Evaluation of the efficacy of mineral trioxide aggregate and bioceramic putty in primary molar pulpotomy with symptoms of irreversible pulpitis (a randomized-controlled trial).

OBJECTIVES: Preserving the primary teeth is important, as they play an important role in the integrity of the dental arch, the development of the craniofacial complex, speech, and chewing. This study aimed to evaluate the effectiveness of both Mineral Trioxide Aggregate (MTA) and Bioceramic putty in primary molar pulpotomy with symptoms of irreversible pulpitis. MATERIALS AND METHODS: In this study, 40 s primary mandibular molars in 40 healthy children aged 6-8 years were examined and classified into 2 groups according to the material: group A, with 20 primary molars capped by MTA, and group B, with 20 teeth capped by Bioceramic putty. Clinical and radiographic evaluation of the treatment results was carried out after 1 week, 3 months, 6 months, 9 months, and 1 year. RESULTS: Clinical and radiological success rates in the MTA group reached 95%, where a case of failure was observed after a year of follow-up. In the Bioceramic group, the success rate reached 100% after a year of follow-up, without any statistically significant differences between groups (p = .311). CONCLUSIONS: Pulpotomy using biocompatibility materials (MTA-Bioceramic) in primary molars with symptoms of irreversible pulpitis is considered effective due to the better advantages of the use of Bioceramic over MTA. This clinical trial was approved by Australian New Zealand Clinical Trials (12621001631897).

Evaluation of Bioceramic Putty in Pulpotomy of Immature Permanent Molars With Symptoms of Irreversible Pulpitis.

Purpose This study aimed to evaluate the effectiveness of both mineral trioxide aggregate (MTA) and bioceramic putty (Well-Root PT) in the pulpotomy of immature permanent molars diagnosed with symptoms of irreversible pulpitis. Materials and methods The study included 30 immature permanent molars with symptoms of irreversible pulpitis in 30 healthy children aged six to eight years. They were randomly distributed into the following two groups according to the material used: group 1 included 15 first permanent molars capped by MTA and group 2 included 15 first permanent molars capped by bioceramic putty. Clinical and radiographical evaluations of the treatment results were made after one week, three months, six months, nine months, and 12 months. Results The success rate in the bioceramic putty group was 93.3% clinically and radiographically after a 12 months follow-up, whereas in the group that underwent MTA treatment no cases of failure were registered with a 100% success rate. No statistical differences were observed between groups (p=0.309). The dentin bridge was formed in 60% of the MTA group and 33.3% of the bioceramic group without any statistically significant differences (p=0.272) after a 12 months follow-up. Conclusion Pulpotomy using biocompatible materials (MTA and bioceramic putty) on immature permanent molars with symptoms of irreversible pulpitis is considered acceptable and effective.

Pain assessment following endodontic treatment using two automated systems compared to manual treatment in primary molars.

BACKGROUND: Root canal treatment in primary teeth is quite difficult and time-consuming, especially canal preparation. Pain is the most common negative outcome following root canal treatment, occurring hours or days after treatment. It is an unpleasant experience for both the patient and the dentist. OBJECTIVES: The objective of this study was to assess the severity and duration of pain following the endodontic treatment of primary molars with the use of rotary and reciprocating preparation systems compared to the traditional manual method. MATERIAL AND METHODS: The research sample consisted of 157 asymptomatic primary lower second molars with non-vital pulp that were indicated for root canal treatment. The patients were randomly divided into 3 groups: in the 1st group, the molars (n = 52) were prepared using the manual method; in the 2nd group (n = 53), a reciprocating automated preparation system (WaveOne®) was used; and in the 3rd group (n = 52), a rotary preparation system (ProTaper Next®) was used. Pain assessment was carried out after 6, 12, 24, 48, and 72 h, and after 1 week, using a four-face facial pain scale. RESULTS: The manual method provided a higher pain score through 6, 12 and 24 h (p < 0.05) as compared to the 2 automated preparation systems. The intensity of pain did not vary between the 2 machine preparation systems after 6, 12 , 24, and 48 h (p > 0.05). There were no differences between the 3 methods after 72 h and after 1 week (p > 0.05). CONCLUSIONS: The manual method caused more pain than the other 2 preparation systems, but there was no difference between the 2 automated methods. Automated root canal preparation systems could be used to reduce the intensity of postoperative pain after the endodontic treatment of primary teeth.

Assessment of the apically extruded debris between a rotary system, a reciprocating system and hand files during the root canal instrumentation of the deciduous molars.

BACKGROUND: One of the factors that most negatively affect the endodontic instrumentation process in primary teeth is the presence of extruded debris in the periapical region. Therefore, different techniques have been evaluated to reach an answer to the question regarding which root canal preparation method produces the least amount of debris extrusion. OBJECTIVES: The main objective of this study was to assess the amount of debris extrusion as well as irrigation associated with 3 different instrumentation techniques: a rotary system (PROTAPER NEXT® - PTN), a reciprocating system (WaveOne® - WO) and hand K-files. MATERIAL AND METHODS: Forty-eight primary mandibular molars with a single distal canal were selected and randomly divided into 3 groups (n = 16). Three different techniques were used for the canal instrumentation of each group, comprising PTN, WO and hand K-files. Pre-weighed Eppendorf tubes were used for the collection of debris extrusion, then stored in an incubator at 70°C for 5 days. A one-way analysis of variance (ANOVA) test was used for data analysis, followed by Tukey's post hoc test. RESULTS: Statistically significant differences were found while comparing the PTN and WO systems with the hand files. Both PTN and WO showed less debris extrusion toward the periapical tissues than the hand files. Still, no statistically significant differences were seen between the PTN and WO groups. CONCLUSIONS: Generally, debris extrusion occurred in all of the 3 experimental groups. The PTN and WO systems showed the least debris extrusion as compared to the hand files during the root canal instrumentation of the primary teeth, and for these reasons along with the shorter operating time, it may be concluded that using rotary and reciprocating systems rather than manual files is highly advisable. However, a clinical assessment is suggested.