The effect of sodium hypochlorite application on the success of calcium hydroxide pulpotomy in primary teeth

Effects of epigallocatechin gallate (EGCG) on the biological properties of human dental pulp stem cells and inflammatory pulp tissue

OBJECTIVE

This study aimed to investigate the effect of epigallocatechin gallate (EGCG) on the proliferation, mineralization, inflammation and hypoxia responses of human dental pulp stem cells (hDPSCs) in vitro and its effect on inflammatory pulp tissue in rats in vivo.

DESIGN

The optimum concentration of EGCG was selected by creating a dose response curve. Expression of odontogenic/osteogenic-related genes and inflammatory cytokines after stimulation with Lipopolysaccharide (LPS) was detected by real-time PCR. Under hypoxic conditions, cell proliferation and expression of reactive oxygen species (ROS) and superoxide dismutase (SOD) were detected.In vivo, the maxillary first molars of SD rats were pulpotomized and stimulated with 5 mg/mL LPS for 30 min. Normal saline and EGCG were used to flush the pulp chamber. After 2 months, samples were removed for micro-CT scanning and HE staining.

RESULTS

CCK-8 assay revealed that 10 μg/mL EGCG had no significant effect on the proliferation of hDPSCs. EGCG inhibited expression of IL-1β, IL-6, and TNF-α. Furthermore, EGCG rescued cell proliferation ability, increased SOD activity and reduced ROS expression under hypoxia.In vivo, reduced inflammatory cell accumulation was observed in the coronal pulp in the EGCG group, while in the control group, diffuse inflammatory cells were observed in the radicular pulp.

CONCLUSION

EGCG had no obvious effects on calcified nodule formation but significantly inhibited the inflammatory response of hDPSCs and inhibited apoptosis of hDPSCs caused by hypoxia injury. In vivo, EGCG exerts inhibitory effects on pulp tissue inflammation.

Clinical and radiographic evaluation of the efficacy of sodium hypochlorite as a haemostatic agent compared with physiologic saline on the success of calcium hydroxide pulpotomies in primary molars: an in vivo study

AIM

To evaluate, via clinical and radiographic assessment; the success of calcium hydroxide pulpotomies with the application of 5% sodium hypochlorite as a haemostatic agent compared with physiologic saline in primary molars and to evaluate if there is improved efficacy of increased concentration of sodium hypochlorite application in calcium hydroxide pulpotomies.

METHODS

Thirty children aged between 3 and 8 years, having at least two vital primary molars (split mouth design) with deep carious lesions with probable exposure of the pulp, were selected. The 60 teeth were randomly allocated to two groups and conventional calcium hydroxide pulpotomies were performed on all selected primary molars in both the groups. A cotton pellet saturated with 5% sodium hypochlorite was applied to teeth as a haemostatic agent in group A (experimental) for 30 s while physiologic saline was used to manage haemorrhage in group B (control). Teeth were restored with preformed metal crowns (PMC) in both the groups after the procedure. Evaluation for clinical and radiological success of calcium hydroxide pulpotomies was performed at baseline, 1, 3, 6 and 12 months follow-up.

RESULTS

Statistical analysis did not show (p > 0.05) significant differences in the clinical and radiological success rates of calcium hydroxide pulpotomies in both the groups at 12 months follow-up.

CONCLUSION

The increased concentration of sodium hypochlorite showed lower success rate in calcium hydroxide pulpotomies when compared to physiologic saline, although this difference was not statistically significant.

Pulpotomia na rede pública em municípios da região norte do Rio Grande do Sul

Objetivo: Avaliar a decisão dos cirurgiões-dentistas frente à utilização da pulpotomia na rede pública em 16 municípios do Rio Grande do Sul, RS. Métodos: O estudo possui desenho transversal, quantitativo, com delineamento descritivo. A amostra não-probabilística, de conveniência, foi formada por 40 cirurgiões-dentistas. A coleta de dados se fez pelo envio de questionários aos profissionais da rede pública, com questões relacionadas à técnica de pulpotomia, e perguntas de relação social. Resultados: os resultados demonstraram que 92,5% (n=37) dos profissionais relataram não realizar tratamento endodôntico no serviço de atendimento público. Em relação à pulpotomia, 52,5% (n=21) realizam a técnica e quanto à técnica ser empregada no serviço público, 77,5% (n=31) relatam que deveria ser empregada. Mais da metade dos profissionais, 67,5% (n=27), responderam que consideram provisória a técnica de pulpotomia. No serviço público em que atuam 57,5% (n=23) não utilizam raio-x. Conclusões: Concluiu-se que um pouco mais da metade dos cirurgiões-dentistas pesquisados realizam a técnica de pulpotomia na rede pública, mesmo sem às vezes possuir as condições ideais para tal, como a ausência de raio-x. Utilizam como substância irrigadora o soro fisiológico e capeamento pulpar o hidróxido de cálcio e acreditando ser viável, porém com caráter provisório.

Comparative Evaluation of Three Different Materials: Mineral Trioxide Aggregate, Triple Antibiotic Paste, and Abscess Remedy on Apical Development of Vital Young Permanent Teeth

Aims

The aim of the study is to compare the success rate of mineral trioxide aggregate (MTA), Triple antibiotic paste, and Abscess remedy in apical development of vital young permanent teeth.

Subjects and Methods

A total of 60 children aged 6-14 years were selected and were randomly divided into three groups, each comprising of 20 children. Group I, Group II, and Group III in which MTA (Pro root), triple antibiotic paste (3Mix MP), and Abscess remedy (Product Dentaire, Switzerland) was used pulpotomy medicament. The children were recalled 1, 6, 9, 12, 18, and 24 months for clinical and radiographic evaluation and were designed as single-blinded randomized clinical trial.

Statistical Analysis Used

Chi-square test.

Results

The follow-up evaluations revealed that 56 teeth appeared to be clinically and radiographically successful at 24 months' postoperative evaluation. Four teeth treated with Abscess remedy reported pain and periapical lesion.

Conclusions

Overall success rate for all the material was 93%, MTA and Triple antibiotic paste have shown 100% success rate, and Abscess remedy has shown 80% success rate.

Immunolocalization of dentin matrix protein-1 in human primary teeth treated with different pulp capping materials

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.

The effectiveness of mineral trioxide aggregate, calcium hydroxide and formocresol for pulpotomies in primary teeth

AIM

To compare the effectiveness of mineral trioxide aggregate (MTA), calcium hydroxide (CH) and formocresol (FC) as pulp dressing agents in carious primary teeth.

METHODOLOGY

Forty-five primary mandibular molars with dental caries in 23 children [AUTHOR QUERY: How many children?] between 5 and 9 years old were treated by a conventional pulpotomy technique. The teeth were randomly assigned to the experimental (CH or MTA) or control (FC) groups. After coronal pulp removal and haemostasis, remaining pulp tissue was covered with MTA paste or CH powder in the experimental groups. In the control group, diluted FC was placed with a cotton pellet over the pulp tissue for 5 min and removed; the pulp tissue was then covered with zinc oxide-eugenol (ZOE) paste. All teeth were restored with reinforced ZOE base and resin modified glass-ionomer cement. Clinical and radiographic successes and failures were recorded at 3, 6, 12, 18 and 24 month follow-up.

RESULTS

Forty-three teeth were available for follow-up. In the FC and MTA groups, 100% of the available teeth were clinically and radiographically successful at all follow-up appointments; dentine bridge formation could be detected in 29% of the teeth treated with MTA. In the CH group, 64% of the teeth presented clinical and radiographic failures detected throughout the follow-up period, and internal resorption was a frequent radiographic finding.

CONCLUSIONS

Mineral trioxide aggregate was superior to CH and equally as effective as FC as a pulpotomy dressing in primary mandibular molars. Internal resorption was the most common radiographic finding up to 24 month after pulpotomies performed with CH.

Importance of the diagnosis in the pulpotomy of immature permanent teeth

Pulpotomy is a conservative therapy performed to remove the inflamed coronal portion of the pulp and preserve the vitality of the remaining radicular pulp. This article reports two cases of immature permanent mandibular molars with clinical signs of pulp vitality and radiographic images of periapical bone rarefaction, which were treated with calcium hydroxide pulpotomy. In Case 1, pulpotomy was performed in a single session, while in Case 2 two sessions were required to complete the treatment. Clinical and radiographic follow up within 13 and 9 months, respectively, showed hard tissue barrier and new bone formation as well as progression of root development. These outcomes are confirmatory that an accurate clinical/radiographic assessment of pulp vitality is of paramount importance for the correct diagnosis and indication of pulpotomy in cases of young permanent teeth with incomplete root formation.