Histological evaluation of enamel matrix derivative as a pulpotomy agent in primary teeth

PURPOSE: The purpose of this study was to evaluate histologically the effect of an enamel matrix derivative as a pulpotomy agent in primary canines. METHODS: Ten carious primary canines among teeth deemed for serial extraction were selected for this study. Emdogain gel was used as the pulp dressing material on the amputated pulp stumps. Teeth were extracted postoperatively after: (1) 1 week; (2) 2 weeks; and (3) 6 months. The extracted teeth were examined histologically to assess the response of the pulp to Emdogain gel after the pulpotomy procedure. RESULTS: Of the teeth extracted after 1 week, the amputated pulpal surface was lined by a thin, nearly continuous cellular layer. Generalized congestion was accompanied by an increase in angiogenesis. Of the teeth extracted after 2 weeks, most showed small islands of dentin-like tissue at different stages of mineralization. Of the teeth extracted after 6 months, several different histological pictures were viewed. Most of the teeth showed coalescing islands of dentin-like tissue trying to bridge the full width of the coronal pulp at the interface between the wounded and unharmed pulp tissue below the amputation site. CONCLUSION: Based on these experiments, Emdogain gel shows promising results as a valuable material for use in pulpotomy procedures, especially in the primary dentition.     

MTA用于年轻恒牙活髓切断的临床观察

目的观察MTA在年轻恒牙活髓切断术中的临床疗效。方法随机选择7-13岁患儿79颗牙根未发育完全而露髓的患牙,随机分为2组,分别用MTA和氢氧化钙作为活髓切断后的盖髓药物,随访观察两组疗效的差异,并采用χ2、U检验作统计学分析。结果MTA组成功率96%,氢氧化钙组成功率71%,两组有显著性差异(P<0.05)。结论MTA是良好的活髓保存药物,用于活髓切断时疗效优于氢氧化钙。     

Clinical long-term evaluation of MTA as a direct pulp capping material in primary teeth

Aim To evaluate the effectiveness of mineral trioxide aggregate (MTA) when used as a pulp capping material in primary teeth. Methodology Clinical follow‐up was performed on 25 symmetrical pairs of primary molars with deep occlusal caries, in 25 patients between the ages of 5 and 8 years. Pulps exposed during cavity preparation were treated by direct pulp capping with MTA or calcium hydroxide, based with resin‐bonded zinc oxide eugenol cement and restored with amalgam. Clinical and radiographic examinations were carried out at 1, 3, 6, 9, 12, 18 and 24 months. Results Twenty‐four‐month clinical and radiographic follow‐ups were carried out on 22 patients. One patient failed to return for evaluation after 1 month, one after 9 months and another after 12 months. During follow‐up, none of the MTA and calcium hydroxide groups exhibited clinical or radiographic failure. Conclusions Mineral trioxide aggregate was found to be as successful as calcium hydroxide when used for direct pulp capping in primary teeth. Further histological investigations are needed to support these findings.     

Partial pulpotomy in young permanent teeth with deep carious lesions

Abstract The material comprised 37 young posterior teeth with deep carious lesions and exposed pulps, treated with partial pulpotomy and dressed with calcium hydroxide. The teeth were divided into two groups. Group 1 consisted of 31 teeth with no clinical or radiographic symptoms before treatment, Group 2 of 6 teeth with temporary pain, widened periodontal space periapically and/or productive osteitis, i.e. increased density of the surrounding alveolar bone. After an observation time of 24 to 140 months (x?= 56 months), healing had occurred in 29 of 31 teeth in Group 1 (93.5%) and in 4 of 6 teeth in Group 2. It was concluded that the present, as well as previously reported results indicate that partial pulpotomy may be an adequate treatment for young permanent molars with a carious exposure, although more studies are needed before the treatment can be recommended for routine clinical use.     

乳牙盖髓剂MTA与新型生物材料Biodentine的比较

目前,牙髓切断术是最常见的乳牙牙髓治疗方法之一,该治疗方法在严格无菌条件下,去除冠部感染牙髓并用盖髓剂覆盖于健康牙髓断面上,达到保留健康活髓的目的.尽管矿物质三氧化物聚集体(MT A)是乳牙牙髓切断术的常用盖髓剂,但其仍有许多缺点.近年出现的新型硅酸钙材料Biodentine(BD)有着优良的机械性能、生物相容性和较好的临床疗效,有望成为MTA的替代品.本文比较了BD和MTA作为盖髓剂的各方面性能及临床疗效等,从而探讨新型材料BD作为乳牙牙髓切断术盖髓剂的应用前景.     

乳牙盖髓剂MTA与新型生物材料Biodentine的比较

目前,牙髓切断术是最常见的乳牙牙髓治疗方法之一,该治疗方法在严格无菌条件下,去除冠部感染牙髓并用盖髓剂覆盖于健康牙髓断面上,达到保留健康活髓的目的.尽管矿物质三氧化物聚集体(MT A)是乳牙牙髓切断术的常用盖髓剂,但其仍有许多缺点.近年出现的新型硅酸钙材料Biodentine(BD)有着优良的机械性能、生物相容性和较好的临床疗效,有望成为MTA的替代品.本文比较了BD和MTA作为盖髓剂的各方面性能及临床疗效等,从而探讨新型材料BD作为乳牙牙髓切断术盖髓剂的应用前景.     

乳牙盖髓剂MTA与新型生物材料Biodentine的比较

目前,牙髓切断术是最常见的乳牙牙髓治疗方法之一,该治疗方法在严格无菌条件下,去除冠部感染牙髓并用盖髓剂覆盖于健康牙髓断面上,达到保留健康活髓的目的.尽管矿物质三氧化物聚集体(MT A)是乳牙牙髓切断术的常用盖髓剂,但其仍有许多缺点.近年出现的新型硅酸钙材料Biodentine(BD)有着优良的机械性能、生物相容性和较好的临床疗效,有望成为MTA的替代品.本文比较了BD和MTA作为盖髓剂的各方面性能及临床疗效等,从而探讨新型材料BD作为乳牙牙髓切断术盖髓剂的应用前景.     

MTA活髓切断术对龋源性露髓恒牙治疗效果的系统评价与meta分析

目的评价MTA活髓切断术治疗龋源性露髓恒牙的疗效。方法通过meta分析的方法,比较MTA和氢氧化钙活髓切断术治疗龋源性露髓恒牙疗效的差异,计算MTA活髓切断术对于可复性牙髓炎组和早期不可复性牙髓炎组平均治疗成功率,研究根尖孔情况和术式对成功率的影响。结果 MTA活髓切断术2年疗效优于氢氧化钙,其可复性牙髓炎组1年、2年和不可复性牙髓炎组1年的成功率均为99%。可复性牙髓炎组中根尖孔闭合和未闭合1年成功率分别为100%vs.99%,2年成功率为97%vs.99%,不可复性牙髓炎组中两者1年成功率分别为99%vs.99%;可复性牙髓炎组中全部和部分冠髓切断术1年成功率为100%vs.99%,2年成功率为99%vs.97%,不可复性牙髓炎组中两者1年成功率为100%vs.87%。结论 MTA活髓切断术优于氢氧化钙。根尖孔未闭合及全部冠髓切断术可能会有利于提高活髓切断术的成功率。     

Evaluation of effectiveness of calcium hydroxide and MTA as pulpotomy agents in permanent teeth: A meta-analysis

AimTo conduct a meta-analysis comparing the effectiveness of traditionally used calcium hydroxide with MTA as pulpotomy agents for permanent teeth.Materials and methodsRandomized Controlled Trials (RCTs) comparing calcium hydroxide and Mineral Trioxide Aggregate as pulpotomy agents for permanent teeth with follow up periods of 6 and 12 months were included in the meta-analysis. A random effects model was used to generate pooled estimates. Odds ratio with a 95% confidence interval was calculated for evaluating the success of pulpotomy with these two agents.ResultsFive studies met the inclusion criteria. Success of pulpotomy using MTA was statistically significant in comparison to calcium hydroxide both at 6 months (OR = 0.31, 95% CI: 0.10–0.96; p = 0.99; I² = 0%) and 12 months (OR = 0.40, 95% CI: 0.16–0.97; p = 0.63; I² = 0%). Value of I² signifies that there was no heterogeneity among the selected studies.ConclusionThis meta-analysis suggests that MTA is a superior material for pulpotomy of cariously exposed permanent teeth. Failure rate of pulpotomies is significantly higher with Calcium hydroxide despite its bactericidal properties.     

Calcium hydroxide pulpotomy for primary teeth: a clinical study

Calcium hydroxide pulpotomies were performed in 17 carious primary mandibular molars. Variables in the pulpotomy procedure were recognized and controlled in an attempt to obtain a more favorable result or end product. The effects of two methods of hemorrhage control were also evaluated. The duration of treatment for the study ranged from three to nine months. Treatment was clinically successful for all 17 teeth. The radiographic evaluations were more favorable for the experimental group than for the control group. Treatment was radiographically successful for 15 teeth, questionable for one tooth, and unsuccessful for one other tooth. The results of this study suggest that the aluminum chloride-calcium hydroxide pulpotomy may be a viable alternative to formocresol pulpotomies in the primary dentition. Although these findings encourage continued research, including a long-term follow-up, a histologic study is indicated.     

不同盖髓材料用于乳磨牙深龋活髓切断术的临床观察

目的　观察在乳磨牙深龋治疗中,矿物三氧化物凝聚体(MTA)与戊二醛用于活髓切断术的临床疗效。方法　选择80例乳磨牙深龋患儿,随机分成2组,治疗组活髓切断术后用MTA盖髓,对照组活髓切断术后用戊二醛盖髓,术后跟踪随访6个月,1年和2年的临床疗效。结果　2组6个月时成功率相近,但1年后及2年后MTA组成功率高于戊二醛组,差异有统计学意义﹙P<0.05﹚。结论　MTA用于乳磨牙活髓切断术远期临床疗效优于戊二醛。     

Histological evaluation of electrosurgery and formocresol pulpotomy techniques in primary teeth in dogs.

The purpose of this study was to compare pulpal and periapical tissue reactions to electrosurgery versus formocresol pulpotomy techniques in the primary teeth of dogs. The study was conducted on 33 primary teeth of three mongrel dogs between the ages of one to three months. Each dog had three teeth treated by Formocresol Pulpotomy with Mechanical Coronal Pulp Removal (FC), three teeth treated by Electrosurgery Pulpotomy with Mechanical Coronal Pulp Removal (ES/MCPR), three teeth treated by Electrosurgery Pulpotomy with Electrosurgical Coronal Pulp Removal (ES/ECPR), and two teeth serving as untreated Controls. Dogs one, two and three were sacrificed performing the pulpotomies at two, four and six weeks, respectively. The pulp, periapical tissue and after surrounding bone were submitted to histological examination and the histological reaction was recorded. The results were fourteen out of 18 unfavorable and zero out of three favorable histological reactions occurred in the FC treated teeth. Six out of 18 unfavorable and one out of three favorable histological reactions occurred in the ES/MCPR treated teeth. Nine out of 18 unfavorable and two out of three favorable histological reactions occurred in the ES/ECPR treated teeth. One out of 18 unfavorable and zero out of three favorable histological reactions occurred in the untreated Control teeth. The conclusion of this study is that of the three experimental groups, the teeth treated by Electrosurgery Pulpotomy with either Mechanical or Electrosurgical Coronal Pulp Removal exhibited less histopathological reaction than the teeth treated by Formocresol Pulpotomy.     

A clinical study of ferric sulfate as a pulpotomy agent in primary teeth.

Pulpotomies were performed on 83 primary molars in 62 patients. Ferric sulfate or formocresol was placed on the pulpal stumps, and teeth were followed for 3-, 6-, and 12-month periods. After the one-year follow-up, 28 of 29 teeth treated with ferric sulfate (FS group) were considered successful and 21 of 27 teeth treated with formocresol (FC group) were judged to be successful. The FS group demonstrated greater combined clinical and radiographic success than the FC group at the one-year recall (P < 0.05). Although the results of this study are promising, further study with longer observation periods is warranted before this technique can be recommended.