ABSTRACT
INTRODUCTION: Paediatric endodontics is part of paediatric dental practice. Teeth with infected root canals, particularly those in which the infection has spread around the apical foramen and furcation area, is a common problem in primary dentition for such conditions pulpectomy is the procedure. Pulpectomy procedure proves to be long and complicated and has remained controversial for a number of reasons. Lesion sterilization and tissue repair therapy (LSTR) is a relatively new biologic approach for carious lesions with or without pulpal and periapical involvement using a mixture of antibiotics. OBJECTIVES: The aim of this study was to evaluate clinical and radiographic success of three different LSTR techniques as treatment options in primary molars requiring pulpectomy. METHODS: Sixty-three primary molars of fifty children aged between 4 and 8 years with primary molars requiring pulpectomy were treated with modified 3Mix-MP antibiotic paste without removal of accessible radicular pulp (Group I), modified 3Mix-MP with removal of accessible radicular pulp (Group II) and Chloramphenicol, tetracycline and zinc oxide eugeno (CTZ) paste (Group III). The subjects were followed up clinically at one, six, and twelve months whereas radiographically at six and twelve months, respectively. RESULTS: The results showed that clinical success rates of Group I, Group II and Group III were 90%, 90.5% and 81.8% respectively and radiographical success rates were 75%, 76.2% and 63.6% respectively after twelve months observation. CONCLUSION: On the basis of the overall success rates of all the three LSTR techniques, following order of performance can be inferred clinical success and radiographical success: - 3Mix-MP without removal of radicular pulp = 3Mix-MP with removal of radicular pulp >CTZ paste.
Subject(s)
Pulpectomy , Tooth, Deciduous , Anti-Bacterial Agents , Child , Child, Preschool , Humans , Molar , Sterilization , Treatment OutcomeABSTRACT
INTRODUCTION: Etching of enamel and dentin surfaces increases the surface area of the substrate for better bonding of the tooth colored restorative materials. Acid etching is the most commonly used method. Recently, hard tissue lasers have been used for this purpose. AIM: The aim of the present study was to evaluate and compare the etching pattern of Er,Cr:YSGG and conventional etching on extracted human enamel and dentin specimens. MATERIALS AND METHODS: Total 40 extracted non-diseased teeth were selected, 20 anterior and 20 posterior teeth each for enamel and dentin specimens respectively. The sectioned samples were polished by 400 grit Silicon Carbide (SiC) paper to a thickness of 1.0 ± 0.5 mm. The enamel and dentin specimens were grouped as: GrE1 & GrD1 as control specimens, GrE2 & GrD2 were acid etched and GrE3 & GrD3 were lased. Acid etching was done using Conditioner 36 (37 % phosphoric acid) according to manufacturer instructions. Laser etching was done using Er,Cr:YSGG (Erbium, Chromium : Ytrium Scandium Gallium Garnet) at power settings of 3W, air 70% and water 20%. After surface treatment with assigned agents the specimens were analyzed under ESEM (Environmental Scanning Electron Microscope) at X1000 and X5000 magnification. RESULTS: Chi Square and Student "t" statistical analysis was used to compare smear layer removal and etching patterns between GrE2-GrE3. GrD2 and GrD3 were compared for smear layer removal and diameter of dentinal tubule opening using the same statistical analysis. Chi-square test for removal of smear layer in any of the treated surfaces i.e., GrE2-E3 and GrD2-D3 did not differ significantly (p>0.05). While GrE2 showed predominantly type I etching pattern (Chi-square=2.78, 0.05
0.10) and GrE3 showed type III etching (Chi-square=4.50, p<0.05). The tubule diameters were measured using GSA (Gesellschaft fur Softwareentwicklung und Analytik, Germany) image analyzer and the 't' value of student 't' test was 18.10 which was a highly significant result (p<.001). GrD2 had a mean dentinal tubule diameter of 2.78µm and GrD3 of 1.09µm. CONCLUSION: The present study revealed type I etching pattern after acid etching, while type III etching pattern in enamel after laser etching. The lased dentin showed preferential removal of intertubular dentin while acid etching had more effect on the peritubular dentin. No significant differences was observed in removal of smear layer between the acid etched and lased groups. Although diameter of the exposed dentinal tubules was lesser after lased treatment in comparison to acid etching, further long term in vivo studies are needed with different parameters to establish the usage of Er,Cr:YSGG as a sole etching agent.
