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Zarabadi MS, Firoozi P, Basir Shabestari S, Maleki A, Nazemi Salman B. 3Mixtatin versus MTA in pulp therapy of primary teeth: a systematic review and meta-analysis of current randomized controlled trials. Evid Based Dent 2024; 25:111-112. [PMID: 38448571 DOI: 10.1038/s41432-024-00987-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 01/15/2024] [Indexed: 03/08/2024]
Abstract
AIM 3Mixtatin (a combination of Metronidazole, Minocycline, and Ciprofloxacin along with statins) is a novel biomaterial in pulp therapy, while Mineral Trioxide Aggregate (MTA) is considered the gold standard in endodontics. This study aimed to compare the clinical and radiographic success rates of MTA and 3Mixtatin in pulp therapy of primary teeth. METHODS AND MATERIALS MEDLINE (PubMed), CENTRAL, Web of Science, Scopus, ProQuest databases, and Google Scholar were searched to identify randomized controlled trials (RCTs) on pulp therapy with 3Mixtatin and MTA in primary teeth, published up to February 2023. It should be noted that the protocol was previously registered in the International Prospective Register of Systematic Reviews (PROSPERO; CRD42021243626). RCTs were assessed independently by two researchers in terms of eligibility and quality. Data extracted and tabulated. The Cochrane Risk of Bias (RoB-2) tool was used to assess the risk of bias. The effect sizes were evaluated utilizing risk ratios (RRs). The heterogeneity investigation was conducted utilizing I² measurement at α = 0.10. RESULTS Out of 86 retrieval records, four articles met the inclusion criteria. Based on clinical and radiographic outcomes, the application of 3Mixtatin in the pulp therapy of primary teeth was as successful as MTA in 12 months (Clinical RR = 1.087 | Radiographic RR = 2.132). The RoB-2 tool showed a low risk of bias in all included RCTs. CONCLUSION The limited evidence showed the clinical and radiographic efficacy of 3Mixtatin as a potential alternative to MTA. Further empirical research with larger sample sizes and strict methodology will be essential to substantiate this assertion.
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Affiliation(s)
- Mobina Sadat Zarabadi
- Department of Pediatric Dentistry, School of Dentistry, Zanjan University of Medical Sciences, Zanjan, Iran
| | | | - Samira Basir Shabestari
- Department of Oral Medicine, School of Dentistry, Firoozgar Clinical Research Development Center, Iran University of Medical Sciences, Tehran, Iran
| | - Azam Maleki
- Social Determinants of Health Research Center, Health and Metabolic Diseases Research Institute, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Bahareh Nazemi Salman
- Department of Pediatric Dentistry, School of Dentistry, Zanjan University of Medical Sciences, Zanjan, Iran.
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Almarji W, Laflouf M, Tolibah YA. Evaluation of the modified 3Mix-Simvastatin combination in non-instrumental endodontic therapy of necrotic primary molars: A two-arm randomized controlled trial. Clin Exp Dent Res 2024; 10:e860. [PMID: 38433296 PMCID: PMC10909793 DOI: 10.1002/cre2.860] [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: 07/03/2023] [Revised: 01/27/2024] [Accepted: 01/31/2024] [Indexed: 03/05/2024] Open
Abstract
OBJECTIVE This study aimed to assess the clinical and radiographic outcomes of non-instrumentation endodontic treatment (NIET) using a modified antibiotic mix of cefixime, ciprofloxacin and metronidazole with simvastatin (an anti-inflammatory, bone regeneration drug) on necrotic primary molars compared to conventional pulpectomy to help preservation of necrotic primary teeth until its natural exfoliation. MATERIALS AND METHODS Forty mandibular primary second molars with necrotic pulp tissue from 38 healthy patients aged between 4 and 8 years were randomly assigned to two groups with a 1:1 allocation ratio. Group A teeth underwent conventional root canal treatment. The procedure involved a two-visit approach, employing k-files and h-files during the initial visit, followed by the application of calcium hydroxide paste as canal dressing between visits, while Group B teeth were treated with 3Mixtatin. All teeth were clinically evaluated after 1, 3, 6, and 12 months, and radiographically at 3, 6, and 12 months. Two external examiners assessed the results. Data analysis was conducted using a chi-square test at a 0.05 significance level. RESULTS At the end of the follow-up interval, 90% of teeth in each group exhibited no clinical signs or symptoms. Additionally, inter-radicular radiolucency healing occurred in 75% of cases in the NIET group and 89.5% in the conventional pulpectomy group. However, no statistically significant difference was found between the two groups. CONCLUSION NIET using 3Mixtatin seems to be a good alternative choice to conventional pulpectomy, offering a less complex treatment approach that may help avoid the complications associated with traditional pulpectomy and could be suitable for teeth with shorter roots.
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Affiliation(s)
- Walaa Almarji
- Department of Pediatric Dentistry, Faculty of DentistryDamascus UniversityDamascusSyria
| | - Mohannad Laflouf
- Department of Pediatric Dentistry, Faculty of DentistryDamascus UniversityDamascusSyria
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Alrayes N, Almaimouni Y, Tounsi A, Tarabzouni K, Alonaizan F, Salem Ibrahim M. The effect of an antibacterial mixture and non-instrumentation endodontic treatment in primary teeth: A systematic review and meta-analyses. Saudi Dent J 2023; 35:575-588. [PMID: 37823084 PMCID: PMC10562132 DOI: 10.1016/j.sdentj.2023.06.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 06/06/2023] [Accepted: 06/07/2023] [Indexed: 10/13/2023] Open
Abstract
Studies assessing the clinical and radiographic success of LSTR in terms of the presence of pain, mobility, swelling, fistula/sinus tract, interradicular radiolucency, and root resorption have not been performed. We therefore performed a systematic review with the aim of evaluating the effectiveness of lesion sterilization and tissue repair (LSTR), using three antibacterial mixtures (3Mix), in treating primary teeth. Well-defined search strategies developed for four electronic databases, Web of Science, OVID, PubMed, and Scopus, were used in this study. Two independent reviewers selected relevant articles from 3,232 studies by screening titles and abstracts. Based on the inclusion criteria, 25 articles were selected. Eight analyses of clinical and radiographic results were conducted based on 6, 12, 18, and 24-month follow-up intervals. Data extraction and quality appraisal were performed by three independent reviewers. The composition of antibiotic mixtures used for LSTR varied substantially, with inconsistent radiographic and clinical success rates across the included studies. A quantitative grouping of the studies showed no significant differences between 3Mix and the control medicaments regarding radiographical and clinical success (p-value > 0.05). The available evidence on different LSTR using 3Mix is scarce, and the study findings were inconsistent. Therefore, additional clinical trials on 3Mix with different compositions are needed.
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Affiliation(s)
- Nabras Alrayes
- College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam 31441, Saudi Arabia
| | - Yara Almaimouni
- Department of Restorative Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam 34212, Saudi Arabia
| | - Abrar Tounsi
- Department of Periodontics and Community Dentistry, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | | | - Faisal Alonaizan
- Department of Restorative Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam 34212, Saudi Arabia
| | - Maria Salem Ibrahim
- Department of Preventive Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam 34212, Saudi Arabia
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Goel N, Kumar A, Singhal R, Jha S, Namdev R, Rani R. Comparative Evaluation of Chlorhexidine Polymer Scaffold, 3Mixtatin, and Formocresol for Vital Primary Pulp Therapy: A Randomized 6-month Clinical Study. Int J Clin Pediatr Dent 2023; 16:478-482. [PMID: 37496952 PMCID: PMC10367291 DOI: 10.5005/jp-journals-10005-2615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/28/2023] Open
Abstract
Introduction The study was performed to evaluate and compare the clinical and radiographic efficacy of chlorhexidine (CHX) polymer scaffold, 3Mixtatin, and formocresol for vital primary pulp therapy-a randomized clinical study. Materials and methods A total of 120 primary molars were included from children aged between 6 and 8 years in this randomized clinical study based on inclusion and exclusion criteria and were randomly allocated into three groups (group I-CHX polymer scaffold, group II-3Mixtatin, and group III-formocresol. Pulpotomy was performed in a vital cariously exposed primary tooth with healthy periodontium where their retention is more beneficial than extraction. Subjects were followed up at 1, 3, and 6 months for clinical and radiographic evaluations. Results At 6 months of follow-up, the overall success rate of pulpotomy in groups I, II, and III was 56.41, 71.05, and 60.52% in each group, respectively. Nonsignificant difference (p > 0.05) was seen during intergroup comparison. Conclusion However, among the three materials used in this study, 3mixtatin comparatively had better results. How to cite this article Goel N. Comparative Evaluation of Chlorhexidine Polymer Scaffold, 3Mixtatin, and Formocresol for Vital Primary Pulp Therapy: A Randomized 6-month Clinical Study. Int J Clin Pediatr Dent 2023;16(3):478-482.
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Affiliation(s)
- Nancy Goel
- Department of Pedodontics & Preventive Dentistry, Post Graduate Institute of Dental Sciences, Rohtak, Haryana, India
| | - Arun Kumar
- Department of Pedodontics & Preventive Dentistry, Post Graduate Institute of Dental Sciences, Rohtak, Haryana, India
| | - Ruchi Singhal
- Department of Pedodontics & Preventive Dentistry, Post Graduate Institute of Dental Sciences, Rohtak, Haryana, India
| | - Shruti Jha
- Department of Pedodontics & Preventive Dentistry, Post Graduate Institute of Dental Sciences, Rohtak, Haryana, India
| | - Ritu Namdev
- Department of Pedodontics & Preventive Dentistry, Post Graduate Institute of Dental Sciences, Rohtak, Haryana, India
| | - Reena Rani
- Department of Pedodontics & Preventive Dentistry, Post Graduate Institute of Dental Sciences, Rohtak, Haryana, India
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Hassanpour S, Aminabadi NA, Rahbar M, Erfanparast L. Comparison between the Radiographic and Clinical Rates of Success for TheraCal and MTA in Primary Tooth Pulpotomy within a 12-Month Follow-Up: A Split-Mouth Clinical Trial. BIOMED RESEARCH INTERNATIONAL 2023; 2023:8735145. [PMID: 37124935 PMCID: PMC10132897 DOI: 10.1155/2023/8735145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Revised: 08/09/2022] [Accepted: 08/16/2022] [Indexed: 05/02/2023]
Abstract
Background The present study was conducted for contrasting the efficacy of TheraCal and MTA for primary molar pulpotomy. Methods During the current split-mouth randomized clinical trial, 90 bilateral primary molars from 45 healthy 5- to 8-year-old children were pulpotomized using TheraCal in one bilateral tooth and MTA in the other, randomly. Glass ionomer (GI) was used to cover these materials. Then, the treated teeth were restored with stainless steel crowns (SSC) and followed up clinically and radiographically at months 6 and 12 after treatment for any pulpotomy failure indications. Finally, data were analyzed by chi-square test considering p value < 0.05 as statistically significant. Results Among 82 teeth available at the final follow-up session, the total success rates were 98.1% and 99.3% for TheraCal and MTA, respectively, showing no significant difference between the two groups (p > 0.05). Conclusion TheraCal can be used as an alternative material for pulpotomy of primary teeth instead of MTA.
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Affiliation(s)
- Sedigheh Hassanpour
- Department of Pediatric Dentistry, School of Dentistry, Bandar Abbas University of Medical Sciences, Bandar Abbas, Iran
| | - Naser Asl Aminabadi
- Department of Pediatric Dentistry, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mahdi Rahbar
- Department of Restorative Dentistry, School of Dentistry, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Leila Erfanparast
- Department of Pediatric Dentistry, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran
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Ildeş GÇ, Sezgin BI, Vieira AR, Mentes A. A randomized clinical trial of hyaluronic acid gel pulpotomy in primary molars with 1 year follow-up. Acta Odontol Scand 2022; 80:273-280. [PMID: 34752723 DOI: 10.1080/00016357.2021.1998612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVE This randomized clinical study aimed to evaluate the success of hyaluronic acid (HA) as a pulpotomy medicament of human primary molars and to compare it with formocresol (FC) and ferric sulphate (FS) pulpotomy treatments up to 12 months. MATERIALS AND METHODS The study was conducted with 130 primary molars of 44 children. The ethical approval and registration to clinical trials (No: NCT04115358) were completed. After the removal of all the coronal pulp tissue, a 0.5% HA gel, or a FC, or a 20% FS solution were applied randomly to the radicular pulp tissues of the primary molars. Then, the pulp chambers were filled with a zinc oxide eugenol cement and restored either with a composite filling material or with a stainless-steel crown. The treatment success rates of the 3 groups were followed and compared clinically and radiographically at 1st-, 3rd-, 6th- and 12th-months. RESULTS Primary molars treated with FC, FS and HA dressings were clinically successful 77.5%, 86.8% and 87.5% respectively after 12th-month follow-up (p > .05). Radiographic successes of FC, FS and HA groups were lower than clinical successes (57.6%, 68.8%, 57.9% respectively at the 12th-month) but the difference between the groups was not statistically significant (p > .05). Equivalence analysis assuming not more than 10% difference between the materials suggested that HA was not inferior to FC or FS. CONCLUSIONS Within the limitations of this study, our randomized clinical trial shows that HA is a promising pulpotomy medicament in primary molars. However, further studies are justified to further improve the HA material success.
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Affiliation(s)
- Gökçe Çiçek Ildeş
- Department of Paediatric Dentistry, Faculty of Dentistry, Marmara University, Istanbul, Turkey
| | - Batın Ilgıt Sezgin
- Department of Pediatric Dentistry, Faculty of Dentistry, Istanbul Kent University, Istanbul, Turkey
| | - Alexandre Rezende Vieira
- Department of Oral and Craniofacial Sciences, School of Dental Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Ali Mentes
- Department of Paediatric Dentistry, Faculty of Dentistry, Marmara University, Istanbul, 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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Tseveenjav B, Furuholm J, Mulic A, Valen H, Maisala T, Turunen S, Varsio S, Auero M, Tjäderhane L. Survival of primary molars with pulpotomy interventions: public oral health practice-based study in Helsinki. Acta Odontol Scand 2021; 79:636-641. [PMID: 34087081 DOI: 10.1080/00016357.2021.1928747] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVES To assess long-term survival of pulpotomized primary molars and factors related to the survival of the teeth. MATERIALS AND METHODS This retrospective longitudinal study was based on electronic dental health records of children who attended public health service. Eligible children were <12 years and had a pulpotomy procedure code in their dental treatment history. Data were obtained in the period between 2002 and 2016. Chi-squared test, t-test, and one-way ANOVA were used to assess for statistical differences. Kaplan-Meier analyses were performed to create survival estimates, and the log-rank test was performed to compare differences in survival distributions. A multivariate Cox regression was conducted, and hazard ratios were calculated to estimate the hazard rate for failure. RESULTS Of interventions, 40% were registered in children 3-6 years of age; 56% were boys. Mean estimated survival of such molars was 82 months (SEM = 0.6) and differed by dental operator's work setting and choice of restorative materials used after pulpotomy intervention. Using a stainless steel crown (SSC) to restore pulp-intervened primary molars had the strongest effect on survival (111 months with SEM = 1.8), followed by if the intervention was performed by a specialist or specializing dentist in paediatric dentistry (99 months with SEM = 2.6). CONCLUSIONS The estimated survival time of pulpotomized primary molars is affected by dental operator-related factors, which should be considered in management of extensively carious primary molars of paediatric patients, both at the clinical and organizational decision-making levels. An increased focus on the use of SSC is recommended to be in the learning objectives of dental education programs.
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Affiliation(s)
- Battsetseg Tseveenjav
- Department of Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Department of Social Services and Health Care, City of Helsinki, Oral Health Care, Helsinki, Finland
- Nordic Institute of Dental Materials (NIOM), Oslo, Norway
- Department of Maxillofacial Surgery, Päijät-Häme Central Hospital, Päijät-Häme Joint Authority for Health and Wellbeing, Lahti, Finland
| | - Jussi Furuholm
- Department of Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Nordic Institute of Dental Materials (NIOM), Oslo, Norway
| | - Aida Mulic
- Nordic Institute of Dental Materials (NIOM), Oslo, Norway
| | - Håkon Valen
- Nordic Institute of Dental Materials (NIOM), Oslo, Norway
| | - Tuomo Maisala
- Department of Social Services and Health Care, City of Helsinki, Oral Health Care, Helsinki, Finland
| | - Seppo Turunen
- Department of Social Services and Health Care, City of Helsinki, Oral Health Care, Helsinki, Finland
| | - Sinikka Varsio
- Department of Social Services and Health Care, City of Helsinki, Oral Health Care, Helsinki, Finland
| | - Merja Auero
- Department of Health, Ministry of Social Affairs and Health, Helsinki, Finland
| | - Leo Tjäderhane
- Department of Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Research Unit of Oral Health Sciences and Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
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Jha S, Goel N, Dash BP, Sarangal H, Garg I, Namdev R. An Update on Newer Pulpotomy Agents in Primary Teeth: A Literature Review. JOURNAL OF PHARMACY AND BIOALLIED SCIENCES 2021; 13:S57-S61. [PMID: 34447043 PMCID: PMC8375955 DOI: 10.4103/jpbs.jpbs_799_20] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Revised: 12/28/2020] [Accepted: 12/29/2020] [Indexed: 11/29/2022] Open
Abstract
Primary molars with asymptomatic reversible pulpitis are commonly treated by pulpotomy procedure. Different pulpotomy materials used so far for pulpotomy that have been mentioned in the literature have been included in this article. This literature review includes all medicaments including natural alternatives. Many significant medicaments with their success rates have been mentioned in this paper. To increase the therapeutic success of pulpotomy procedure, it is necessary to identify a novel effective and preferably natural pulpotomy medicament.
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Affiliation(s)
- Shruti Jha
- Department of Paedodontics and Preventive Dentistry, Post Graduate Institute of Dental Sciences, Rothak, Haryana, India
| | - Nancy Goel
- Department of Orthodontics and Dentofacial Orthopedics, Kalinga Institute of Dental Sciences, KIIT Deemed to be University, Bhubaneswar, Odisha, India
| | - Bhagabati Prasad Dash
- Department of Paedodontics and Preventive Dentistry, Post Graduate Institute of Dental Sciences, Rothak, Haryana, India
| | - Heena Sarangal
- Department of Paedodontics and Preventive Dentistry, Post Graduate Institute of Dental Sciences, Rothak, Haryana, India
| | - Ishika Garg
- Department of Paedodontics and Preventive Dentistry, Post Graduate Institute of Dental Sciences, Rothak, Haryana, India
| | - Ritu Namdev
- Department of Paedodontics and Preventive Dentistry, Post Graduate Institute of Dental Sciences, Rothak, Haryana, India
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Aminabadi NA, Asl Aminabadi N, Jamali Z, Shirazi S. Primary tooth pulpectomy overfilling by different placement techniques: A systematic review and meta-analysis. J Dent Res Dent Clin Dent Prospects 2020; 14:250-261. [PMID: 33575016 PMCID: PMC7867685 DOI: 10.34172/joddd.2020.043] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Accepted: 10/12/2020] [Indexed: 11/23/2022] Open
Abstract
Background. This study was conducted to investigate root canal overfilling with different material placement techniques in primary teeth. Methods. A systematic search was undertaken by searching PubMed/MEDLINE and Scopus for English language peer-reviewed articles published until February 2018 that reported primary tooth pulpectomy overfilling. Two reviewers independently screened and identified studies in terms of the selection criteria and independently collected the data using a specially designed data extraction form. The overfilling rate was the primary summary measure. The weighted pooled overfilling rates were estimated by random-effects meta-analysis. Results. Twenty clinical and four in vitro studies met the eligibility criteria. In the clinical studies, the pooled overfilling rate for zinc oxide-eugenol (ZOE) was 23.3% with a lentulo spiral mounted on a handpiece, 22.7% with a hand-held lentulo spiral, and 17% with a plugger. The pooled overfilling rate for calcium hydroxide-based materials was 16.7% with a lentulo spiral mounted on a handpiece, 14.7% with a hand-held lentulo spiral, 19.6% with a syringe, and 25.7% with a plugger. In the in vitro studies, neither individual overfilling rates nor two-by-two comparisons were subjected to meta-analysis because of an inadequate number of studies. Conclusion. The lowest overfilling rate in the clinical studies was related to plugger and handheld lentulo spiral techniques for ZOE and calcium hydroxide-based materials, respectively.
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Affiliation(s)
- Naser Asl Aminabadi
- Department of Pediatric Dentistry, Faculty of Dentistry, Tabriz University of Medical Science, Tabriz, Iran
| | - Nahid Asl Aminabadi
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Zahra Jamali
- Department of Oral Medicine, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Sajjad Shirazi
- Department of Oral Biology, College of Dentistry, University of Illinois at Chicago, Chicago, IL, USA
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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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Vafaei A, Rahbar M, Dadkhah R, Ranjkesh B, Erfanparast L. Children's Pain Perception and Behavioral Feedback during Local Anesthetic Injection with Four Injection Site Preparation Methods. MAEDICA 2020; 14:343-349. [PMID: 32153664 DOI: 10.26574/maedica.2019.14.4.343] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Introduction:An effective pain control significantly contributes to an optimal dental treatment in pediatric dentistry. This study was conducted to compare children's pain perception and behavioral feedback during local anesthetic injection accompanied with counter-irritation, refrigerant, ice precooling or topical benzocaine. Methods:This study was conducted on 99 children who needed dental treatment in bilateral maxillary primary molars by local anesthesia. Subjects were randomly assigned to three groups, in which the injection site was prepared using counter-irritation in group I, ice precooling in group II, and refrigerant spray precooling in group III. In all three groups, 20% benzocaine gel was used in the injection site of opposite quadrant as a control. The perceived pain and behavioral feedback of children during injection were evaluated using the visual analogue scale (VAS) and sound, eye, and motor (SEM) indexes. Sign and Kruskal-Wallis tests were used to analyze data at a significance level of P < 0.05. Results:The perceived pain was significantly lower when using benzocaine compared to the other three methods (P < 0.05). Behavioral feedback of children when using benzocaine was not significantly different from the counter-irritation method (P=1.00). However, behavioral feedback with counter-irritation was significantly better than precooling (P < 0.05). Counter-irritation was significantly more effective than precooling methods in reduction of pain perception and improvement of behavioral feedback (P < 0.05). Conclusions:The perceived pain was significantly lower when the benzocaine method was used. Behavioral feedback was significantly better with benzocaine and counter-irritation methods compared to precooling procedures.
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Affiliation(s)
- Ali Vafaei
- Department of Pediatric Dentistry, Dental School, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mahdi Rahbar
- Department of Operative and Esthetic Dentistry, Dental School, Tabriz University of Medical Sciences, Tabriz, Iran
| | | | - Bahram Ranjkesh
- Department of Dentistry and Oral Health - Section for Prosthetic Dentistry, Dental School, Aarhus University, Aarhus, Denmark
| | - Leila Erfanparast
- Department of Pediatric Dentistry, Dental School, Tabriz University of Medical Sciences, Tabriz, Iran
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