Clinical and Radiographic Success Rates of Pulpotomies in Primary Molars Treated with Formocresol, BiodentineTM, and Endo Repair: A Randomized Clinical Trial

ABSTRACT Objective: To compare the clinical and radiographic success rates of formocresol, BiodentineTM, and Endo Repair agents in primary molars after 12 months. Material and Methods: This randomized double-blind clinical trial was conducted on healthy children referred to the Department of Pediatric Dentistry, Kerman, Iran, in 2018. One hundred twenty children (human primary molar teeth) aged 3-9 years were selected and randomly divided into three interventions (with pulpotomy medicament agents), including formocresol, BiodentineTM, and Endo Repair. All pulpotomized teeth were restored using stainless steel crowns and evaluated clinically and radiographically during a 12-month follow-up. Fisher exact test was used to determine the association of categorical variables and the data were analysed with SPSS 25. Results: All the available teeth in formocresol and BiodentineTM groups obtained clinical success, whereas 62.5% of the Endo Repair group was successful in this regard. Radiographic success rates of the formocresol, BiodentineTM, and Endo Repair groups were 94.7%, 70%, and 28.1% after a 12-month follow-up, respectively. Moreover, pulp canal obliteration was observed in 26.3%, 25%, and 12.5% of the formocresol, BiodentineTM, and Endo Repair groups. Conclusion: This study reported a high rate of clinical success using both BiodentineTM and formocresol pulpotomy techniques. However, the radiographic success rate of formocresol was higher than that of BiodentineTM, and Endo Repair was not considered a suitable pulpotomy medicament agent.

Amniotic Membrane versus Formocresol as Pulpotomy Agents in Human Primary Molars: An in vivo Study

Objective: To determine and compare the efficacy of Amniotic Membrane (AM) as a pulpotomy agent with Formocresol (FC) clinically and radiographically. Material and Methods: 30 deciduous molars warranted for pulpotomy in 24 children (4-9 years) were divided equally into two groups of 15 each. Group1: Amniotic membrane pulpotomy and Group 2: Formocresol pulpotomy, which was followed by placement of glass ionomer cement and stainless steel crown restoration. The patients were recalled after 1, 3, 6 and 9 months for clinical and radiographic evaluation. Fisher's exact test and Mcnemar test were used for statistical analysis. Results: Results indicated both clinically and radiographically amniotic membrane performed at par with formocresol. Conclusion: Amniotic membrane with its regenerative, antibacterial properties and the ability to deliver growth factors has shown promising results comparable to gold standard formocresol when used as a pulpotomy agent and hence can be recommended as an alternative pulpotomy agent.

Comportamento dos tecidos apicais e periapicais de dentes de cães portadores de reação periapical crônica em função da técnica de neutralização do conteúdo séptico-tóxico e do cimento obturador empregado no tratamento endodôntico. Avaliação radiográfica e histopatológica / Apical e periapical tissue response of dog's teeth, with induced periapical lesion, in relation to neutralization techniques and filling methods for endodontic therapy. Histophatologic and radiologic evaluation

O objetivo do presente trabalho foi avaliar radiográfica e histologicamente a reparação apical e periapical de dentes de cães com reação periapical crônica induzida, empregando duas diferentes técnicas de neutralização do conteúdo séptico-tóxico do canal radicular e dois diferentes cimentos obturadores durante o tratamento endodôntico. Foram utilizados canais radiculares de pré-molares superiores e inferiores de cinco cães, os quais foram expostos ao meio bucal por sete dias, sendo, a seguir, realizado o selamento das cavidades oclusais com o objetivo de induzir as lesões periapicais. Após a constatação radiográfica das lesões, foi realizado o tratamento endodôntico. A neutralização foi realizada pelo método mediato, com emprego do tricresol formalina, seguido do preparo biomecânico utilizando líquido de Dakin como solução irrigadora, ou pelo método imediato, no qual foi empregada aa soda clorada durante a irrigação. Para a obturação foram utilizados os cimentos Sealapex ou Fill Canal, definindo os quatro grupos experimentais. Ao final da obturação dos canais radiculares e após 270 dias, foram realizadas radiografias padronizadas para análise radiográfica do reparo das lesões. Decorridos 270 dias após a obturação, os animais foram sacrificados e, após processamento histológico de rotina, os cortes foram corados pelas técnicas de hematoxilina e eosina, tricrômico de Mallory e Brown e Brenn. A análise radiográfica do reparo das lesoes não demonstrou diferença estatística entre as técnicas de neutralizaça ou cimentos empregados. A avaliação histopatológica dos reparos apical e periapical evidenciou que não houve diferença significante entre as técnicas de neutralização do canal radicular. Porém, houve influência significante do cimento obturador, com melhores resultados de reparo apical e periapical nos grupos onde foi empregado o cimento Sealapex. Menor presença bacteriana foi observada nos grupos obturados com o Sealapex

The scope of this study was the radiologic and histologic evaluation of apical and periapical repair, utilizing two different techniques of neutralization and two different sealers during endodontic treatment. It was used upper and lower pre-molar root canals of five dogs, exposed to mouth fluids during seven days and sealed in order to induce periapical lesion. After radiographic verification of periapical lesion, root canal therapy was performed upon different techniques. Neutralization was done on mediate method, utilising tricresol formalin, followed by instrumentation, using sodium hypochlorite at 0,5%, or imediate method using sodium hypochlorite at 4-6%. Filling techniques were done using Sealapex or Fill Canal, stablishing four experimental groups. After root canal filling and after 270 days, standard X-ray was performed to study the periapical lesion repair, aniamls were killed and histotechnique was done using hematoxilin and eosin, Mallory Tricome and Brown and Brenn technique. The radiographic evaluation did not show significant statistical difference in relation to neutralization methods or filling materials. Histopathological evaluation had the same performance in relation to techniques, but the best results were found when Sealapex were utilized. A fewer number of microorganisms were found in Sealapex group