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).

Effectiveness of Three Agents in Pulpotomy Treatment of Permanent Molars with Incomplete Root Development: A Randomized Controlled Trial.

The aim of this study was to investigate and compare, radiographically and clinically, the impacts of calcium-silicate based-cement (CSBC), nano-hydroxyapatite and platelet-rich fibrin (PRF) as pulpotomy agents in permanent immature molars with incomplete root development. Sixty-three participants (63 permanent immature molars) were included in this study. The patients were randomly divided into three equal groups. Fast setting MTA (MM-MTA), nano-hydroxyapatite and platelet-rich fibrin were used as pulpotomy agents. The teeth were evaluated clinically and radiographically after 6 and 12 months by two blinded examiners. Apical closure and pulp canal obliteration percentages were recorded. The in vitro reaction of the tested materials after a 7-day immersion period of the different materials in phosphate-buffered solution was analyzed using scanning electron microscopy to associate the in vitro mineralization with in vivo pulp canal obliteration percentages. Data were analyzed using Chi-square and ANOVA tests (α = 0.05). No significant difference was found between the three tested groups in terms of clinical and radiographic success (p > 0.05). All cases demonstrated evidence of root growth, including complete apical closure or continued apical closure. At 12 months, complete apical closure was found among the MM-MTA group (50%), nano-hydroxyapatite group (55%) and platelet-rich fibrin group (60%) (p > 0.05). After 12 months, pulp canal obliteration was more observed in the MM-MTA and nano-hydroxyapatite groups than in the PRF group (p < 0.05). MM-MTA (auto-mixed), NHA (hand-mixed) and PRF (autologous) could be used as pulpotomy agents since they exhibit comparable high clinical and radiographic success rates. However, the fact that the groups managed with MM-MTA and NHA have a higher tendency to canal obliteration might indicate that PRF should be considered the first choice material as pulpotomy agent, as it would make retreatment considerably easier.

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.

Single-Visit Pulp Revascularization of a Nonvital Immature Permanent Tooth Using Biodentine.

UNLABELLED: An 11-year-old female patient was referred with a chief complaint of pain in the right mandibular second premolar. Clinical and radiographic examinations showed secondary caries under an old composite restoration, a negative response to a pulp test and an immature root with an open apex. After root canal cleaning and shaping, bleeding was invoked in the canal up to 2 mm short of the cemento-enamel junction (CEJ). After 10 min to allow clotting at this level, a plug of Biodentine was placed over the blood clot and the tooth was temporized with glass ionomer cement. At the next visit, the tooth was free of symptoms and a permanent filling was placed. Clinical and radiographic examinations during a two-year follow-up showed complete root maturation and intact supporting soft tissues without sinus tract, pain or swelling. CONCLUSION: The use of Biodentine in a single-visit apexification protocol to treat an immature permanent tooth with necrotic pulp can create a suitable environment for revascularization, resulting in the completion of root maturation.

Time-dependence of coronal seal of temporary materials used in endodontics.

The aim of this in vitro study was to compare parametrically the coronal seal ability over different periods of times of four restorative materials used to seal the pulpal access cavity after endodontic treatment. One hundred and thirty-five mandibular premolars were divided randomly into three time groups (1, 2 and 4 weeks), each of which was in turn divided into four subgroups. Each subgroup was restored using one of four restorative materials: Coltosol, glass ionomer cement (GIC), zinc phosphate (ZP) cement, or intermediate restorative material (IRM) cement. The root canals were prepared using the crown-down technique, and obturated using lateral condensation. Following placement of the restorative material, the samples were incubated in distilled water at 37 degrees C and were subjected to 50 thermocycles (0 +/- 4, 56 +/- 4C). After immersing in (2%) methylene blue dye for 24 h, teeth were longitudinally sectioned and examined under a stereomicroscope. The results showed that Coltosol and GIC cement were significantly superior in sealing ability to ZP and IRM cements (P < 0.05). There was no significant difference between GIC cement and Coltosol. Both Coltosol and GIC after 1 week were significantly better than 4 weeks. There was no significant difference in the seal ability at different time periods when ZP and IRM cements were used.