Evaluation of the furcation area permeability of deciduous molars treated by neodymium:yttrium-aluminum-garnet laser or adhesive

Survival analysis of pulpectomy in primary molars performed under dental general anaesthesia: a two-year retrospective study

BACKGROUND

To retrospectively investigate the success rate of primary-molar pulpectomy performed under general anaesthesia and the potential risk factors that affect the 24-month success rate.

METHODS

The case data and two-year follow-up records of children (aged 3-6 years) who received pulpectomy in primary molars performed under general anaesthesia were reviewed and assessed. Potential risk factors included age, gender, decayed-missing-filled teeth, endodontic diagnosis, tooth location, and postobturation sealing of the pulp chamber floor with MTA. With a two-year follow-up period, the outcomes of all the primary molars were classified into success and failure. Survival analysis was used to assess the outcomes. The Kaplan-Meier method was used to analyse the success rate. Univariate and multivariate Cox proportional hazards regression models were used to evaluate the potential risk factors associated with the overall survival of primary molars.

RESULTS

A total of 410 teeth from 163 children (88 boys and 75 girls) were included in this study. The overall two-year success rate was 66.1% for all primary molars. The mean overall survival time for this study was 22.1 (95% CI, 21.73‒22.48) months. Multivariate Cox regression analysis demonstrated that endodontic diagnosis (irreversible pulpitis or periapical periodontitis), tooth location (maxillary or mandibular primary molar), and postobturation sealing of the pulp chamber floor (MTA or no-MTA) were significant risk factors for overall survival in this study (P < .05). The differences in success rates were not statistically significant in terms of age, gender, and decayed-missing-filled teeth (P > .05).

CONCLUSIONS

When compared to teeth diagnosed with irreversible pulpitis, those with periapical periodontitis failed more frequently. Postobturation sealing of the pulp chamber floor with MTA improved the success rate of pulpectomy in primary molars, especially when the inflammation did not spread to the periradicular area.

Three-Dimensional Analysis of the Pulp Chamber and Coronal Tooth of Primary Molars: An In Vitro Study

The anatomical variability of primary molars promotes research to improve clinical restorative activity, forensic identification, and industrial development. The objective was to study the morphology of the pulp chamber and its three-dimensional relationship with the external morphology of the tooth. A total of 151 deciduous molars were collected and subjected to three-dimensional imaging analysis in order to determine dental crown (CV) and pulp chamber (PV) volumes, their ratio (VR), pulp chamber roof (PCR) and pulp chamber floor (PCF) area, the furcation length (FD), and morphological peculiarities. The data were compared using the Kruskal–Wallis test in SPSS 26 software. The statistical analysis determined statistically significant differences between the four groups of molars for all variables. Great anatomical variability was observed, especially in the maxillary first molar, the volumes were higher in the maxillary second molar and the highest risk of furcal perforation was seen in the mandibular first molar. Additionally, mandibular second molars with six pulp horns, and some different density images compatible with accessory canals and pulp stones were found. Based on the findings of this investigation, we confirm the great anatomical variability that exists between the maxillary and mandibular molars.

Comparison of Two Base Materials Regarding Their Effect on Root Canal Treatment Success in Primary Molars with Furcation Lesions

Introduction. The aim of this study was to compare MTA with another base material, IRM, which is generally used on pulpal floor after root canal treatment, regarding their effect on the success of root canal treatment of primary teeth with furcation lesions. Materials and Methods. Fifty primary teeth with furcation lesions were divided into 2 groups. Following root canal treatment, the pulpal floor was coated with MTA in the experimental group and with IRM in the control group. Teeth were followed up considering clinical (pain, pathological mobility, tenderness to percussion and palpation, and any soft tissue pathology and sinus tract) and radiographical (pathological root resorption, reduced size or healing of existing lesion, and absence of new lesions at the interradicular or periapical area) criteria for 18 months. For the statistical analysis, Fisher's exact test and Pearson's chi-square tests were used and a p value of <0.05 was considered to be statistically significant. Results. Although there were no statistically significant differences between two groups in terms of treatment success, lesions healed significantly faster in the MTA group. Conclusion. In primary teeth with furcation lesions, usage of MTA on the pulpal floor following root canal treatment can be a better alternative since it induced faster healing.

An investigation of accessory canals in primary molars - an analytical study

AIM

To evaluate the number, anatomical morphology and patency of accessory canals in the furcation of carious primary molar teeth and to ascertain whether these anatomic variations contribute to endodontic infection.

DESIGN

The accessory canals were observed under radiovisiography or RVG (Phase 1), scanning electron microscopy or SEM (Phase 2) and light microscopy (Phase 3).

RESULTS

The prevalence of accessory canals was 34.3% with a mean ± SD of 0.73 ± 0.980 in Phase 1, 73.3% with a mean ± SD of 3.07 ± 3.151 in Phase 2 and 64.3% with a mean ± SD of 1.68 ± 2.405 in Phase 3. The results observed were Phase 1 vs Phase 2<0.001 (highly significant), Phase 1 vs Phase 3 0.110 (ns) and Phase 2 vs Phase 3<0.001 (highly significant) employing Wilcoxon signed-rank test. The canals were predominantly oval in shape and ranged from 1 μ to 225 μ in diameter. Only 7% canals were observed to be patent.

CONCLUSIONS

Accessory canals may not be the primary cause of transmission of infection in the inter-radicular area of primary molars. Other factors enhancing permeability of the pulpal floor may be of more significance and need evaluation on a larger scale.