RESUMEN
The preservation of deciduous teeth is crucial in pediatric dentistry to maintain normal speech, development, and self-esteem, while also preventing secondary issues like space loss and tooth impaction. Different materials and approaches have been explored over time, ranging from mummification to maintaining pulp vitality and promoting healing. In today's conservative dentistry, techniques like indirect pulp treatment and partial pulpotomy (PP) have gained popularity. Adults diagnosed with irreversible pulpitis due to deep caries often receive root canal therapy (RCT). However, coronal pulpotomy treatment (CPT) has emerged as an affordable alternative for those unable to afford RCT. CPT removes the coronal pulp, allowing the remaining pulp to remain vital. PP and complete pulpotomy are explored as treatments for teeth with signs of irreversible pulpitis. Success depends on eliminating infected tissue, using aseptic techniques, and achieving a tight restorative seal. Materials like MTA have shown favorable outcomes. Direct pulp therapy and PP can effectively preserve vital pulp in primary and young permanent teeth. The choice of pulpotomy material, such as MTA, plays a significant role in success rates.
RESUMEN
Objective: The objective of this study was to determine the most suitable material for indirect pulp treatment (IPT) clinically and to determine the thickness (in mm) and type of tissue in terms of radiodensity (in Hounsfield units [HU]) formed after pulp capping using cone‑beam computed tomography (CBCT) scan. Materials and Methods: A longitudinal interventional single‑blind randomized clinical trial was conducted on 94 children (7–12 years) with a deep carious lesion in one or more primary second molar and permanent first molar without the history of spontaneous pain indicated for indirect pulp capping (IPC) procedure. About 109 teeth were treated using three materials, namely, calcium hydroxide (setting type), glass ionomer cement (Type VII), and mineral trioxide aggregate randomly. The teeth were followed up at an interval of 8 weeks, 6 months, and 1 year for success of IPT as per the American Academy of Pediatric Dentistry clinical criteria. For determining the thickness and type of dentin tissue formed, a CBCT scan was done immediately postoperative and another scan at an interval of 6 months. The scans were compared to evaluate the average thickness of the dentin bridge formed. Results and Conclusions: Success rate for IPC was 96.85%. A significant difference was obtained in the average thickness of reparative dentin at immediate postoperative and 6‑month postoperative values in all three groups suggesting distinct barrier formation. Similar significant findings were obtained in radiodensity of barrier formed (in HU). All three materials were found to be equally suitable as IPC agents suggesting mineral gain.
RESUMEN
OBJECTIVES: To comparatively evaluate the efficacy of photo-activated disinfection (PAD), calcium hydroxide (CH) and their combination on the treatment outcome of indirect pulp treatment (IPT). MATERIALS AND METHODS: Institutional ethical clearance and informed consent of the patients were taken. The study was also registered with clinical registry of India. Sixty permanent molars exhibiting deep occlusal carious lesion in patients with the age range of 18 - 22 yr were included. Clinical and radiographic evaluation and set inclusion and exclusion criteria's were followed. Gross caries excavation was accomplished. In group I (n = 20) PAD was applied for sixty seconds. In group II (n = 20), CH was applied to the remaining carious dentin, while in group III (n = 20), PAD application was followed by CH placement. The teeth were permanently restored. They were clinically and radiographically followed-up at 45 day, 6 mon and 12 mon. Relative density of the remaining affected dentin was measured by 'Radiovisiography (RVG) densitometric' analysis. RESULTS: Successful outcome with an increase in radiographic grey values were observed in all three groups. However, on inter-group comparison, this change was not significant (p > 0.05). CONCLUSIONS: PAD and CH both have equal disinfection efficacy in the treatment of deep carious dentin. PAD alone is as effective for treatment of deep carious lesion as calcium hydroxide and hence can be used as an alternative to CH. They can be used independently in IPT, since combining both does not offer any additional therapeutic benefits.