Direct Pulp Capping of Primary Molars with Calcium Hydroxide or MTA Following Hemorrhage Control with Different Medicaments: Randomized Clinical Trial.

Purpose: This study aimed to evaluate the effects of different medicaments (sterile saline [SS]; ferric sulfate [FS]; or sodium hypochlorite [SH]) and pulp capping materials (calcium hydroxide [CH] or mineral trioxide aggregate [MTA]) on the success of direct pulp capping (DPC) in primary molars. Methods: The study was conducted with 55 children aged four to eight years. A total of 118 teeth, in which occlusal caries removal resulted in pulp exposure, were treated with DPC across six groups: SS+CH; FS+CH; SH+CH; SS+MTA; FS+MTA; and SH+MTA. Teeth were restored with Class I composite resin. Results: After two years, the overall clinical and radiographical success for DPC were 94.1 percent (111 out of 118 teeth) and 88.9 percent (105 out of 118 teeth), respectively. The clinical and radiographical success, respectively, for hemorrhage control medicaments were 92.1 percent and 89.5 percent for SS, 92.5 percent and 82.5 percent for FS, 97.5 percent, and 95.0 percent for SH (P>0.05). Internal resorption was significantly higher in the FS+CH group when compared to other groups (P<0.05). MTA had significantly higher success than CH for clinical (98.3 percent versus 89.7 percent) and radiographical success (98.3 percent versus 79.3 percent) (P<0.05, each comparison). Conclusions: For primary molars with occlusal caries and less than one-mm exposure sites, these findings suggest that direct pulp capping with MTA following hemorrhage control with the tested solutions offers a more predictable outcome compared to CH. Further, the findings of this study indicate an increased risk for internal resorption when FS and CH are used for DPC.

Isolated bilateral macrodontia of mandibular second premolars: A case report.

Isolated bilateral macrodontia of mandibular second premolars is an extremely rare dental anomaly with only 5 cases reported to date. This case report presents clinical and radiographic findings of isolated bilateral macrodontia in a 12-year-old child. The patient was referred to the clinic with local crowding of mandibular posterior teeth. Radiographic findings revealed the presence of impacted macrodont mandibular second premolars and their distinct morphological appearance, characterized by large, multitubercular, molariform crowns, and tapering, single roots. Following surgical removal of the impacted premolars, orthodontic therapy was initiated to correct the malocclusion. Along with the features and treatment of this rare anomaly, this case report also illustrates the benefits, in terms of treatment planning and surgical technique, of supplementing conventional radiography with cone-beam computed tomography to localize the macrodont premolars and accurately establish their relationship with the neighboring roots and anatomic structures.

Effect of bleaching agents on sealing properties of different intraorifice barriers and root filling materials.

OBJECTIVE: To evaluate the effect of intracoronal bleaching agents on the sealing properties of different intraorifice barriers and root filling materials. STUDY DESIGN: The root canals of extracted human premolars (n=180) were prepared by using System GT rotary files and filled with either gutta-percha+AH Plus or Resilon+Epiphany sealer. In both groups, the coronal 3mm of root filling was removed and replaced with one of the following materials applied as intraorifice barriers (n=30/group): 1. ProProot-MTA; 2. Conventional Glass ionomer cement; and 3. Hybrid resin composite. In each subgroup, intracoronal bleaching was performed using either sodium perborate with distilled water or 35% hydrogen peroxide gel for 3 weeks. The leakage of specimens was measured using fluid-filtration and dye penetration tests. The data were analyzed statistically with One-way ANOVA, Repeated Measures t-test and Independent Samples t-test (p=0.05). RESULTS: The fluid conductance values of the test groups were not influenced by the type of the bleaching agent, the intraorifice barrier, or the root filling material (all p>0.05). However, the extent of dye leakage was significantly affected by the type of intraorifice barrier material (p<0.05), which showed the following statistical ranking: glass ionomer cement > resin composite > ProRoot-MTA (p<0.05). CONCLUSIONS: The effect of 35% hydrogen peroxide gel or sodium perborate/distilled water on the sealing properties of tested intraorifice barriers and root filling materials varied conforming leakage assessment. These properties were not affected by using fluid filtration test, while the glass ionomer barrier showed the greatest amount of dye leakage in both gutta-percha and Resilon root-filled teeth.

Healing of External Inflammatory Root Resorptions and Periapical Lesions without Surgical Treatment in an Operated Oblique Facial Cleft Case.

This paper describes an operated oblique facial cleft case with external inflammatory root resorption (EIRR) of the permanent maxillary left incisors and canine in a 12-year old patient. Due to the facial oblique cleft, the plastic surgery department operated on the patient five times and placed her on fixed orthodontic therapy. EIRR treatment of the maxillary left incisors and canine was performed using long-term calcium hydroxide therapy. The permanent root canal fillings of the lateral incisor and canine were performed using conventional gutta percha fillings. Because no sufficient apical barrier stop of the central incisor occurred, it was filled with Mineral Trioxide Aggregate (MTA); the canine crown fracture was restored using a carbon-covered fiberglass post and a light-cured composite resin. Examination after 42 months revealed good esthetics and no periapical pathology.

Double inverted mesiodentes: report of an unusual case.

This report presents an extremely rare occurrence of two inverted mesiodentes in a child patient. Extraction of both mesiodentes was indicated, owing to the axial rotation of the permanent central incisors caused by these impacted supernumerary teeth. Radiographic evidence of complete healing was observed 24 months following surgical removal of the inverted mesiodentes.

Unusual ectopic eruption of a permanent central incisor following an intrusion injury to the primary tooth.

Intrusive luxation of primary teeth carries a high risk of damage to underlying permanent tooth germs. Ectopic eruption of permanent incisors is an unusual outcome of traumatic injury to their predecessors. In this case report, we describe the multidisciplinary management of the consequences of a primary tooth intrusion that led to severe ectopic eruption of the permanent left central incisor in a horizontal position at the level of the labial sulcus.