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Pandiyan R, Lehl GK, Kumar R, Sharma U, Jagachandiran VV. Assessing the efficacy of Laser pulpotomy versus conventional pulpotomy in primary teeth: A systematic review and meta-analysis of clinical trials. Lasers Med Sci 2024; 39:198. [PMID: 39073657 DOI: 10.1007/s10103-024-04145-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Accepted: 07/12/2024] [Indexed: 07/30/2024]
Abstract
PURPOSE This study systematically reviewed the clinical and radiographic outcomes of laser versus conventional pulpotomy in primary teeth. It also compared the success and effectiveness of different lasers to enhance the understanding and use of laser pulpotomy as an alternative treatment. METHODOLOGY An electronic search was carried out in PubMed and Cochrane from 1st January 1999 to 31st December 2023. The published articles in the English language were searched using MeSH terms and text words. Only randomized controlled trials with a sample size of more than 10 and follow-ups over 6 months were included. Meta-analysis and forest plots were evaluated by utilizing Review Manager 5.4 software. Two reviewers assessed the risk of bias using the RoB 2 tool and discrepancies were resolved by the third reviewer. The success rates were combined using a random effects model to determine clinical and radiographic outcomes. We used risk ratios with 95% confidence intervals (CI) as the primary effect measures and set the significance level at 0.05. RESULTS Only 18 studies met the inclusion criteria after an electronic search. Among them, 13 studies evaluated the clinical and radiographic outcomes of laser with formocresol pulpotomy, 2 studies compared with ferric sulfate pulpotomy, and the remaining studies with Mineral trioxide aggregate (MTA) pulpotomy. The various studies showed different levels of bias. There was no significant difference in the clinical success rate (p = 0.47; RR: 1.01; 95% CI 0.98-1.04; I2 = 0%; p = 0.70) and radiographic success rate (p = 0.94; RR: 1.00; 95% CI 0.91-1.09; I2 = 64%; p = 0.001) between laser pulpotomy and formocresol. Similarly, there was no significant difference between laser pulpotomy and ferric sulfate or MTA pulpotomy. CONCLUSION Diode laser and LLLT can be considered as alternative pulpotomy agents to formocresol in primary teeth. However, high-quality trials are needed to confirm the accuracy and reliability of these findings.
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Affiliation(s)
- Ramanandvignesh Pandiyan
- Department of Pediatric and Preventive Dentistry, Adhiparasakthi Dental College and Hospital, The Tamilnadu Dr. M.G.R. Medical University, Melmaruvathur, 603319, India.
| | - Gurvanit Kaur Lehl
- Department of Dentistry, Government Medical College and Hospital, Sector-32, Chandigarh, 160030, India
| | - Rega Kumar
- Department of Conservative Dentistry and Endodontics, Maulana Azad Institute of Dental Sciences, New Delhi, 110002, India
| | - Urvashi Sharma
- Department of Pediatric Dentistry, Dr. Harvansh Singh Judge Institute of Dental Sciences & Hospital, Sector-25, Chandigarh, 160014, India
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Sezgin BI, Ildes Sezgin GC, Koyuncu Ö, Mentes A. Hyaluronic acid as a pulpotomy material in primary molars: an up to 30 months retrospective study. BMC Oral Health 2024; 24:683. [PMID: 38867194 PMCID: PMC11167839 DOI: 10.1186/s12903-024-04405-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2024] [Accepted: 05/23/2024] [Indexed: 06/14/2024] Open
Abstract
BACKGROUND The aim of this retrospective study was to determine the long-term clinical and radiographic success of our previous randomized clinical trial and to compare the success of hyaluronic acid, with the widely used formocresol and ferric sulphate agents. METHODS This retrospective study is the extension of the 1-year survey of our randomized clinical trial that had compared the effectiveness of a hyaluronic acid pulpotomy over formocresol and ferric sulphate pulpotomies and included clinical and radiographic evaluations with a follow-up period of over 24 months for 44 children who applied to our clinic between May 2019 and September 2019. Long-term clinical and radiographic data were obtained from the periodic files of our department, wherein each tooth's file was examined to identify any clinical and radiographic findings. Descriptive statistics and Pearson's chi-square tests were used to evaluate the data. Statistical significance was considered as p < 0.05. RESULTS The clinical and radiographic success rates of the hyaluronic acid, formocresol, and ferric sulphate groups were not statistically different at > 24 months. None of the teeth in the hyaluronic acid group showed any clinical findings at > 24 months. CONCLUSIONS Hyaluronic acid pulpotomies exhibited comparable success rates to formocresol and ferric sulphate materials spanning over 24 months examinations. Because of convenient accessibility and applicability of hyaluronic acid, it may be recommended as a promising alternative medicament for pulpotomy treatments of primary molars. However, further long-term follow-up human studies are needed to better understand the effect of hyaluronic acid on the dental pulp of human primary molars.
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Affiliation(s)
- Batın Ilgıt Sezgin
- Department of Paediatric Dentistry, Faculty of Dentistry, Istanbul Galata University, Istanbul, Türkiye, 34430, Turkey.
| | | | - Özge Koyuncu
- Department of Paediatric Dentistry, Faculty of Dentistry, Marmara University, Istanbul, Türkiye, 34854, Turkey
| | - Ali Mentes
- Department of Paediatric Dentistry, Faculty of Dentistry, Marmara University, Istanbul, Türkiye, 34854, Turkey
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Afkhami F, Rostami G, Xu C, Peters OA. The application of lasers in vital pulp therapy: clinical and radiographic outcomes. BMC Oral Health 2024; 24:333. [PMID: 38486157 PMCID: PMC10938664 DOI: 10.1186/s12903-024-04026-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 02/14/2024] [Indexed: 03/18/2024] Open
Abstract
The main purpose of vital pulp therapy (VPT) is to preserve the integrity and function of the pulp. A wide variety of materials and techniques have been proposed to improve treatment outcomes, and among them, the utilization of lasers has gained significant attention. The application of lasers in different stages of VPT has witnessed remarkable growth in recent years, surpassing previous approaches.This study aimed to review the applications of lasers in different steps of VPT and evaluate associated clinical and radiographic outcomes. An electronic search using Scopus, MEDLINE, Web of Science and Google Scholar databases from 2000 to 2023 was carried out by two independent researchers. The focus was on human studies that examined the clinical and/or radiographic effects of different laser types in VPT. A total of 4243 studies were included in this narrative review article. Based on the compiled data, it can be concluded that although current literature suggests laser may be proposed as an adjunct modality for some procedural steps in VPT, more research with standardized methodologies and criteria is needed to obtain more reliable and conclusive results.
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Affiliation(s)
- Farzaneh Afkhami
- School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran.
- School of Dentistry, The University of Queensland, Brisbane, Australia.
| | | | - Chun Xu
- School of Dentistry, The University of Queensland, Brisbane, Australia
| | - Ove A Peters
- School of Dentistry, The University of Queensland, Brisbane, Australia
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Akman H, Surme K. Retrospective analysis of ferric sulfate and sodium hypochlorite pulpotomy procedures in primary molars. J Dent Res Dent Clin Dent Prospects 2023; 17:182-187. [PMID: 38023801 PMCID: PMC10676537 DOI: 10.34172/joddd.2023.39312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Accepted: 07/29/2023] [Indexed: 12/01/2023] Open
Abstract
Background Pulpotomy is a vital pulp treatment procedure frequently used in primary molars to preserve pulp vitality and function until tooth exfoliation. There is currently no pulp medicament with all the features of the ideal pulpotomy material. The present study compared the radiographic success of sodium hypochlorite with ferric sulfate (FS) when used for pulpotomy in primary molars. Methods A retrospective analysis was performed to evaluate the success rates of primary molars pulpotomized using sodium hypochlorite or FS according to radiographic findings. Healthy 4‒10-year-old children who had pulpotomy procedures on primary molars between 2018 and 2021 at the pediatric dental clinic and had a control radiograph at least 12 months later were enrolled in the study. The chi-squared test was used to determine the differences in success between these two materials. Results A total of 142 teeth, including 85 (59.9%) first primary molars and 57 (40.1%) second primary molars, in 98 healthy children were evaluated. The mean follow-up period of the teeth included in the study was 585.1±249.4 days. Radiographic success rates for NaOCl and FS groups were 73.8% and 71.0%, respectively, with no statistically significant difference (P>0.05). Internal root resorption (IRR) was the most common cause of radiographic failure in both groups. Conclusion Radiographic success rates of both materials were similar, and using these materials in primary molar pulpotomy procedures can be recommended in clinical practice.
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Affiliation(s)
| | - Koray Surme
- Department of Pediatric Dentistry, Faculty of Dentistry, Alanya Alaaddin Keykubat University, Antalya, Turkey
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Afkhami F, Rostami G, Xu C, Walsh LJ, Peters OA. The application of lasers in vital pulp therapy: a review of histological effects. Lasers Med Sci 2023; 38:215. [PMID: 37733149 PMCID: PMC10514114 DOI: 10.1007/s10103-023-03854-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 08/08/2023] [Indexed: 09/22/2023]
Abstract
Vital pulp therapy (VPT) is primarily intended to preserve the vitality of pulp tissues, which have been exposed for any reason. Various materials and techniques have been proposed to improve treatment outcomes, including the use of lasers. This study aimed to review the histological results of different dental lasers including low-level lasers, carbon dioxide (CO2), erbium-doped yttrium aluminum garnet laser (Er:YAG), neodymium-doped yttrium aluminum garnet (Nd:YAG), erbium, chromium:yttrium-scandium-gallium-garnet (Er,Cr:YSGG) lasers, and diode lasers for VPT. This focused review included a comprehensive electronic search of Scopus, MEDLINE, Web of Science, and Google Scholar databases from 2000 to 2022 by two independent investigators. Different combinations of keywords were used, and reference mining of related papers was done. The review included studies related to histologic evaluation of laser-assisted vital pulp therapy that stated the laser parameters that were used. Articles with radiographic or clinical assessments or articles lacking necessary data were excluded. Non-English articles were excluded unless their abstract was in English and encompassed the necessary data. Most studies indicated the efficacy of lasers for reduction of inflammation, acceleration of healing, and increasing the thickness of dentinal bridge. According to the evidence, lasers used in combination with pulp capping agents are beneficial to enhance the success rate of VPT.
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Affiliation(s)
- Farzaneh Afkhami
- School of Dentistry, The University of Queensland, 288 Herston Road, Brisbane, QLD, 4006, Australia.
- Department of Endodontics, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran.
| | - Golriz Rostami
- Laser Research Center of Dentistry, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Chun Xu
- School of Dentistry, The University of Queensland, 288 Herston Road, Brisbane, QLD, 4006, Australia
| | - Laurence J Walsh
- School of Dentistry, The University of Queensland, 288 Herston Road, Brisbane, QLD, 4006, Australia
| | - Ove A Peters
- School of Dentistry, The University of Queensland, 288 Herston Road, Brisbane, QLD, 4006, Australia
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Guo J, Zhang N, Cheng Y. Comparative efficacy of medicaments or techniques for pulpotomy of primary molars: a network meta-analysis. Clin Oral Investig 2023; 27:91-104. [PMID: 36580161 PMCID: PMC9876877 DOI: 10.1007/s00784-022-04830-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Accepted: 12/18/2022] [Indexed: 12/30/2022]
Abstract
OBJECTIVES We performed this network meta-analysis to determine the comparative efficacy of formocresol (FC), ferric sulfate (FS), sodium hypochlorite (NaOCl), calcium hydroxide (CH), mineral trioxide aggregate (MTA), biodentine, and laser for pulpotomy of molar teeth. MATERIALS AND METHODS An updated search was conducted in PubMed, Embase, and the Cochrane Library to identify relevant randomized controlled trials (RCTs) published before October 30, 2022, after screening previous meta-analyses. The Cochrane risk of bias assessment tool was used to appraise the methodological quality of included studies. Clinical and radiographic success rates were assessed as outcomes. Random network meta-analysis was performed by using STATA software (version 14.0) with "network" command. RESULTS A total of 43 RCTs were included. Network meta-analysis indicated that CH was inferior to other medicaments and techniques in all outcomes, and MTA and biodentine was better than FC, FS, and NaOCl in terms of clinical and radiographic success rates. Results of ranking probabilities suggested that MTA ranked first in all outcomes except for clinical success at both 6 months. CONCLUSIONS Our results suggested that MTA was associated with significant improvement in both clinical and radiographic success than other pulpotomy medicaments and techniques, with the highest probability of being the optimal option. CLINICAL RELEVANCE The current network meta-analysis determined the comparative efficacy and safety of 7 common pulpotomy medicaments in molar pulpotomy, including FC, FS, NaOCl, CH, MTA, biodentine, and laser, and the pooled results revealed comparable efficacy in clinical and radiographic success rates at 6 and 12 months between FC, FS, and NaOCl in primary molars pulpotomies. However, MTA, biodentine and laser may have more advantages than other pulpotomy medicaments for clinical and radiographic success. Therefore, in clinical practice, practitioners should select MTA, biodentine, or laser as pulpotomy medicaments in molar pulpotomy.
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Affiliation(s)
- Jiehua Guo
- Department of Oral Medicine, Shanxi Provincial People's Hospital, NO.29 The Twin Towers Temple District, Taiyuan, Shanxi, China.
| | - Na Zhang
- Department of Oral Medicine, Shanxi Provincial People's Hospital, NO.29 The Twin Towers Temple District, Taiyuan, Shanxi, China
| | - Yuzhao Cheng
- Department of Oral Medicine, Shanxi Provincial People's Hospital, NO.29 The Twin Towers Temple District, Taiyuan, Shanxi, China
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Kaya C, Elbay ÜŞ, Elbay M, Uçar G. The comparison of calcium hydroxide + biostimulation, calcium hydroxide, formocresol, and MTA pulpotomies without biostimulation in primary teeth: 12-months clinical and radiographic follow-up. Lasers Med Sci 2022; 37:2545-2554. [PMID: 35230575 DOI: 10.1007/s10103-022-03536-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Accepted: 02/23/2022] [Indexed: 12/31/2022]
Abstract
This study has aimed to evaluate the clinical and radiographic success rates of calcium hydroxide pulpotomy (CH) with biostimulation (PBMT) and compare them to that of CH, formocresol (FC), mineral trioxide aggregate (MTA) pulpotomies without PBMT in primary molars. A total of 172 pulpotomies were performed on primary first or second mandibular molars in 94 children who were 5-8 years old. The pulpotomy procedure was performed with four different techniques. In the PBMT group, before the CH placement, 820-nm diode laser radiation was applied to each pulp-stump for 12 s (10 mW, 2.5 J/cm2). The clinical (lack of spontaneous pain, abscess or fistula, and pathological mobility) and radiographic success (lack of periapical/furcal lesions and internal/external resorption) were recorded at 6 and 12 months. The data was statistically evaluated. p value < 0.05 was considered as significant. After 12 months, the clinical and radiographic success rate (a tooth with at least one of the findings was considered unsuccessful) was 97%/92% for FC and 97%/95%, 87%/73%, and 71%/45% for MTA, CH + PBMT, and CH, respectively. There was no significant difference between the CH + PBMT and the other groups in clinical success, while a significant difference was found between CH and FC, MTA groups. In radiographic success, there was a significant difference between the CH and the other groups. No significant difference was found between the 6th- and 12th-month results in clinical success for all the groups. A decrease in success over time was seen only in the CH group for radiographic results. CH without PBMT showed the worst clinical and radiographic results among the groups. CH + PBMT showed similar clinical success compared to the MTA and FC groups. In radiographic success, CH + PBMT showed higher success compared to CH, but this success was not high as compared to MTA and FC.
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Affiliation(s)
- Can Kaya
- Department of Pediatric Dentistry, Faculty of Dentistry, Kocaeli University, Kocaeli, Turkey
| | - Ülkü Şermet Elbay
- Department of Pediatric Dentistry, Faculty of Dentistry, Kocaeli University, Kocaeli, Turkey.
| | - Mesut Elbay
- Department of Pediatric Dentistry, Faculty of Dentistry, Kocaeli University, Kocaeli, Turkey
| | - Gül Uçar
- Department of Pediatric Dentistry, Faculty of Dentistry, Kocaeli University, Kocaeli, Turkey
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Stratigaki E, Tong HJ, Seremidi K, Kloukos D, Duggal M, Gizani S. Contemporary management of deep caries in primary teeth: a systematic review and meta-analysis. Eur Arch Paediatr Dent 2022; 23:695-725. [PMID: 34981447 DOI: 10.1007/s40368-021-00666-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Accepted: 09/12/2021] [Indexed: 01/30/2023]
Abstract
PURPOSE To systematically evaluate the available evidence regarding contemporary management of deep caries in vital primary teeth. This review was carried out to facilitate the development of European Academy of Paediatric Dentistry (EAPD) guidelines on deep caries management of primary teeth in paediatric dentistry. METHODS A systematic electronic literature search was conducted to locate studies reporting on interventions and medicaments used for the treatment of deep caries in vital primary teeth. To facilitate this, the Cochrane Library (1992 to up to December 6th, 2020), MEDLINE (PubMed, 1946 to December Week 1, 2020), Ovid MEDLINE (In-Process & Other Non-Indexed Citations, December 6th, 2020); EMBASE (Embase.com, 1974 to December 6th, 2020) and LILACS (1982 to December 6th, 2020) were accessed. Hand search of reference lists of included articles, as well as handbooks and grey literature search was also performed. Study screening was done in duplicate and study inclusions were agreed upon by all authors. Data extraction, and methodological quality and risk of bias assessment were carried out in duplicate for each of the included studies. Overall success rate of each intervention and medicament within the intervention was reported. Meta-analysis was also performed for high-quality studies reporting similar interventions and comparable outcomes in homogeneous population. RESULTS A total of 1332 papers were identified. Following the primary and secondary assessment process, 36 papers were included in the review. Of these, 8 papers were deemed to represent 4 individual studies, leaving a total of 32 unique studies eventually included in the final analysis. These studies were further categorized into three main vital pulp treatment methods for analysis: indirect pulp capping (IPC), direct pulp capping (DPC), and pulpotomy (PP). Overall, IPC, DPC and PP interventions have high success rates with the reported clinical success rates higher than radiographic success rates. Medicaments used for IPC and DPC have similar success rates. Mineral trioxide aggregate (MTA), ferric sulfate (FS) and formocresol (FC) PP showed similar success rates, and which were all higher than calcium hydroxide (CH). Majority of included studies (n = 22; 63%) were rated low in terms of their potential risk of bias, 6 studies were rated high (17%), and 7 studies were of unclear risk (20%). CONCLUSION Within the limitations of the studies included, IPC, DPC, and PP can be recommended as effective treatment modalities for primary teeth with deep caries under specific conditions.
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Affiliation(s)
- Eirini Stratigaki
- Department of Pediatric Oral Health and Orthodontics, University Center of Dental Medicine, Basel, Switzerland
| | - Huei Jinn Tong
- Discipline of Orthodontics and Paediatric Dentistry, Faculty of Dentistry, National University of Singapore, Singapore, Singapore
| | - Kyriaki Seremidi
- Department of Paediatric Dentistry, Athens School of Dentistry, National & Kapodistrian University of Athens, Athens, Greece
| | - Dimitrios Kloukos
- Department of Orthodontics and Dentofacial Orthopedics, School of Dental Medicine, University of Bern, Bern, Switzerland
- Department of Orthodontics and Dentofacial Orthopedics, 251 Hellenic Air Force and VA General Hospital, Athens, Greece
| | - Monty Duggal
- School of Dental Medicine, Qatar University, QU Health, Doha, Qatar
| | - Sotiria Gizani
- Department of Paediatric Dentistry, Athens School of Dentistry, National & Kapodistrian University of Athens, Athens, Greece.
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Bolukbasi B, Kucukyilmaz E. Evaluation of the bond strengths of restorative materials to primary tooth dentin treated with different pulpotomy techniques. Microsc Res Tech 2021; 84:1309-1320. [PMID: 33754435 DOI: 10.1002/jemt.23689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Revised: 12/05/2020] [Indexed: 11/06/2022]
Abstract
The aim of this study was to investigate the changes of different pulpotomy techniques on the primary tooth dentin and to evaluate the effects of these pulpotomy methods on the shear bond strength of restorative materials to primary tooth dentin. Two hundred and forty dentin specimens were distributed randomly to the study groups as; control, ferric sulphate, Biodentine® , Nd:YAG laser, photobiomodulation, and atmospheric pressure cold plasma (APCP). After the application of pulpotomy methods, samples were again randomly divided to two restorative materials (glass hybrid and composite resin) (n = 20) and shear bond strength (SBS) test was performed. Then, 12 new dentin specimens were prepared for all groups for surface analysis. Surface examination (n = 12) and fracture analyses (n = 240) were carried out with scanning electron microscope (SEM). Statistical significance range was accepted as α <.05 for all data. A statistically significant difference was obtained among all study groups for glass hybrid material as well as composite material (p <.05). While the highest mean SBS value was obtained with Nd:YAG laser (7.58 ± 0.60 MPa), the lowest value was observed with Biodentine® (6.70 ± 0.91 MPa; p = .001) for glass hybrid material. For composite material, the highest mean SBS value was calculated for Nd:YAG laser (13.79 ± 1.24 MPa), while the lowest value was obtained with ferric sulphate (10.17 ± 1.45 MPa; p = .001). Fracture modes were mainly adhesive and mixed type according to SEM analysis. Moreover, morphological changes were observed with SEM on the dentin surfaces of ferric sulphate, Biodentine® and Nd:YAG laser. Within the limitations of this study, Nd:YAG laser increased the shear bond strength values in groups of composite resin. RESEARCH HIGHLIGHTS: In this article, we report the results of the shear bonding strength test of two restorative materials (glass-hybrid vs. composite resin) to primary tooth dentin following the application of five different pulpotomy techniques (ferric sulfate, Biodentine® , Nd:YAG laser, photobiomodulation, and atmospheric pressure cold plasma) were reported. This article will contribute to the literature that there are considerably limited researches concerning the bond strength of glass hybrid to primary dentin and also atmospheric pressure cold plasma in pulpotomies. The SEM examination was performed in two stages in this study; the morphological changes in both treated dentin surfaces and the surfaces of the samples subjected to the shear bond strength test.
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Affiliation(s)
- Basak Bolukbasi
- Faculty of Dentistry, Department of Pediatric Dentistry, Izmir Katip Celebi University, Izmir, Turkey
| | - Ebru Kucukyilmaz
- Faculty of Dentistry, Department of Pediatric Dentistry, Izmir Katip Celebi University, Izmir, Turkey
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Cunha NNDO, Junqueira MA, Cosme-Silva L, Santos LDST, Oliveira GAVD, Moretti Neto RT, Nogueira DA, Brigagão MRPL, Moretti ABDS. Expression of Matrix Metalloproteinases-8 and Myeloperoxidase in Pulp Tissue after Pulpotomy with Calcium Silicate Cements. PESQUISA BRASILEIRA EM ODONTOPEDIATRIA E CLÍNICA INTEGRADA 2021. [DOI: 10.1590/pboci.2021.038] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
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Chandran V, Ramanarayanan V, Menon M, Varma B, Sanjeevan V. Effect of LASER therapy Vs conventional techniques on clinical and radiographic outcomes of deciduous molar pulpotomy: A systematic review and meta-analysis. J Clin Exp Dent 2020; 12:e588-e596. [PMID: 32665819 PMCID: PMC7335597 DOI: 10.4317/jced.56436] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Accepted: 04/26/2020] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND To systematically review the effectiveness primary molar pulpotomy based on the clinical and radiographic outcomes using lasers over the conventional therapies. MATERIAL AND METHODS This systematic review and meta-analysis included Randomized or Quasi-randomized trials comparing LASER with conventional pulpotomy therapies (formocresol, ferric sulphate, MTA or calcium hydroxide) with atleast 6-month follow-up period was included. Risk of bias of included studies was assessed and metanalysis was done using RevMan software. RESULTS Of the 1383 articles that were searched, only 14 studies were included for qualitative synthesis and 10 for meta- analysis. There was no statistically significant difference in clinical success rate [OR 0.99, 95%CI (0.19,5.22)] or radiographic success rate [OR 0.77, 95%CI (0.31,1.87)] of LASER therapy compared to Formocresol in primary molar pulpotomy for 6 months. No statistically significant difference were found in clinical success rate [OR 1.04, 95%CI (0.35,3.07)] and radiographic success rate [OR 0.71, 95%CI (0.37,1.35)] at 12 month follow-up also. Comparison of LASER with Ferric Sulphate also did not show a statistically significant difference. CONCLUSIONS Meta-analysis showed no statistically significant difference in clinical and radiographic outcomes of LASER pulpotomy with conventional pulpotomy (formocresol and ferric sulphate) at 6 and 12 months follow-up. However, there was considerable risk of bias in the included studies. Key words:Pulp therapy, Laser, formocresol.
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Affiliation(s)
- Vennila Chandran
- Department of Pedodontics and Preventive Dentistry, Amrita School of Dentistry, Amrita Vishwa Vidyapeetham, Kochi, Kerala, India
| | - Venkitachalam Ramanarayanan
- Department of Public Health Dentistry, Amrita School of Dentistry, Amrita Vishwa Vidyapeetham, Kochi, Kerala, India
| | - Medhini Menon
- Department of Pedodontics and Preventive Dentistry, Amrita School of Dentistry, Amrita Vishwa Vidyapeetham, Kochi, Kerala, India
| | - Balagopal Varma
- Department of Pedodontics and Preventive Dentistry, Amrita School of Dentistry, Amrita Vishwa Vidyapeetham, Kochi, Kerala, India
| | - Vinita Sanjeevan
- Department of Public Health Dentistry, Goa Dental College, Bambolim, Goa, India
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Bossù M, Iaculli F, Di Giorgio G, Salucci A, Polimeni A, Di Carlo S. Different Pulp Dressing Materials for the Pulpotomy of Primary Teeth: A Systematic Review of the Literature. J Clin Med 2020; 9:jcm9030838. [PMID: 32204501 PMCID: PMC7141304 DOI: 10.3390/jcm9030838] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Revised: 03/13/2020] [Accepted: 03/16/2020] [Indexed: 12/13/2022] Open
Abstract
Background: Pulpotomy of primary teeth provides favorable clinical results over time; however, to date, there is still not a consensus on an ideal pulp dressing material. Therefore, the aim of the present systematic review was to compare pulpotomy agents to establish a preferred material to use. Methods: After raising a PICO question, the PRISMA guideline was adopted to carry out an electronic search through the MEDLINE database to identify comparative studies on several pulp dressing agents, published up to October 2019. Results: The search resulted in 4274 records; after exclusion, a total of 41 papers were included in the present review. Mineral trioxide aggregate (MTA), Biodentine and ferric sulphate yielded good clinical results over time and might be safely used in the pulpotomies of primary molars. Among agents, MTA seemed to be the material of choice. On the contrary, calcium hydroxide showed the worst clinical performance. Although clinically successful, formocreosol should be replaced by other materials, due to its potential cytotoxicity and carcinogenicity. Conclusion: MTA seemed to be the gold standard material in the pulpotomy of primary teeth. Promising results were also provided by calcium silicate-based cements. Further randomized clinical trials (RCTs) with adequate sample sizes and long follow-ups are encouraged to support these outcomes.
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Affiliation(s)
- Maurizio Bossù
- Department of Oral and Maxillofacial Science, “Sapienza” University of Rome, 00185 Rome, Italy; (M.B.); (A.S.); (A.P.); (S.D.C.)
| | - Flavia Iaculli
- Pediatric Dentistry School, Department of Oral and Maxillofacial Science, “Sapienza” University of Rome, 00185 Rome, Italy;
| | - Gianni Di Giorgio
- Pediatric Dentistry School, Department of Oral and Maxillofacial Science, “Sapienza” University of Rome, 00185 Rome, Italy;
- Correspondence: ; Tel.: +39-349-547-7903
| | - Alessandro Salucci
- Department of Oral and Maxillofacial Science, “Sapienza” University of Rome, 00185 Rome, Italy; (M.B.); (A.S.); (A.P.); (S.D.C.)
| | - Antonella Polimeni
- Department of Oral and Maxillofacial Science, “Sapienza” University of Rome, 00185 Rome, Italy; (M.B.); (A.S.); (A.P.); (S.D.C.)
| | - Stefano Di Carlo
- Department of Oral and Maxillofacial Science, “Sapienza” University of Rome, 00185 Rome, Italy; (M.B.); (A.S.); (A.P.); (S.D.C.)
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Lopes CS, Junqueira MA, Cosme-Silva L, Pegoraro CDOR, Garbelini CCD, Oliveira TM, Martins NS, Neves JDS, Sakai VT. Initial inflammatory response after the pulpotomy of rat molars with MTA or ferric sulfate. J Appl Oral Sci 2019; 27:e20180550. [PMID: 31365709 PMCID: PMC6690728 DOI: 10.1590/1678-7757-2018-0550] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Revised: 01/30/2019] [Accepted: 02/07/2019] [Indexed: 11/22/2022] Open
Abstract
PURPOSE To compare, both qualitatively and quantitatively, the inflammatory cells, vascular density and IL-6 immunolabeled cells present in the pulp after pulpotomy with white MTA versus 15.5% ferric sulfate (FS). METHODOLOGY Forty-eight mandibular first molars from 24 Wistar rats were divided into MTA or FS groups and subdivided according to the period after pulpotomy procedure (24, 48 and 72 hours). Four teeth (sound and untreated) were used as controls. Histological sections were obtained and assessed through the descriptive analysis of morphological aspects of pulp tissue and the quantification of inflammatory cells, vascular density and interleukin-6 (IL-6) expression. Data were statistically analyzed (p<0.05). RESULTS The number of inflammatory cells was similar in both groups, being predominantly localized at the cervical radicular third. In the MTA group, increased inflammation was observed at 48 hours. Vascular density was similar in both groups and over time, being predominant in the medium radicular third. No correlation was found between the number of inflammatory cells and the vascular density. Pulp tissue was more organized in MTA-treated teeth. In both groups, a weak to moderate IL-6 expression was detected in odontoblasts and inflammatory cells. Comparing both groups, there was a greater IL-6 expression in the cervical radicular third of teeth treated with MTA at 24 hours and in the medium and apical thirds at 72 hours, while in the FS group a greater IL-6 expression was found in the apical third at 24 hours. CONCLUSION The MTA group presented better histological features and greater IL-6 expression than the FS group. However, no difference was observed between the groups regarding the inflammatory status and vascularization, suggesting the usefulness of FS as a low-cost alternative to MTA.
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Affiliation(s)
- Camila Soares Lopes
- Universidade Federal de Alfenas (UNIFAL-MG), Faculdade de Odontologia, Departamento de Clínica e Cirurgia, Alfenas, Minas Gerais, Brasil
| | - Marina Azevedo Junqueira
- Universidade Federal de Alfenas (UNIFAL-MG), Faculdade de Odontologia, Departamento de Clínica e Cirurgia, Alfenas, Minas Gerais, Brasil
| | - Leopoldo Cosme-Silva
- Universidade do Estado de São Paulo (UNESP), Faculdade de Odontologia de Araçatuba, Departamento de Endodontia, Araçatuba, São Paulo, Brasil
| | | | | | - Thais Marchini Oliveira
- Universidade de São Paulo, Faculdade de Odontologia de Bauru, Departamento de Odontopediatria, Ortodontia e Saúde Coletiva, Bauru, São Paulo, Brasil
| | - Natália Silva Martins
- Universidade Federal de Alfenas (UNIFAL-MG), Instituto de Exatas, Departamento de Estatística, Alfenas, Minas Gerais, Brasil
| | - Juliana Dos Santos Neves
- Universidade Federal de Alfenas (UNIFAL-MG), Departamento de Biologia Estrutural, Alfenas, Minas Gerais, Brasil
| | - Vivien Thiemy Sakai
- Universidade Federal de Alfenas (UNIFAL-MG), Faculdade de Odontologia, Departamento de Clínica e Cirurgia, Alfenas, Minas Gerais, Brasil
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Silva LLCE, Cosme-Silva L, Sakai VT, Lopes CS, Silveira APPD, Moretti Neto RT, Gomes-Filho JE, Oliveira TM, Moretti ABDS. Comparison between calcium hydroxide mixtures and mineral trioxide aggregate in primary teeth pulpotomy: a randomized controlled trial. J Appl Oral Sci 2019; 27:e20180030. [PMID: 31116277 PMCID: PMC6534371 DOI: 10.1590/1678-7757-2018-0030] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2018] [Revised: 10/06/2018] [Accepted: 11/11/2018] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVES To evaluate the effect of calcium hydroxide (CH) associated with two different vehicles as a capping material for pulp tissue in primary molars, compared with mineral trioxide aggregate (MTA). METHODOLOGY Forty-five primary mandibular molars with dental caries were treated by conventional pulpotomy using one of the following materials: MTA only (MTA group), CH with saline (CH+saline group) and CH with polyethylene glycol (CH+PEG group) (15 teeth/group). Clinical and periapical radiographic examinations of the pulpotomized teeth were performed 3, 6, and 12 months after treatment. Data were tested by chi-squared analysis and a multiple comparison post-test. RESULTS The MTA group showed both clinical and radiographic treatment success in 14/14 teeth (100%), at all follow-up appointments. By clinical evaluation, no teeth in the CH+saline and CH+PEG groups had signs of mobility, fistula, swelling or inflammation of the surrounding gingival tissue. However, in the CH+saline group, radiographic analysis detected internal resorption in up to 9/15 teeth (67%), and inter-radicular bone resorption and furcation radiolucency in up to 5/15 teeth (36%), from 3 to 12 months of follow-up. In the CH+PEG group, 2/11 teeth (18%) had internal resorption and 1/11 teeth (9%) presented bone resorption and furcation radiolucency at all follow-up appointments. CONCLUSION CH with PEG performed better than CH with saline as capping material for pulpotomy of primary teeth. However, both combinations yielded clinical and radiographic results inferior to those of MTA alone.
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Affiliation(s)
- Lidiane Lucas Costa E Silva
- Universidade Federal de Alfenas (UNIFAL), Faculdade de Odontologia, Departamento de Clínica e Cirurgia, Alfenas, Minas Gerais, Brasil
| | - Leopoldo Cosme-Silva
- Universidade Estadual Paulista (UNESP), Faculdade de Odontologia de Araçatuba, Departamento de Dentística Restauradora - Endodontia, Araçatuba, São Paulo, Brasil
| | - Vivien Thiemy Sakai
- Universidade Federal de Alfenas (UNIFAL), Faculdade de Odontologia, Departamento de Clínica e Cirurgia, Alfenas, Minas Gerais, Brasil
| | - Camila Soares Lopes
- Universidade Federal de Alfenas (UNIFAL), Faculdade de Odontologia, Departamento de Clínica e Cirurgia, Alfenas, Minas Gerais, Brasil
| | - Ana Paula Pereira da Silveira
- Universidade Federal de Alfenas (UNIFAL), Faculdade de Odontologia, Departamento de Clínica e Cirurgia, Alfenas, Minas Gerais, Brasil
| | - Rafael Tobias Moretti Neto
- Universidade Federal de Alfenas (UNIFAL), Faculdade de Odontologia, Departamento de Clínica e Cirurgia, Alfenas, Minas Gerais, Brasil
| | - João Eduardo Gomes-Filho
- Universidade Estadual Paulista (UNESP), Faculdade de Odontologia de Araçatuba, Departamento de Dentística Restauradora - Endodontia, Araçatuba, São Paulo, Brasil
| | - Thais Marchini Oliveira
- Universidade de São Paulo, Faculdade de Odontologia de Bauru, Departamento de Odontopediatria, Ortodontia e Saúde Coletiva, Bauru, São Paulo, Brasil
| | - Ana Beatriz da Silveira Moretti
- Universidade Federal de Alfenas (UNIFAL), Faculdade de Odontologia, Departamento de Clínica e Cirurgia, Alfenas, Minas Gerais, Brasil
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Gopalakrishnan V, Anthonappa R, Ekambaram M, King NM. Qualitative assessment of published studies on pulpotomy medicaments for primary molar teeth. ACTA ACUST UNITED AC 2019; 10:e12389. [DOI: 10.1111/jicd.12389] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2018] [Accepted: 11/10/2018] [Indexed: 11/28/2022]
Affiliation(s)
| | - Robert Anthonappa
- School of DentistryThe University of Western Australia Perth Western Australia Australia
| | - Manikandan Ekambaram
- Department of Oral SciencesFaculty of DentistryUniversity of Otago Dunedin New Zealand
| | - Nigel M. King
- School of DentistryThe University of Western Australia Perth Western Australia Australia
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Nuvvula S, Bandi M, Mallineni SK. Efficacy of ferric sulphate as a pulpotomy medicament in primary molars: an evidence based approach. Eur Arch Paediatr Dent 2018; 19:439-447. [PMID: 30341716 DOI: 10.1007/s40368-018-0375-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2017] [Accepted: 08/12/2018] [Indexed: 11/24/2022]
Abstract
AIM To evaluate the available evidence on the efficacy of ferric sulphate (FS) compared to other pulpotomy medicaments in primary molars. METHODS A comprehensive literature search was conducted through five databases (PubMed, Ovid®, EBSCOhost, Cochrane Library and ProQuest) and only those papers which met the inclusion criteria were accepted. The quality of the studies used for systematic review was rated by two independent researchers based on Fuks and Papagiannoulis (Eur Arch Paediatr Dent 7:64-71, 2006) criteria and graded as A (38-42), B1 (32-37), B2 (25-31), C (≤ 24). Inter-examiner reliability was measured using Kappa statistics. RESULTS A total of 1371 studies were available, of which only two studies full-text articles were included for quality assessment with an excellent inter-researcher agreement (k = 0.9). The comprehensive search revealed that, none of the 20 studies obtained grade A. Only three studies were graded as B1, 5 studies received grade B2 and 12 studies attained grade C. Only 4 prospective randomised clinical trials reported high success rate with FS compared to other materials. Remaining 14 studies revealed low success rate with FS compared to other pulpotomy medicaments. CONCLUSION There is insufficient evidence to support the application of FS as a pulpotomy medicament in primary molars in the existing English literature. Hence, properly planned randomised clinical trials with large sample size and long-term follow up are needed to support FS as an effective pulpotomy medicament compared to other traditional and new medicaments.
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Affiliation(s)
- S Nuvvula
- Department of Paedodontics and Preventive Dentistry, Narayana Dental College and Hospital, Nellore, Andhra Pradesh, India
| | - M Bandi
- Department of Paedodontics and Preventive Dentistry, Narayana Dental College and Hospital, Nellore, Andhra Pradesh, India
| | - S K Mallineni
- Department of Paedodontics and Preventive Dentistry, Narayana Dental College and Hospital, Nellore, Andhra Pradesh, India.
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Nematollahi H, Sarraf Shirazi A, Mehrabkhani M, Sabbagh S. Clinical and radiographic outcomes of laser pulpotomy in vital primary teeth: a systematic review and meta-analysis. Eur Arch Paediatr Dent 2018; 19:205-220. [DOI: 10.1007/s40368-018-0358-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2017] [Accepted: 05/16/2018] [Indexed: 12/01/2022]
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Laser pulpotomy—an effective alternative to conventional techniques—a systematic review of literature and meta-analysis. Lasers Med Sci 2018; 33:1621-1629. [DOI: 10.1007/s10103-018-2588-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2017] [Accepted: 07/09/2018] [Indexed: 11/27/2022]
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19
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Clinical outcomes for primary molars treated by different types of pulpotomy: A retrospective cohort study. J Formos Med Assoc 2018; 117:24-33. [DOI: 10.1016/j.jfma.2017.02.010] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2017] [Revised: 02/08/2017] [Accepted: 02/14/2017] [Indexed: 11/24/2022] Open
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Deng Y, Zhu X, Zheng D, Yan P, Jiang H. Laser use in direct pulp capping: A meta-analysis. J Am Dent Assoc 2016; 147:935-942. [PMID: 27665108 DOI: 10.1016/j.adaj.2016.07.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2016] [Revised: 07/23/2016] [Accepted: 07/26/2016] [Indexed: 11/20/2022]
Abstract
BACKGROUND The authors of this study evaluated the effects of lasers on the outcome of direct pulp capping by means of a meta-analysis. TYPES OF STUDIES REVIEWED The authors completed a literature search on PubMed, Cochrane Library, Embase, and China National Knowledge Infrastructure, as well as a manual search of the reference lists of all identified articles since the introduction of lasers in endodontics in 1971 through May 30, 2016. The authors systematically evaluated the studies that met the inclusion criteria and performed a meta-analysis. RESULTS The authors selected 5 studies about 4 laser systems (carbon dioxide; diode; erbium,chromium:yttrium-selenium-gallium-garnet; and erbium:yttrium-aluminum-garnet) from the 510 articles to be included in this meta-analysis. Using a fixed-effects model, they found no significant heterogeneity between these studies (χ2 = 0.83, P = .99, I2 = 0%). Their results showed that the success rate (89.9%) of the laser groups was higher than that of 67.2% of the control groups, and the difference was statistically significant (risk ratio, 1.35; 95% confidence interval, 1.23-1.49; P < .00001). CONCLUSIONS AND PRACTICAL IMPLICATIONS On the basis of the limited evidence, the use of lasers effectively improved the prognosis of direct pulp capping treatment for permanent teeth.
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Goyal P, Pandit IK, Gugnani N, Gupta M, Goel R, Gambhir RS. Clinical and radiographic comparison of various medicaments used for pulpotomy in primary molars: A randomized clinical trial. Eur J Dent 2016; 10:315-320. [PMID: 27403046 PMCID: PMC4926581 DOI: 10.4103/1305-7456.184144] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Objective: To evaluate and compare the efficacy of ferric sulfate, glutaraldehyde, and mineral trioxide aggregate (MTA) as pulpotomy medicaments in primary molars. Materials and Methods: This was a perspective randomized clinical trial. A total of 90 molars from 42 children aged 4–8 years were selected for pulpotomy procedure. Teeth were randomly divided into three equal groups of 30 teeth each. Teeth in Group I were intended to be treated with ferric sulfate, Group II were intended to be treated with buffered glutaraldehyde and Group III with MTA. All the molars were evaluated clinically at 24 h and both clinically and radio graphically at 1, 3, and 6 months. The observations were statistically analyzed using Chi-square test and Fisher's exact test. Results: After 1 month, there was no clinical finding observed in all the three groups. At 3 months postoperative evaluation, 13.3% of teeth in Group I and 12.5% of teeth in Group II had mobility. At 6 months interval, pain and sinus formation each was noted in 9.1% of primary teeth in Group I while periodontal ligament widening was reported in 66.7% of teeth in Group I and 85.7% of teeth in Group II. Conclusion: MTA exhibited overall best results as pulpotomy agent for primary molars followed by 15.5% ferric sulfate, whereas 2% buffered glutaraldehyde was found to be least effective as a pulpotomy agent.
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Affiliation(s)
- Prachi Goyal
- Department of Pedodontics, MM College of Dental Sciences and Research, Mullana, Haryana, India
| | - I K Pandit
- Department of Pedodontics, DAV Dental College, Yamuna Nagar, Haryana, India
| | - Neeraj Gugnani
- Department of Pedodontics, DAV Dental College, Yamuna Nagar, Haryana, India
| | - Monica Gupta
- Department of Pedodontics, DAV Dental College, Yamuna Nagar, Haryana, India
| | - Richa Goel
- Department of Public Health Dentistry, MM College of Dental Sciences and Research, Mullana, Haryana, India
| | - Ramandeep Singh Gambhir
- Department of Public Health Dentistry, Rayat and Bahra Dental College and Hospital, Mohali, Punjab, India
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Rajasekharan S, Martens LC, Vandenbulcke J, Jacquet W, Bottenberg P, Cauwels RGEC. Efficacy of three different pulpotomy agents in primary molars: a randomized control trial. Int Endod J 2016; 50:215-228. [DOI: 10.1111/iej.12619] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2015] [Accepted: 02/08/2016] [Indexed: 11/28/2022]
Affiliation(s)
- S. Rajasekharan
- Department of Paediatric Dentistry and Special Care; PAECOMEDIS Research Cluster; Ghent University; Ghent Belgium
| | - L. C. Martens
- Department of Paediatric Dentistry and Special Care; PAECOMEDIS Research Cluster; Ghent University; Ghent Belgium
| | - J. Vandenbulcke
- Department of Paediatric Dentistry and Special Care; PAECOMEDIS Research Cluster; Ghent University; Ghent Belgium
| | - W. Jacquet
- Faculty of Medicine and Pharmacy; MOND-EDWE; Vrije Universiteit Brussel; Brussel Belgium
| | - P. Bottenberg
- Department of Oral Health Sciences; Vrije Universiteteit Brussel; Brussel Belgium
| | - R. G. E. C. Cauwels
- Department of Paediatric Dentistry and Special Care; PAECOMEDIS Research Cluster; Ghent University; Ghent Belgium
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Abstract
The aim of this paper was to review the history and the scientific literature published on pulpotomy medicaments and to present the findings of these studies. The review showed that pulpotomy of primary teeth has been treated with many different techniques and medicaments, that some of these approaches are controversial and that their results have presented variables of success rates in term of clinical, radiographic and histologic observation. It is important that all clinicians, particularly for pediatric dentists, be up to date with the recent trends in this area of dental treatment for children.
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Affiliation(s)
- Yousef H Al-Dlaigan
- Program Director Postgraduate Pediatric Dentistry; Associate Professor Department of Pediatric Dentistry and Orthodontics, Division of Pediatric Dentistry, College of Dentistry, King Saud University PO BOX 60169, Riyadh 11545, Saudi Arabia, Phone: 0114677228, e-mail:
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Evidence of pulpotomy in primary teeth comparing MTA, calcium hydroxide, ferric sulphate, and electrosurgery with formocresol. Eur Arch Paediatr Dent 2015; 16:303-12. [DOI: 10.1007/s40368-015-0174-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2014] [Accepted: 01/21/2015] [Indexed: 10/23/2022]
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Fernandes AP, Lourenço Neto N, Teixeira Marques NC, Silveira Moretti AB, Sakai VT, Cruvinel Silva T, Andrade Moreira Machado MA, Marchini Oliveira T. Clinical and radiographic outcomes of the use of Low-Level Laser Therapy in vital pulp of primary teeth. Int J Paediatr Dent 2015; 25:144-50. [PMID: 24974864 DOI: 10.1111/ipd.12115] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
AIM This study aimed to compare the clinical and radiographic effectiveness of Low Level Laser Therapy in vital pulp of human primary teeth. METHODS Sixty mandibular primary molars of children aged between 5-9 years were assigned into four groups: Diluted Formocresol (FC), Calcium Hydroxide (CH), Low Level Laser Therapy (LLLT) and Calcium Hydroxide preceded by Low Level Laser Therapy (LLLT + CH). The clinical and radiographic evaluations were performed at 6, 12 and 18 post-operative months. RESULTS All the groups studied were successful in the clinical evaluation over the follow-up period. At 6 months, the radiographic success rate for FC group was 100%, 60% for CH group, 80% for LLLT group and 85.7% for LLLT + CH group. After 12 months, the radiographic success rate was 100% for FC group, 50% for CH group, 80% for LLLT group and 78.6% for LLLT + CH group. At the 18 months follow-up, 100% of the FC group, 66.7% of CH group, 73.3% of the LLLT group and 75% of the LLLT + CH group. CONCLUSION These findings suggest that Low Level Laser Therapy may be considered as an adjuvant alternative for vital pulp therapy on human primary teeth. Low Level Laser Therapy preceding the use of calcium hydroxide showed satisfactory results.
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Affiliation(s)
- Ana Paula Fernandes
- Department of Pediatric Dentistry, Orthodontics and Public Health, Bauru School of Dentistry, University of São Paulo, São Paulo, Brazil
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Lourenço Neto N, Marques NCT, Fernandes AP, Rodini CO, Sakai VT, Abdo RCC, Machado MAAM, Santos CF, Oliveira TM. Immunolocalization of dentin matrix protein-1 in human primary teeth treated with different pulp capping materials. J Biomed Mater Res B Appl Biomater 2015; 104:165-9. [PMID: 25678029 DOI: 10.1002/jbm.b.33379] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2014] [Revised: 11/21/2014] [Accepted: 01/09/2015] [Indexed: 01/25/2023]
Abstract
The aim of this study was to evaluate the immunolocalization of dentin matrix protein (DMP)-1 in human primary teeth treated with different pulp capping materials. Twenty-five primary molars were divided into the following groups: formocresol (FC), calcium hydroxide (CH), mineral trioxide aggregate (MTA), corticosteroid/antibiotic solution + CH (O + CH), and Portland cement (PC), and all received conventional pulpotomy treatment. The teeth at the regular exfoliation period were extracted for histological analysis and immunolocalization of DMP-1. Statistical analysis was performed using the χ(2) test (p < 0.05). Histological analysis revealed statistically significant differences in the comparison among the groups through the use of a score system regarding the presence of hard tissue barrier, odontoblastic layer, and internal resorption, but not regarding pulp calcification. Immunohistochemical analysis showed immunostaining for DMP-1 in groups CH, MTA, O + CH, and PC. Internal resorption was observed in the groups FC and CH. MTA and PC showed pulp repair without inflammation and with the presence of hard tissue barrier. DMP-1 immunostaining was higher for MTA and PC, confirming the reparative and bioinductive capacity of these materials.
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Affiliation(s)
- Natalino Lourenço Neto
- Department of Pediatric Dentistry, Orthodontics and Public Health, Bauru School of Dentistry, University of São Paulo, Bauru, São Paulo, Brazil
| | - Nádia C T Marques
- Department of Pediatric Dentistry, Orthodontics and Public Health, Bauru School of Dentistry, University of São Paulo, Bauru, São Paulo, Brazil
| | - Ana Paula Fernandes
- Department of Pediatric Dentistry, Orthodontics and Public Health, Bauru School of Dentistry, University of São Paulo, Bauru, São Paulo, Brazil
| | - Camila O Rodini
- Department of Biological Sciences, Bauru School of Dentistry, University of São Paulo, Bauru, São Paulo, Brazil
| | - Vivien T Sakai
- Department of Clinics and Surgery, Federal University of Alfenas, Alfenas, Minas Gerais, Brazil
| | - Ruy Cesar C Abdo
- Department of Pediatric Dentistry, Orthodontics and Public Health, Bauru School of Dentistry, University of São Paulo, Bauru, São Paulo, Brazil
| | - Maria Aparecida A M Machado
- Department of Pediatric Dentistry, Orthodontics and Public Health, Bauru School of Dentistry, University of São Paulo, Bauru, São Paulo, Brazil
| | - Carlos F Santos
- Department of Biological Sciences, Bauru School of Dentistry, University of São Paulo, Bauru, São Paulo, Brazil
| | - Thais M Oliveira
- Department of Pediatric Dentistry, Orthodontics and Public Health, Bauru School of Dentistry, University of São Paulo, Bauru, São Paulo, Brazil
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Halperson E, Moss D, Tickotsky N, Weintraub M, Moskovitz M. Dental pulp therapy for primary teeth in children undergoing cancer therapy. Pediatr Blood Cancer 2014; 61:2297-301. [PMID: 25214367 DOI: 10.1002/pbc.25227] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2014] [Accepted: 07/29/2014] [Indexed: 12/11/2022]
Abstract
BACKGROUND Childhood cancer treatment negatively affects the immune system, increasing the risk for bacteremia and septicemia. As the oral cavity is a major entry portal for pathogens into the bloodstream dental care in such children tends to be radical, favouring tooth extraction over less drastic treatments such as pulpotomy, the amputation of infected dental pulp. The present study aimed to compare pulpotomy treatment success rate in children with cancer receiving immunosuppressive therapy with that of healthy children, and investigate if unsuccessful pulpotomy treatment in oncologic patients may lead to systemic complications. PROCEDURE Twenty-six medical records of children from a paediatric oncology referral centre who had dental pulpotomy treatment (in 41 teeth) while receiving active cancer care during the years 2006-2012 were compared with records of 41 randomly selected healthy children who had undergone pulpotomy treatment (41 teeth) in the same institute during these years. Clinical and radiographic data were collected during treatments and at the end of the follow-up period (six months post dental treatment). RESULTS No statisticaly significant difference was found between pulpotomy success rate amongst the two groups. Treatments success rates in the study and control groups were 82.9% (± 5.9) and 90.2% (± 4.7), respectively. No patient in the study group suffered from sepsis from a dental origin during follow-up period. CONCLUSIONS Pulpotomy in paediatric cancer patients did not increase the risk for bacteremia or systemic complications from oral origin. We therefore recommend the re-evaluation of the current protocol for treating paediatric oncology patients.
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Affiliation(s)
- Elinor Halperson
- Department of Pediatric Dentistry, the Hebrew University - Hadassah School of Dental Medicine, Jerusalem, Israel
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Marques NCT, Neto NL, Rodini CDO, Fernandes AP, Sakai VT, Machado MAAM, Oliveira TM. Low-level laser therapy as an alternative for pulpotomy in human primary teeth. Lasers Med Sci 2014; 30:1815-22. [DOI: 10.1007/s10103-014-1656-7] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2014] [Accepted: 09/09/2014] [Indexed: 11/29/2022]
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Primary molar pulpotomy: A systematic review and network meta-analysis. J Dent 2014; 42:1060-77. [DOI: 10.1016/j.jdent.2014.02.001] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2013] [Revised: 01/31/2014] [Accepted: 02/01/2014] [Indexed: 11/20/2022] Open
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De Coster P, Rajasekharan S, Martens L. Laser-assisted pulpotomy in primary teeth: a systematic review. Int J Paediatr Dent 2013; 23:389-99. [PMID: 23171469 DOI: 10.1111/ipd.12014] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
OBJECTIVE The purpose of this systematic review was to identify high-quality articles comparing laser with conventional pulpotomy procedures, and to assess whether laser treatment may offer an appreciable benefit over conventional approaches. METHODS A systematic search was implemented for MEDLINE, WEB of SCIENCE and Cochrane's CENTRAL databases (1980-2012) to identify eligible studies. Two reviewers independently assessed the methodological quality of the articles (Κ = 0.89) using specific study design-related quality assessment forms (Dutch Cochrane Collaboration). RESULTS Seven articles met the inclusion criteria, of which five randomized control trials (RCT) and two case series (CS), involving Nd:YAG, Er:YAG, CO₂ and 632/980 nm diode lasers. Although heterogeneity between pulpotomy studies was high, odds ratios (OR) were generally <1, indicating that laser is less successful than conventional pulpotomy techniques. CONCLUSION Given the paucity and high heterogeneity of high-quality articles, general recommendations for the clinical use of laser in pulpotomy in primary teeth can yet not be formulated.
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Affiliation(s)
- Peter De Coster
- Oral Biology, Dental School, Ghent University, Ghent, Belgium
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