005) to the pre-existing infection causing excess root resorption (>1 mm preoperative root resorption = 44.4% defects) but were not related to overretention of ZOE filler (P = 1) or length of fill (P = 0.36). The PE procedure was not related to causing succedaneous tooth defects since teeth replacing PEs showed no significant increase in the incidence of defects compared with untreated contralateral controls (P = 0.99). There was a 20% incidence of succedaneous tooth anterior cross-bite or palatal eruption following incisor PEs and 21.6% ectopic eruption of premolars following primary molar PEs. Most PEs (95.9%) were lost at their normal exfoliation time or earlier, but 35.8% needed extraction due to overretention by soft tissue at the time of shedding. Pulpectomy success rates showed that the most important preoperative predictor was the amount of primary tooth root resorption. Greater than 1 mm of root resorption resulted in only a 23.1% success rate, which was significant (P = 0.001). Pulpectomies filled short or to the apex had a significantly greater success (P = 0.011) than long fills. Pulpectomies correctly done do not appear to contribute to adverse effects on succedaneous tooth formation but have a 20% chance of altering the path of permanent tooth eruption.

Amelogenesis↗
PubMed2001

Results of crown-height reduction and partial coronal pulpectomy in rhesus monkeys (Macaca mulatta).

BACKGROUND AND PURPOSE: In research facilities using non-human primates, crown-height reduction with partial coronal pulpectomy ("vital pulpotomy") is routinely performed on canine teeth of adult male monkeys to reduce self-trauma and the potential for injury to staff or cage-mates. Success of pulpotomy techniques in humans is reportedly 40 to 60%. Failure leads to chronic inflammation and pulp necrosis, which introduces variability in research animals, and may affect research results. The purpose of the study reported here was to determine failure rate of this procedure by evaluating clinical and radiographic findings at 3, 9, and 24 months after crown amputation and partial coronal pulpectomy of maxillary canines in adult male rhesus monkeys. METHODS: Forty-seven maxillary canine teeth from 24 adult male rhesus monkeys were treated by use of crown amputation and partial coronal pulpectomy, using standard dental technique. Follow-up clinical and radiographic examination was performed 3, 9, and 24 months after surgery. RESULTS: At three months after surgery, there was no clinical evidence of failure at any of the teeth. On the basis of radiographic findings, 2 of 47 teeth had failed and one was suspicious for early failure. At nine months, clinical evidence of failure was not apparent; radiographically, 5 of 44 teeth appeared to have failed and 3 others were suspect. Two years post-operatively, failure was clinically evident at two teeth, with radiographic evidence of failure in five teeth, and suspicion of early failure in an additional six of 41 teeth [corrected]. CONCLUSIONS: The failure rate of crown amputation and partial coronal pulpectomy of canine teeth in adult male rhesus monkeys is high, and the chronic inflammation associated with this is cause for concern.

Animals↗
PubMed1994

Irritating effect of formocresol after pulpectomy in vivo.

A study was carried out to investigate the effect of formocresol (formalin-creosote) on the periapical tissue after pulpectomy in rats. A pulpectomy was performed on the mesial root of the right mandibular first molar, and, in group A, a paper point containing saline was inserted into the root canal. In group B, a paper point containing formocresol was inserted, and in group C, a drop of formocresol was applied and a paper point containing formocresol was inserted into the root canal. The periapical tissue was examined histologically and histometrically at 3, 7, 14, and 28 days after insertion, and the inflammatory cells and fibroblasts in the apical granulation tissue were also counted. Histologically, in group A, the inflammation observed was slight at 14 and 28 days, while in groups B and C, a moderate inflammation remained. Histometrically, the area of the apical periodontal ligament in groups B and C was increased significantly compared with that in group A at 14 and 28 days. The inflammatory cell count in groups B and C increased significantly compared with that in group A at 7, 14, and 28 days, whereas the fibroblast count in Groups B and C decreased compared with that in Group A at 7, 14, and 28 days. These results demonstrate that formocresol delayed the healing of periapical tissue after pulpectomy.

Animals↗
PubMed1993

Periodontal cell migration into the apical pulp during the repair process after pulpectomy in immature teeth: an autoradiographic study.

The migration of dental papilla cells into the periodontium during the process of root development may occur as part of the process involved in the formation of the periodontal tissues. The question posed is whether such cells under pathological conditions could retromigrate from periodontium into dental pulp and together with other apical pulp cells of immature teeth, take part in the production of additional dental tissue, e.g. 1) the tertiary/dentine under deep carious lesion where odontoblasts had been destroyed 2) the dentine bridge on an amputation wound and 3) calcified tissue which closes an apex during the apexification process in immature teeth. The migration of periodontal cells locally marked by H3 thymidine immediately after partial pulpectomy in immature dog's teeth was analysed at observation periods of 2, 24 and 50 h and also without H3 thymidine labelling of periodontal cells 8 weeks after pulpectomy. The marked cells were found in the early observation periods after pulpectomy just in the places where the hard tissues were formed in the later observation period of 8 weeks. They were found in large numbers just around the coagulated necrotic foci. The finding supports the assumption that firm necrotic masses are a very important stimulative factor in the reparation process in pulp and periodontium. The experiment also corroborated the existence of periodontal cell retromigration into apical dental papilla of immature teeth. Future research should assess the possible role of the pathological condition in the determination of undifferentiated odontogenic ectomesenchymal periodontal cells into odontoblasts.

Animals↗
PubMed1978

Clinical and radiographic study of pulpectomy and root canal therapy.

A clinical and radiographic reexamination of 2,459 roots 2-7 years after initial pulpectomy or root canal therapy is presented. The overall success rate, which was 53%, was not affected by the sex or age of the patient, or by the jaw in which the tooth was situated. The tooth group, however, had a significant influence on the success rate, the worst results being obtained for incisors and especially the mandibular central and maxillary lateral incisors. The prognosis was clearly better for the pulpectomies than for the root canal therapy. Mortal pulpectomy was found to succeed more often than vital. The presence of a primary periapical rarefaction worsened the success rate. The success rate was lower for the teeth in which a posttreatment prosthetic crown had been fitted. Fillings which went beyond the apex had a significantly lower success rate than those which nearly or exactly reached the apex.

Adolescent↗
PubMed1979

Pulpectomy procedure for deciduous teeth with severe pulpal necrosis.

Pulpectomies of deciduous teeth with severe pulpal necrosis should be considered as a possible treatment plan. Systemic and dental criteria have been devised to help the clinician to select cases in which successful results may be produced. A clinical success occurs when the pulpectomized tooth is painless, is firm in its alveolar socket, and is without a fistulous tract. Radiographically, any radiolucent area should be resolving with six months, and no pathologic root resorption should be observed. Research should determine whether pulpectomies may be done on children with severe systemic disease and should determine long-term consequences of underfilled and overfilled pulpectomies.

Dental Pulp Capping↗
PubMed2000

Defence reaction in dental pulp after pulp capping and partial pulpectomy in dogs.

The dental pulp was capped indirectly or directly, or partial vital pulpectomy was performed on the 12 functionally most important teeth of 24 beagle dogs. For pulp capping, calcium hydroxide was used, followed by zinc phosphate as a lining, and the preparation was restored with amalgam or composite material. Histological sections were prepared and examined for degree and type of pulp inflammation (hyperaemia, pulpitis, necrosis or gangrene). Degenerative changes of dental pulp (vacuolation, calcification, amyloid or hyaline changes) were also determined. For indirect pulp capping the width of predentine in crown and root dental pulp was measured, and for direct pulp capping and partial pulpectomy (vital pulpotomy) the width and quality of the dentinal bridge were graded. The radical method of partial vital pulpectomy of the coronal part of the dental pulp in dogs produced better quality and continuity of the dentinal bridge than the less radical method of direct pulp capping. This was particularly obvious in small single root teeth such as incisors.

Animals↗
PubMed2004

Zinc oxide-eugenol and calcium hydroxide pulpectomies in baboon primary molars: histological responses.

AIM: To compare histological responses to zinc oxide-eugenol (ZOE) and calcium hydroxide (CH) pulpectomies in primary molar teeth with inflamed pulps. STUDY DESIGN: This was an experimental study in 17 juvenile baboons (Papio ursinus). METHODS: Pulpitis was induced with fresh human carious dentine or Streptococcus mutans placed into occlusal cavities in 78 primary molars; after 14 days a pulpectomy was performed on the same primary molars with the two root fillings randomly allocated. The root canal openings were then 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 ZOE-treated versus CH-treated teeth were: no recognisable pulp 89% and 82%, internal root resorption 0% and 1%, external root resorption 11% and 24%, presence of bacteria 5% and 18%, periapical abscesses 24% and 52%. STATISTICS: Fisher's exact probability test showed a statistically significant higher prevalence of periapical abscesses in the CH-treated group (P=0.03, relative risk 2.2). CONCLUSIONS: ZOE pulpectomy is preferred to CH for the treatment of infected pulps in primary molars.

Animals↗
PubMedDate not supplied

A retrospective assessment of zinc oxide-eugenol pulpectomies in vital maxillary primary incisors successfully restored with composite resin crowns.

PURPOSE: The purpose of this retrospective study was to evaluate, via clinical and radiographic assessments, the treatment outcome of zinc oxide-eugenol (ZOE) pulpectomies performed in vital maxillary primary incisors successfully restored with composite resin crowns. METHODS: Pulpectomized vital primary incisors were treated by a uniformed technique, filled with ZOE paste, and successfully restored with composite resin crowns. Those that remained intact and noncarious for the assessment interval were evaluated for the outcome (success or failure) based on clinical and radiographic findings and compared to: (1) the reason for treatment; (2) the canal filling extent; (3) the type of composite resin crown restoration performed; and (4) the eruption status of its succedaneous tooth. RESULTS: For 104 maxillary primary incisors meeting the inclusion criteria, failure, as judged by presence of pathologic root resorption and/or apical lucency, was determined to be 24% (25/104), for a mean duration of 18 months observation. Failures were statistically associated with the reason for treatment (higher for trauma), the extent of ZOE paste filler in the pulp canal (higher for gross overfill), and the eruption status of the associated succedaneous permanent incisor (higher for delayed eruption). CONCLUSIONS: This study determined a failure rate (24%) for pulpectomies-using ZOE paste and performed on vital primary incisors-comparable to that reported for nonvital pulpectomies. A statistically significant increase in failure rates was found for: (1) incisors treated for trauma (42%) vs those treated for dental caries (19%); and (2) grossly overfilled canals (80%) vs canals filled to the apex (0%).

Child, Preschool↗
PubMed1990

[Effect of formalin-creosote on the rat periapical tissues after pulpectomy].

The purpose of the present study was to investigate histologically, histometrically and immunohistochemically the effect of formalin-creosote (FC) on the periapical tissues after pulpectomy in rats. Experiment I. Seventy-five rats were divided into 3 groups. In all Groups, the mesial root of the right mandibular first molar was removed. After pulpectomy, in Group A, a paper point containing saline was inserted into the root canal. In Group B, a paper point containing FC was inserted, whereas, in Group C, FC was applied and then a paper point containing FC was inserted. The access cavity was sealed with amalgam. The animals were killed at 1, 3, 7, 14 and 28 days. The periapical tissues were examined histologically. The vertical length and the area of the apical periodontal ligament were measured histometrically. The inflammatory cells and the fibroblasts per unit area in the apical granulation tissue were counted. Experiment II. Eighteen rats were divided into 3 groups. In all Groups, pulpectomy was performed as in the experiment I. In Group a, a paper point containing saline was inserted into the root canal. In Group b, a paper point containing FC was inserted, whereas, in Group c, FC was applied and then a paper point containing FC was inserted. The animals were killed at 14 and 28 days. The presence of macrophages in the granulation tissue was examined using polyclonal antibody to lysozyme immunohistochemical techniques. The results were as follows. Experiment I. Histologically, in Group A, severe inflammation was observed in the periapical tissues at 1 and 3 days. Inflammation became moderate and fibrous tissue proliferation was observed in the periapical tissues at 7 days. Inflammation became slight and fibrous tissue increased at 14 and 28 days. In Group B, severe inflammation was observed in the periapical tissues at 1 and 3 days. Inflammation became moderate at 7 and 14 days. Resorption of alveolar bone was observed after 7 days. Fibrous tissue proliferation and resorption of the apical root were seen after 14 days. Inflammation became slight at 28 days. In Group C, severe inflammation was found in the periapical tissues at 1, 3 and 7 days. Resorption of alveolar bone was seen after 7 days. Moderate inflammation remained and fibrous tissue proliferation was seen at 14 and 28 days. Resorption of the apical root was observed after 14 days. Histometrically, vertical length and area of the apical periodontal ligament in Groups B and C increased significantly compared with those in Group A at 14 and 28 days.(ABSTRACT TRUNCATED AT 400 WORDS)

Alveolar Bone Loss↗