ABSTRACT
PURPOSE: The purpose of this retrospective study was to evaluate pulpotomies completed without the use of a fixative, preservative, or astringent agent prior to placement of a reinforced zinc oxide-eugenol (ZOE) sub-base in the pulp chamber and subsequent restoration. METHODS: Clinical and radiographic data were collected from a private pediatric dental office in Toronto, Ontario, Canada. The pulpotomy technique used involved: amputation of coronal pulp; radicular hemostasis via pressure with dry cotton pellet; placement of ZOE into the pulp chamber; and restoration with stainless steel crown or amalgam. RESULTS: One-hundred-ninety primary molars in 116 children (follow-up=6-94 months; mean=35.8 months) met the inclusion criteria. The radiographic, clinical, and overall success rates were approximately 95%, 97%, and 94%, respectively. The most frequently observed pathologic pulpal response was furcation radiolucency (N=7, â¼4%). The patient's age at time of pulpotomy, restoration type, tooth type, arch, and location of treatment (in-office vs general anesthesia) were not statistically significant factors influencing the success of the reinforced ZOE pulpotomy technique. CONCLUSION: The success rates indicate that the reinforced zinc oxide-eugenol pulpotomy technique may be an acceptable treatment modality for primary molars requiring vital pulp therapy.
Subject(s)
Pulp Capping and Pulpectomy Agents/therapeutic use , Pulpotomy/methods , Zinc Oxide-Eugenol Cement/therapeutic use , Child , Child, Preschool , Crowns , Dental Alloys/chemistry , Dental Amalgam/chemistry , Dental Pulp Cavity/diagnostic imaging , Dental Pulp Cavity/pathology , Dental Restoration, Permanent/methods , Female , Follow-Up Studies , Hemostasis, Surgical/methods , Humans , Male , Molar/diagnostic imaging , Molar/pathology , Periapical Diseases/diagnostic imaging , Periapical Diseases/etiology , Postoperative Complications , Radiography , Retrospective Studies , Stainless Steel/chemistry , Tooth, Deciduous/diagnostic imaging , Tooth, Deciduous/pathology , Treatment OutcomeABSTRACT
Lesch-Nyhan syndrome is a rare X-linked recessive disorder of purine metabolism, caused by complete absence of the enzyme hypoxanthine-guanine phosphoribosyl transferase. Persons affected with this incurable disease are developmentally and physically delayed, and suffer from self-injurious behavior. The most typical feature results in partial or total destruction of perioral tissues. The purpose of this paper was to discuss a case of Lesch-Nyhan syndrome with self-mutilative behavior and lip injuries, including some suggestions of a preventive approach avoiding the extraction of teeth. A soft mouthguard fabricated to prevent the destruction of perioral soft tissues and combined psychiatric pharmacologic therapy proved to have satisfactory results.
