Ferric Sulfate Versus Calcium-Enriched Mixture Cement in Pulpotomy of Primary Molars: A Randomized Clinical Trial

ABSTRACT Objective: To evaluate the postoperative pain and clinical and radiographic success of pulpotomized primary molars using two materials, Ferric Sulfate (FS) and Calcium-Enriched Mixture (CEM) cement, over a period of 3 and 6 months. Material and Methods: This randomized clinical trial was conducted on a total of 38 teeth selected from 19 patients aged 3-9 years. FS 15.5% and CEM cement were used as pulpotomy agents. Permanent restorations were Stainless Steel Crowns (SSCs) in both groups. Patients were recalled for follow-up at 3 and 6 months intervals for clinical and radiographic assessment. Postoperative pain was recorded by using Visual Analogue Scale up to ten days following the treatment. The data were statistically analyzed using chi-square test and repeated measures ANOVA. Results: At 6 months, a 100% clinical success rate was observed in the FS and CEM cement groups. The radiographic success rate in the FS group was 94.7%, whereas 100% in the CEM cement group at 6 months. No statistically significant difference was found between the two groups (p>0.05). There was no significant difference in postoperative pain between the teeth that received either FS or CEM cement as pulpotomy agents following the procedure (p>0.05). Conclusion: There were favorable outcomes of FS and CEM cement in pulpotomy of primary molar teeth.

Immediate restoration after mineral trioxide aggregate pulpotomy with amalgam condensation: an in vitro study.

Mineral trioxide aggregate (MTA) pulpotomy may be an alternative to root canal therapy, with reported success rates as high as 85%. However, little technique-specific information has been reported regarding MTA placement in 1 visit. The purpose of this study was to evaluate different placement methods for MTA and resin-modified glass ionomer (RMGI) cement before immediate restoration with amalgam. Forty pulpotomized extracted third molars were randomly divided into 4 groups, and moist cotton was used to simulate pulp tissue in all teeth. In group 1, cotton was placed over the entire pulp chamber floor and in each canal orifice, and MTA was placed over the cotton. The procedure for group 2 was the same as that for group 1 except that a layer of RMGI was placed over the MTA. In group 3, cotton was placed in the canal orifices only, a layer of MTA was placed only over the cotton in the orifices, and RMGI was layered over the MTA and pulp chamber floor. The procedure for group 4 was the same as that for group 3 except that RMGI was placed over the MTA but not on the pulpal floor. Each of these procedures was followed by amalgam condensation. After a 7-day setting period, restored teeth were sectioned mesiodistally, photographed, measured, and evaluated for disturbance of the MTA-restoration junction. The study findings showed that the MTA layer was disturbed in 40% of the specimens in group 1, whereas 10%-20% of specimens in groups 2 through 4 demonstrated disturbed MTA. Analysis with a Pearson chi-square test indicated that the difference between group 1 and groups 2 through 4 was statistically significant (P < 0.05), but there was no significant difference (P > 0.05) between groups 2, 3, and 4. Group 3, in which MTA was placed over each canal orifice and RMGI was placed over the entire pulpal floor, performed best--only 10% of specimens exhibited deformed MTA. The findings suggest that RMGI may protect initially placed MTA during amalgam condensation.

Applications of Light Amplification by Stimulated Emission of Radiation (Lasers) for Restorative Dentistry.

Light amplification by stimulated emission of radiation (laser) has been used widely in a range of biomedical and dental applications in recent years. In the field of restorative dentistry, various kinds of lasers have been developed for diagnostic (e.g. caries detection) and operative applications (e.g. tooth ablation, cavity preparation, restorations, bleaching). The main benefits for laser applications are patient comfort, pain relief and better results for specific applications. Major concerns for using dental lasers frequently are high cost, need for specialized training and sensitivity of the technique, thereby compromising its usefulness particularly in developing countries. The main aim of this paper is to evaluate and summarize the applications of lasers in restorative dentistry, including a comparison of the applications of lasers for major restorative dental procedures and conventional clinical approaches. A remarkable increase in the use of lasers for dental application is expected in the near future.

The effect of working time on the displacement of Biodentine™ beneath prefabricated stainless steel crown: a laboratory study.

OBJECTIVE: To investigate the displacement of Biodentine™ following cementation of stainless steel crowns (SSC) with glass-ionomer cement (GIC) on plastic deciduous teeth prepared for pulpotomy. METHODS: Twenty plastic teeth with prepared occlusal cavities were divided into four groups and had Biodentine™ placed as a mock pulpotomy agent. The pulp chamber was filled with freshly mixed Biodentine™ then a GIC-loaded SSC was seated on the tooth using a standardized seating force for periods of: 1 min (Group 1); 2 min (Group 2), 3 min (Group 3) and 6 min (Group 4) after mixing. After 24 h at 37°C and 90% humidity, the crowns were sectioned mesio-distally and standardized digital photographs taken. Image analysis software was used to determine the ratio of the surface area of displaced Biodentine™ relative to the surface area of the pulp chamber. The thinnest section of the remaining Biodentine™ was measured. RESULTS: The lowest values of Biodentine™ displacement and the highest values of remaining Biodentine™ thickness were associated with Group 4. There were no significant differences between the results in Group 3 and Group 4. CONCLUSION: Within the limitations of this in vitro study, a GIC-loaded SSC can be seated on Biodentine™ placed into a pulp chamber 3 min after mixing.

Comparative evaluation of pro-inflammatory cytokine levels in pulpotomized primary molars.

The present in vivo study was performed to investigate the levels of the pro-inflammatory cytokines, interleukin (IL)-1α, IL-6, and IL-8, in primary molars for which pulpotomy was clinically indicated, and to evaluate the success rates of three different pulpotomy agents employed for cariously (CExp) or mechanically exposed (MExp) primary molars. Forty-seven primary molars were classified as MExp or CExp according to the type of pulpal exposure. Pulp tissue was harvested and analyzed using enzyme-linked immunosorbent assay (ELISA). Subsequently, three pulpotomy agents-calcium hydroxide (CH), mineral trioxide aggregate (MTA), and formocresol (FC)-were applied randomly, and the outcome was observed radiographically for 18 months. Levels of IL-6 and IL-8 were significantly higher in CExp pulp than in MExp pulp (P < 0.05). In the CH pulpotomy group, MExp teeth showed a higher success rate than CExp teeth. There was no significant difference in success rate between MExp and CExp teeth in both the FC and MTA groups. The levels of IL-6 and IL-8 have the potential to become indicators of pulp status and can be monitored by researchers to make the prognosis of vital pulp therapies less uncertain. As MTA and FC yielded higher rates of success than CH in CExp teeth, the choice of pulpotomy agent appears to be important in this context.

Clinical and radiographic evaluation of Portland cement added to radiopacifying agents in primary molar pulpotomies.

AIM: This was to evaluate the clinical and radiographic outcomes of Portland cement (PC) added to radiopacifying agents in primary molar pulpotomies. METHODS: Thirty primary mandibular molars of children aged between 5 and 9 years were randomly assigned to the following groups: PC; PC with iodoform (PC + CHI(3)); PC with zirconium oxide (PC + ZrO(2)) and treated by pulpotomy technique. Clinical and radiographic follow-up assessments were performed at 6, 12 and 24 months. Statistical analysis was performed by Fisher's exact test (P < 0.05). RESULTS: The clinical and radiographic evaluations showed 100 % success rates, and the results showed no statistically significant difference between groups. CONCLUSIONS: According to this study, PC added to radiopacifying agents exhibited satisfactory clinical and radiographic results in primary molar pulpotomies.

Pulpotomy in caries-exposed immature permanent molars using calcium-enriched mixture cement or mineral trioxide aggregate: a randomized clinical trial.

OBJECTIVE: To compare clinical and radiographic outcomes of pulpotomy treatment using calcium-enriched mixture (CEM) cement and mineral trioxide aggregate (MTA) in carious-exposed vital immature permanent first molars. DESIGN: Fifty-one immature molars with clinical carious exposure with symptomatic/asymptomatic pulpitis met the inclusion criteria and randomly assigned to one of the treatment groups (CEM [26 teeth; 59 roots], MTA [25 teeth; 59 roots]). After performing pulpotomy and covering the radicular pulps with the biomaterials, all teeth were permanently restored. Blinded clinical and radiographic evaluations were performed at 6 and 12 months after operation for signs of success or failure. Radiographs were evaluated for complete/partial apical closure. The data were analysed using chi-square test and generalized estimating equation (GEE) model. RESULTS: There was no significant difference at the baseline between the two experimental groups. All available cases (49 teeth) showed pulp survival and signs of continuous root development after 12 months. Overall, complete apical closure (apexogenesis) occurred in 76.8% and 73.8% of radiographically interpreted roots in CEM cement and MTA groups, respectively. There was no statistical difference in terms of radiographic outcomes between two groups. CONCLUSIONS: Calcium-enriched mixture cement and MTA showed similar performance in pulpotomy of immature caries-exposed permanent molars.

Root canal obturation of primary teeth: disposable injection technique.

The aim of the study was to outline a simple, cost-effective technique for obturation of primary tooth root canals. A total of 75 primary teeth were treated in 52 subjects by the technique discussed, i.e. injecting plastic flowable material into the root canals after desired preparation, using disposable needle and syringe. All the patients were followed up for 3 years and 6 months, with no clinical or radiologic evidence of pathology or need for untimely extraction. In conclusion, the technique described is simple, economical, can be used with almost all filling materials used for the purpose, and is easy to master with minimal chances of failure.

Estudo clínico randomizado do laser de baixa intensidade em pulpotomias de dentes decíduos humanos / Randomized clinical study of lower intensity laser in human deciduous teeth after pulpotomy

O objetivo deste estudo foi verificar por meio de observações clínicas e radiográficas a resposta in vivo do complexo dentinopulpar de dentes decíduos humanos após pulpotomia com diferentes terapêuticas para manter a vitalidade pulpar. Sessenta molares decíduos inferiores de crianças com idade entre 5 e 9 anos foram criteriosamente selecionados. Os dentes foram randomizadamente divididos nos grupos Formocresol de Buckley diluído a 1/5 (Grupo I), Hidróxido de Cálcio (Grupo II), Laser de Baixa Intensidade (Grupo III) e Hidróxido de Cálcio precedido por Laser de Baixa Intensidade (Grupo IV) e tratados pela técnica convencional de pulpotomia em uma única sessão. As avaliações clínicas e radiográficas foram realizadas nos períodos de 3, 6 e 12 meses do pós-operatório. Nos resultados observou-se que clinicamente não houve diferença estatisticamente significativa nos grupos estudados. Radiograficamente houve associação em relação à presença de reabsorção interna no grupo II (HC) dos 3 meses para os 6 meses e dos 3 meses para os 12 meses de proservação (p= 0,04) e, em relação à presença de calcificação pulpar nos grupos I (FC) com p=0,04 e no grupo III (LBI+OZE) com p=0,01 dos 3 meses para os 12 meses e dos 6 meses para os 12 meses. Na comparação entre os grupos, a análise estatística dos resultados demonstrou que houve associação entre formação de barreira dentinária entre os grupos I (FC) e II (HC), entre os grupos I (FC) e IV (LBI+HC), entre os grupos II (HC) e III (LBI+OZE) e entre os grupos III (LBI+OZE) e IV (LBI+HC) nos três períodos de avaliação (p=0,00). O Formocresol apresentou os maiores índices de sucesso clínico e radiográfico entre os grupos de estudo, entretanto não está associado à formação de barreira dentinária. O Laser de Baixa Intensidade mostrou maiores índices de sucesso clínico e radiográfico com relação à reabsorção interna e calcificação pulpar em comparação com os grupos II (HC) e IV (LBI+HC), entretanto também não está associado...

The aim of this study was to determine through clinical and radiographic observations response in vivo dentinopulpar complex in human deciduous teeth after pulpotomy with different therapies to maintain their pulp vitality. Sixty mandibular primary molars of children aged between 5 and 9 years were carefully selected. The teeth were randomly divided into groups Formocresol Buckley diluted 1/5 (Group I), Calcium Hydroxide (Group II), Low Intensity Laser (Group III) and Calcium Hydroxide preceded by Low Intensity Laser (Group IV) and treated by a conventional pulpotomy technique in a single session. The clinical and radiographic evaluations were performed at 3, 6 and 12 months postoperatively. The results showed that there was no clinically significant difference among groups. Radiographically there was an association for the presence of internal reabsorption in the group I (FC) of 3 months to 6 months and 3 months to 12 months, and an association for the presence of pulp calcification in groups I (FC) with p=0,04 and group III (LBI+ZOE) with p=0,01 of 3 months to 12 months and 6 months to 12 months. In comparison among the groups in each period, the statistical analysis of results showed that there was an association between the formation of dentin barrier for groups I (FC) and II (CH), for groups I (FC) and IV (LBI+CH), for groups II (CH) and III (LBI+ZOE) and for groups III (LBI+ZOE) and IV (LBI+CH) in the three periods evaluation (p = 0.00). The formocresol showed the higher levels of clinical and radiografic success among the study groups, however is not associated with the formation of dentin barrier. The Low Intensity Laser showed higher levels of clinical and radiographic success with respect to internal resorption and pulp calcification compared with groups II (CH) and IV (LBI + CH), but it is also not associated with the formation of dentin barrier. Thus, it is suggested that Low Intensity Laser may be considered an alternative...

Estudo clínico randomizado do laser de baixa intensidade em pulpotomias de dentes decíduos humanos / Randomized clinical study of lower intensity laser in human deciduous teeth after pulpotomy

O objetivo deste estudo foi verificar por meio de observações clínicas e radiográficas a resposta in vivo do complexo dentinopulpar de dentes decíduos humanos após pulpotomia com diferentes terapêuticas para manter a vitalidade pulpar. Sessenta molares decíduos inferiores de crianças com idade entre 5 e 9 anos foram criteriosamente selecionados. Os dentes foram randomizadamente divididos nos grupos Formocresol de Buckley diluído a 1/5 (Grupo I), Hidróxido de Cálcio (Grupo II), Laser de Baixa Intensidade (Grupo III) e Hidróxido de Cálcio precedido por Laser de Baixa Intensidade (Grupo IV) e tratados pela técnica convencional de pulpotomia em uma única sessão. As avaliações clínicas e radiográficas foram realizadas nos períodos de 3, 6 e 12 meses do pós-operatório. Nos resultados observou-se que clinicamente não houve diferença estatisticamente significativa nos grupos estudados. Radiograficamente houve associação em relação à presença de reabsorção interna no grupo II (HC) dos 3 meses para os 6 meses e dos 3 meses para os 12 meses de proservação (p= 0,04) e, em relação à presença de calcificação pulpar nos grupos I (FC) com p=0,04 e no grupo III (LBI+OZE) com p=0,01 dos 3 meses para os 12 meses e dos 6 meses para os 12 meses. Na comparação entre os grupos, a análise estatística dos resultados demonstrou que houve associação entre formação de barreira dentinária entre os grupos I (FC) e II (HC), entre os grupos I (FC) e IV (LBI+HC), entre os grupos II (HC) e III (LBI+OZE) e entre os grupos III (LBI+OZE) e IV (LBI+HC) nos três períodos de avaliação (p=0,00). O Formocresol apresentou os maiores índices de sucesso clínico e radiográfico entre os grupos de estudo, entretanto não está associado à formação de barreira dentinária. O Laser de Baixa Intensidade mostrou maiores índices de sucesso clínico e radiográfico com relação à reabsorção interna e calcificação pulpar em comparação com os grupos II (HC) e IV (LBI+HC), entretanto também não está associado...

The aim of this study was to determine through clinical and radiographic observations response in vivo dentinopulpar complex in human deciduous teeth after pulpotomy with different therapies to maintain their pulp vitality. Sixty mandibular primary molars of children aged between 5 and 9 years were carefully selected. The teeth were randomly divided into groups Formocresol Buckley diluted 1/5 (Group I), Calcium Hydroxide (Group II), Low Intensity Laser (Group III) and Calcium Hydroxide preceded by Low Intensity Laser (Group IV) and treated by a conventional pulpotomy technique in a single session. The clinical and radiographic evaluations were performed at 3, 6 and 12 months postoperatively. The results showed that there was no clinically significant difference among groups. Radiographically there was an association for the presence of internal reabsorption in the group I (FC) of 3 months to 6 months and 3 months to 12 months, and an association for the presence of pulp calcification in groups I (FC) with p=0,04 and group III (LBI+ZOE) with p=0,01 of 3 months to 12 months and 6 months to 12 months. In comparison among the groups in each period, the statistical analysis of results showed that there was an association between the formation of dentin barrier for groups I (FC) and II (CH), for groups I (FC) and IV (LBI+CH), for groups II (CH) and III (LBI+ZOE) and for groups III (LBI+ZOE) and IV (LBI+CH) in the three periods evaluation (p = 0.00). The formocresol showed the higher levels of clinical and radiografic success among the study groups, however is not associated with the formation of dentin barrier. The Low Intensity Laser showed higher levels of clinical and radiographic success with respect to internal resorption and pulp calcification compared with groups II (CH) and IV (LBI + CH), but it is also not associated with the formation of dentin barrier. Thus, it is suggested that Low Intensity Laser may be considered an alternative...

Comparison of the efficacy of articaine and prilocaine local anaesthesia for pulpotomy of maxillary and mandibular primary molars.

AIM: The aim of this study was to compare the local anaesthetic efficacy of articaine HCl and prilocaine HCl during an operative procedure after their administration by either mandibular nerve block or maxillary infiltration. STUDY DESIGN: The study was a double-blind clinical study which comprised 162 children (81 boys and 81 girls), who required a pulpotomy on their primary molars. Pain-related behaviours were used to assess the severity of pain during the injection of either prilocaine HCl or articaine HCl and the operative procedures following either a maxillary infiltration or mandibular nerve block of the two local anaesthetic agents. The frequencies of post-procedural adverse events in the prilocaine and articaine anaesthetised groups were also determined. RESULTS: Significantly more discomfort (p<0.05) was observed following maxillary infiltration compared to mandibular nerve block. There were no significant differences in the pain-related behaviours scores between the two local anaesthetic agents administered during the dental operative procedures, except for the removal of the coronal pulp. For this latter procedure, the pain-related behaviour score was 1.5- times higher in the prilocain-anaesthetised children than in the articaine-anaesthetised children. The frequencies of post- procedural adverse events in the prilocaine-treated children were similar to those found in the articaine-treated children. CONCLUSION: We concluded that local anaesthesia following mandibular nerve block is more effective than that following maxillary infiltration in 6-8-year-old children. However, the intensity of pain that was experienced by the children during administration of either prilocaine or articaine and some of the dental procedures after their administration were similar.

Lasers in dental traumatology.

AIM: Dental traumas are frequent in children. They can be complex events and sometimes real emergencies. Since very little attention is devoted to this topic in the international literature and there are no well-coded laser guidelines for these specific clinical events, our aim is to consider and present those situations in which laser-assisted therapy can offer new treatment possibilities. The authors' aim is to stimulate more extensive scientific research in this area, which might not only increase the use of these technologies, but also improve outcomes and reduce complications connected to dental trauma, particularly in children. Furthermore, laser-assisted therapies drastically reduce the need for analgesics and anti- inflammatory medications compared with conventional procedures. CONCLUSION: Using laser equipment to obtain anaesthesia is another challenge, while the use of low power setting for desensitising tissue and to obtain anaesthesia is also an open field.

Treatment of deep caries lesions in adults: randomized clinical trials comparing stepwise vs. direct complete excavation, and direct pulp capping vs. partial pulpotomy.

Less invasive excavation methods have been suggested for deep caries lesions. We tested the effects of stepwise vs. direct complete excavation, 1 yr after the procedure had been carried out, in 314 adults (from six centres) who had received treatment of a tooth with deep caries. The teeth had caries lesions involving 75% or more of the dentin and were centrally randomized to stepwise or direct complete excavation. Stepwise excavation resulted in fewer pulp exposures compared with direct complete excavation [difference: 11.4%, 95% confidence interval (CI) (1.2; 21.3)]. At 1 yr of follow-up, there was a statistically significantly higher success rate with stepwise excavation, with success being defined as an unexposed pulp with sustained pulp vitality without apical radiolucency [difference: 11.7%, 95% CI (0.5; 22.5)]. In a subsequent nested trial, 58 patients with exposed pulps were randomized to direct capping or partial pulpotomy. We found no significant difference in pulp vitality without apical radiolucency between the two capping procedures after more than 1 yr [31.8% and 34.5%; difference: 2.7%, 95% CI (-22.7; 26.6)]. In conclusion, stepwise excavation decreases the risk of pulp exposure compared with direct complete excavation. In view of the poor prognosis of vital pulp treatment, a stepwise excavation approach for managing deep caries lesions is recommended.

Análise química do formocresol após simulação de uso em clínica / Chemical analysis of formocresol after simulated clinical use

Objetivo: Analisar o teor de formaldeído em diversas marcas de formocresol e verificar se há alteração na fórmula do produto após simulação de uso, bem como das marcas entre si. Método: Neste estudo in vitro foram utilizados quatro diferentes marcas comerciais do medicamento formocresol (Biodinâmica, Iodontec, Inodon e Iodontosul) realizando simulação de seu uso em clínica através da manipulação diária dos produtos por um período de 60 dias. A análise química foi realizada nos laboratórios da Faculdade de Química da PUCRS, com o formaldeído, principal componente com propriedade de evaporação significativa do formocresol, onde foram realizadas três análises químicas pelo método de cromatografia gasosa. Resultados: Houve diminuição no teor de formaldeído durante o período de 60 dias nas quatro marcas comerciais, sugerindo que a eficácia do produto pode ser diminuída ao longo do uso. Constatou-se também que houve diferença na quantidade inicial de formaldeído entre as marcas pesquisadas. Conclusão: A eficácia do produto pode ser diminuída ao longo do uso, porém não há evidências conclusivas, havendo a necessidade de estudos adicionais.

Objective: To analyze the formaldehyde content in different brands of formocresol and to evaluate whether there are alterations in the product formula after simulated use and among the brands. Method: This in vitro study used four commercial brands of formocresol (Biodinâmica®, Iodontec®, Inodon® and Iodontosul®) simulating its clinical use by handling these products daily during 60 days. The chemical analysis was performed at the laboratory of PUCRS's Chemistry School and focused on formaldehyde, which is formocresol's main component with Signify cant evaporation property. The analysis comprised three chemical analyses by the gaseous chromatography method. Results: There was a decrease in the formaldehyde content decreased in the 60-day period for all four brands, suggesting that the product efficiency may decrease with time. It was also observed that the initial formaldehyde content differed among the researched brands. Conclusion: The efficacy of the product may decrease with time, but the results are not conclusive, needing further research.

Contamination of handpieces during pulpotomy therapy on primary teeth.

PURPOSE: The purpose of this in vivo study was to determine the potential for internal bacteriol contamination of low-speed handpiece/ contraangle systems. METHODS: Clinical contamination was measured for 24 pulpotomies on primary first or second molar teeth from 20 subjects. The investigators used microbiologic analysis to determine the extent of bacterial contamination from the patient's saliva using enriched trypticase soy agar (ETSA) plates. Analysis for the presence of blood also occurred. RESULTS: Microbial analysis indicated aerobic and anaerobic bacterial contamination at all 3 culturing sites from all 24 handpieces (100% contamination, 95% confidence intervals [CI] = 86%-100%). Aerobic and anaerobic bacteria levels (CFU/mL) were not significantly different (P = .43 overall, P > .25 for each of the 3 evaluated sites). The sites also did not have significantly different CFU/mL levels (P = .13 overall, P = .63 for aerobic, P = .14 for anaerobic). The analysis showed no blood contamination at any of the 3 culturing sites for any of the 24 handpieces (0% contamination, 95% CI = 0%-14%). CONCLUSIONS: The in vivo data suggest that low-speed handpiece/contraangle systems can become bacterially contaminated during the performance of pulpotomies and, unless properly sterilized between patients, there is the potential for pathogenic micro-organisms to enter, adhere, and then emit during use on subsequent patients.

Assessment of the anesthetic effectiveness of anterior and middle superior alveolar injection using a computerized device versus traditional technique in children.

UNLABELLED: The study aims to evaluate the anesthetic effectiveness of the Anterior and Middle Superior Alveolar (AMSA) injection administered through a computer-controlled local anesthetic delivery system (CCLAD), and compare it with the traditional buccal and palatal injections used to anesthetize maxillary primary molars. MATERIALS AND METHODS: The sample included 80 primary maxillary molars, divided into 2 equal groups: Pulpotomy and extraction groups. Each group was divided equally into 4 subgroups: A. First molars anesthetized with the traditional technique, B. first molars anesthetized with the CCLAD, C. second molars anesthetized with the traditional technique, and D. second molars anesthetized with the CCLAD. The evaluation was done single blind using SEM scale. RESULTS: The AMSA injection with the CCLAD was found to be effective in anesthetizing maxillary primary molars in pulpotomy and extraction procedures. There was no significant difference between the two anesthetic techniques except in the step of gingival retraction buccally in, which the traditional injections were more effective than the CCLAD during extractions. No significant difference was found between first and second primary molars in the effectiveness of both techniques. CONCLUSION: The AMSA injection using CCLAD was found to be effective in children.

Histopathological evaluation of pulpotomy with Er,Cr:YSGG laser vs formocresol.

The purpose of this study was to histologically investigate whether pulpotomy with Er,Cr:YSGG laser is an acceptable alternative for formocresol. Pulpotomy of 48 dog's primary canine teeth was performed with formocresol or Er,Cr:YSGG laser. Histological evaluations on hematoxylin and eosin-stained pulp tissues were made by an optical microscope 7 or 60 days later. Statistical analysis was performed with Fisher's exact test, Mann-Whitney U test, and Student's t test. Seven days after pulpotomy, samples treated with laser had significantly favorable histological features in the following measures: continuity of odontoblastic layer (P<0.001), presence of hemorrhage (P<0.008), amount of inflammation (P<0.002), tissue necrosis (P<0.001), internal resorption (P<0.002), level of vascularization (P<0.002), and size of abscess (P<0.041). Similar results were observed 60 days after pulpotomy, except that the differences were not mostly significant due to natural exfoliation of 16 teeth. In conclusion, Er,Cr:YSGG laser system is an acceptable alternative for formocresol in pulpotomy of deciduous teeth.

Pulpotomías en molares primarios. Evaluación clínico radiográfica de formocresol o trióxido mineral agregado / Pulpotomies in primary molars. A clinical and radiographic evaluation of formocresol or mineral trioxide aggregate

A pesar de los avances registrados en las últimas décadas en Odontología, aún no se ha identificado un agente para el tratamiento pulpar ideal que revelealto grado de éxito en molares primarios hasta su normal exfoliación. El formocresol ha sido el medicamentopara pulpotomías más empleado, si bien se ha demostrado que posee características tóxicas para lostejidos con los que entra en contacto. El objetivo de este trabajo prospectivo fue evaluar el comportamiento clínico y radiográfico de un trióxido mineralagregado de fabricación nacional, disponible en el mercado y con aprobación del ANMAT, comparadocon formocresol, como agente de pulpotomías en molares primarios. Metodología: 30 molares primariosde pacientes sin compromiso sistémico, con indicación de pulpotomía recibieron alternadamente, pulpotomías con formocresol diluido (FC) y con Trióxido mineral agregado (TMA) CPM®, siendoevaluados clínica y radiográficamente en un rango de 180 a 300 días. Se registraron como fracasos: la observación clínica de fístula, dolor espontáneo y movilidad no fisiológica, y la radiográfica de reabsorción interna, externa, ensanchamiento periodontaly radiolucidez interradicular. Resultados: La edad media de los pacientes para FC fue 5,6 + 1,24 años, yTMA 6 + 1,64 años. (p = 0.4). El éxito clínico para ambos grupos fue del 94 por ciento, y el radiográfico de 87 por cientopara FC y 94 por ciento para TMA (p = 0.7). Conclusiones: En este trabajo preliminar el Trióxido mineral agregadoy el formocresol demostraron comportamiento clínico y radiográfico semejante. Estos resultados ameritanfuturos estudios aumentando el número de casos y tiempo de observación.