Clinical and Radiographic Success of 2% Chlorhexidine Gluconate with Mineral Trioxide Aggregate in Indirect Pulp Treatment of Primary Molars.

Purpose: To compare the clinical and radiographic success rates of indirect pulp treatment (IPT) in primary molars using mineral trioxide aggregate (MTA) with and without two percent chlorhexidine gluconate (CHX).
Methods: A blinded, randomized, controlled clinical trial was performed in a split-mouth desi gn. Eighty primary molars in 40 subjects from four to eight years of age were randomly allocated so that each subject had one tooth treated with MTA and CHX and the other tooth treated with MTA alone. Study teeth had deep caries without signs and symptoms of pulpal inflammation or necrosis. All teeth were restored with stainless steel crowns. Follow-up was done at 12 months to evaluate the teeth clinically and radiographically.
Results: At the follow-up, one tooth from each group had failed. Upon the clinical and radiographic evaluations, the overall success rate for both groups was 97 percent. No statistically significant difference was found in the success rate between the two groups.
Conclusions: IPT in primary molars using MTA with or without CHX demonstrated satisfactory clinical and radiographic outcomes in a period of 12 months.

Recent Advances in Indirect Pulp Treatment Materials for Primary Teeth: A Literature Review.

AIM: To provide an overview of the techniques of indirect pulp treatment (IPT) and the new materials used. BACKGROUND: Indirect Pulp Treatment (IPT) is a conservative treatment approach that can be used in primary molars. Pulpotomy has been adopted as the treatment of choice for deep caries in primary molars. IPT showed higher success rates in recent researches. MATERIALS AND METHODS: Electronic search of English scientific papers was accomplished using PubMed, ScienceDirect, and Scopus. Papers published from 1995 to 2019 were included. Search terms used were recent advances, indirect pulp treatment, mineral trioxide aggregate (MTA), biodentine, TheraCal-LC, chlorhexidine gluconate (CHX), resin-modified glass ionomer (RMGI), and calcium hydroxide. REVIEW RESULTS: Seventy two papers were obtained from the electronic search and references of selected studies. Thirty five papers explained recent advances in IPT materials for primary molars. MTA produces more dentinal bridging with superior quality than calcium hydroxide. Similarly, Biodentine can form reparative dentin in a very short period. TheraCal-LC has increased stability and durability with strong physical properties and low solubility. Furthermore, CHX is a chemical disinfectant which can aid in increasing the success rate of IPT when conjugated with other materials. It produced highly successful IPT when combined with RMGI or calcium hydroxide. CONCLUSION: IPT is the preferred treatment approach for preservation of primary dentition. CHX is an emerging material that can provide promising results in IPT when combined with other materials. CLINICAL SIGNIFICANCE: Up to date, no material had replaced the popular use of calcium hydroxide in IPT. The use of CHX with RMGI can increase the success rate while preserving the advantages of the latter as it is considered the liner of choice for primary teeth, making IPT a suitable substitute for pulpotomy in primary molars. HOW TO CITE THIS ARTICLE: Saber AM, El Meligy OA, Alaki SM. Recent Advances in Indirect Pulp Treatment Materials for Primary Teeth: A Literature Review. Int J Clin Pediatr Dent 2021;14(6):795-801.

Atraumatic Restorative Treatment and Interim Therapeutic Restoration: A Review of the Literature.

This review discusses the techniques and uses of atraumatic restorative treatment (ART) and interim therapeutic restoration (ITR) and states the differences between these two approaches. ART and ITR are similar approaches and are performed using the same material, but they differ in the purpose of their use. ART is used in cases when there are obstacles to reaching dental care units and has been proven to have high success rates in primary and permanent dentitions. ITR is used as a temporary restoration that will be replaced with a more definitive one. ITR is used in cases when the ideal dental treatment cannot be performed. Conventional glass polyalkenoate (ionomer) restorative cement (GIC) is the material of choice that has been used for ART and ITR. This is because of its fluoride release properties, including its ability to bond to enamel and dentine, its pulpal biocompatibility, and its ease of manipulation. High-viscosity glass ionomer performed better than low and medium-viscosity glass ionomer in ART. Combining GIC with conditioner, as well as the use of a chemo-mechanical approach, improved the success rate of ART. Both ATR and ITR are acceptable strategies, with success rates comparable to the traditional treatment methods.

Consequences of early extraction of compromised first permanent molar: a systematic review.

BACKGROUND: The aim of this study was to systematically review the literature to determine the sequelae of early extraction of compromised first permanent molars (FPMs) with regard to the skeletal and dental development of 5- to 15-year-old children. Meta-analysis was conducted when applicable. METHODS: Our research protocol included a search strategy, inclusion/exclusion criteria, and a data extraction plan. The search engines used were PubMed, Scopus, and Science Direct. Study selection was performed independently by three reviewers. Articles published from 1960 to 2017 were reviewed based on inclusion and exclusion criteria. Meta-analysis was performed to compare space closure between upper and lower arches. RESULTS: Eleven studies fulfilled the inclusion criteria. The consequences were decrease in post extraction space, accelerated development and eruption of second permanents molars (SPMs) and third molars, a decrease in caries and/or fillings on the proximal surfaces of adjacent teeth, lingual tipping and retrusion of incisors, and counter clockwise rotation of the occlusal plane. CONCLUSION: There were several consequences of early extraction of FPMs, which were related to skeletal and dental development. Our systematic review suggests that comprehensive evaluation of the compromised FPMs should be performed before planning an extraction. The ideal time for FPM extraction is when the SPM is at the early bifurcation stage in order to achieve complete closure of the extraction space by the SPM. Benefits should be weighed over the risks to decrease the risk of unfavorable outcomes as much as possible. However, due to the limited evidence on the outcomes and variables that influence them, high-quality prospective studies are needed.