scholarly journals Biodentine Total Pulpotomy as an Effective Alternative to Conventional Endodontic Therapy for Young Permanent Teeth – A Study from Calicut, India

2021 ◽  
Vol 10 (21) ◽  
pp. 1593-1597
Author(s):  
Amith Adyanthaya ◽  
Prathyusha P ◽  
Risana K ◽  
Aparna Sivaraman ◽  
Nazreen Ayub K ◽  
...  

BACKGROUND The vitality of dental pulp is essential for long-term survival of the tooth. Vital pulp therapy (VPT) intends to maintain healthy pulp tissue by eliminating bacteria from the dentin-pulp complex. There are many treatment options for vital pulp therapy in extensively decayed teeth. Pulp capping or pulpotomy procedures rely upon an accurate assessment of the pulp status, and careful management of the remaining pulp tissue. We wanted to evaluate as to whether biodentine total pulpotomy is an effective alternative to conventional endodontic therapy for young permanent teeth. METHODS Full coronal pulpotomy was performed in young permanent molars diagnosed with acute irreversible pulpitis with Biodentine as the pulpotomy medicament. Follow up evaluation was done clinically and radiographically at 3, 6 and 12 months. RESULTS During follow-up periods clinical signs/symptoms were absent including pulpal pain, swelling or presence of sinus and percussion pain. Continuous root development and healing of periapical radiolucency were noticed in the study which were indicative of maintenance of vitality of the pulp. CONCLUSIONS Within the limitations of this clinical study, it is concluded that total pulpotomy with Biodentine has a promising scope in regenerative approaches in the treatment of carious young permanent teeth. KEY WORDS Biodentine, Coronal Pulpotomy, Permanent Teeth, Total Pulpotomy

2021 ◽  
pp. 089875642110463
Author(s):  
Amalia Zacher ◽  
Sandra Manfra Marretta

Immature permanent teeth with crown fractures present a unique challenge in human and animal patients. Immature permanent teeth have not yet developed completely, often presenting with thin dentin walls, incomplete apical formation, and increased crown-to-root ratios. Loss of pulp function at this stage has devastating long-term implications for these teeth. Ideally, attempts should be made to preserve pulp vitality in immature permanent teeth to allow for continued dental development. The range of treatment options for vital teeth includes odontoplasty with bonding and sealing +/− restoration, indirect pulp capping, and direct pulp capping/vital pulp therapy. These treatments have long been established in human and veterinary medicine, and cases have been reported in dogs and cats. Apexification using calcium hydroxide is a well-established treatment for nonvital immature teeth. The advent of mineral trioxide aggregate and other bioceramic materials for use in vital pulp therapy and apexification has reduced treatment sessions and improved outcomes. Recent developments in the field of regenerative endodontic therapy further expand treatment options and provide the possibility for continued development of a formerly nonvital tooth. Selecting the appropriate treatment based on the severity of tooth fracture and status of pulp vitality can avoid a lifetime of poor structure and function for the affected tooth. This article provides multiple step-by-step protocols for the management of immature permanent teeth with crown fractures in small animals.


Pharmaceutics ◽  
2020 ◽  
Vol 12 (7) ◽  
pp. 644
Author(s):  
Tien Thuy Vu ◽  
Minh Truong Nguyen ◽  
Polkit Sangvanich ◽  
Quang Ngoc Nguyen ◽  
Pasutha Thunyakitpisal

Direct pulp-capping, a vital pulp therapy, is used to protect and preserve pulp vitality by applying a biomaterial on the pulp exposure site. Acemannan, a polysaccharide extracted from Aloe vera, induces osteodentin-bridge formation to cover the exposure site in vivo. We evaluated the effect of acemannan sponges on partial pulpotomized permanent teeth with caries or accident-induced pulp exposure (n = 50). After removing infected dentin and inflamed pulp tissue, the teeth were randomly divided into acemannan or control (mineral trioxide aggregate (MTA) groups (n = 25). The teeth were examined immediately after treatment (baseline) and at 6- and 12-month follow-ups for clinical and cone beam computed tomography (CBCT) examination. The three-dimensional tooth length and root apex area were simulated to determine treatment success. We found that the overall success rate in the acemannan and MTA groups from baseline to 12-month follow-up was 90.91% and 95.65%, respectively, with no significant difference between the two groups (p > 0.05). In the success teeth in both groups, the root length increased, and the apex area significantly decreased (p < 0.05), indicating continued root formation. Our results suggest that acemannan is a promising low-cost biomaterial for partial pulpotomy treatment for immature permanent teeth requiring vital pulp therapy.


2016 ◽  
Vol 60 (2) ◽  
Author(s):  
Piotr Makowiecki ◽  
Matylda Trusewicz ◽  
Łukasz Tyszler ◽  
Jadwiga Buczkowska-Radlińska

The vitality of dental pulp is essential for long­‍‑term tooth survival. The aim of vital pulp therapy is to preserve vital, healthy pulp tissue. This therapy’s foundation is the elimination of bacteria from the dentin­‍‑pulp complex. The treatment option depends on the cause and extent of mineralised tooth tissue destruction. The outcome of such treatment is determined by accurate assessment of the pulp’s status and the dentist’s ability to predict the success of the therapy. The aim of this review is to facilitate the dentist in making a proper decision referring to vital pulp therapy in permanent teeth, and to provide an overview of new approaches in such treatment.


2021 ◽  
Vol 45 (3) ◽  
pp. 158-164
Author(s):  
Bushra Rahman ◽  
Mousumi Goswami

Objective: In a tooth with deep dentinal caries; judicious removal of infected dentin and isolating affected dentin from oral fluids with suitable biocompatible material is called indirect pulp therapy (IPT). This randomized clinical trial was done to evaluate and compare the efficacy of Biodentine, Theracal LC and. Dycal as an indirect pulp capping agent in young permanent teeth. Study Design: IPT was performed in 60 young permanent molars with caries approaching pulp in 55 healthy children using Biodentine, Theracal and Dycal. A 2–3mm layer of GIC was placed over the intervening material followed by restoration of cavity with composite. Clinical and radiographic examinations were conducted at 3 weeks, 3 months, 6 months,12 months, 18 months and 24 months. The data was compared using chi-square test at a significance level of 0.05. Results: By end of 24 months ,54 teeth presented for follow up with overall success rate of 100% in Theracal, 94.44% in Biodentine, and 77.78% in Dycal. Overall success of Theracal was statistically significant in comparison to Biodentine and Dycal at 24 months follow up (p= 0.03) Conclusions: Radiographic and clinical outcomes of Theracal and Biodentine suggest their use as an alternative material for IPT in young permanent molars with higher success.


2015 ◽  
Vol 2015 ◽  
pp. 1-12 ◽  
Author(s):  
Raji Viola Solomon ◽  
Umrana Faizuddin ◽  
Parupalli Karunakar ◽  
Grandhala Deepthi Sarvani ◽  
Sevvana Sree Soumya

Aim. (1) The aim of the clinical study revolves around the accurate diagnosis, proper case selection, and the management of acute irreversible pulpitis in permanent molars with closed apices using conservative and economical treatment modalities like vital pulpotomies with regenerative approaches over conventional root canal procedures. (2) To evaluate the use of autologous substances such as platelet concentrates and calcium silicate based materials in promoting the healing and regeneration of the inflamed pulp.Summary. Vital pulpotomy was performed on 5 carious involved, permanent molars diagnosed with acute irreversible pulpitis in 17- to 22-year-old patients. Taking into consideration the patient’s age and the condition of the underlying pulp tissue, PRF pulpotomy was planned in view of preserving the vitality of the intact radicular pulps. Regenerative procedures with second generation blood matrices were chosen to encourage the recovery of the inflamed pulps. The systematic follow-up examinations performed at 3, 6, 9, 12, 18, 22, and 24 months revealed a successful clinical and radiological outcome. Within the limits of the present clinical study and correlating the success across the treated clinical cases, we safely conclude the potential scope of regenerative pulpotomy approaches in acute irreversible pulpitis in adult permanent teeth.


Materials ◽  
2021 ◽  
Vol 14 (2) ◽  
pp. 305
Author(s):  
Chung-Min Kang ◽  
Saemi Seong ◽  
Je Seon Song ◽  
Yooseok Shin

The use of hydraulic silicate cements (HSCs) for vital pulp therapy has been found to release calcium and hydroxyl ions promoting pulp tissue healing and mineralized tissue formation. The present study investigated whether HSCs such as mineral trioxide aggregate (MTA) affect their biological and antimicrobial properties when used as long-term pulp protection materials. The effect of variables on treatment outcomes of three HSCs (ProRoot MTA, OrthoMTA, and RetroMTA) was evaluated clinically and radiographically over a 48–78 month follow-up period. Survival analysis was performed using Kaplan–Meier survival curves. Fisher’s exact test and Cox regression analysis were used to determine hazard ratios of clinical variables. The overall success rate of MTA partial pulpotomy was 89.3%; Cumulative success rates of the three HSCs were not statistically different when analyzed by Cox proportional hazard regression analysis. None of the investigated clinical variables affected success rates significantly. These HSCs showed favorable biocompatibility and antimicrobial properties in partial pulpotomy of permanent teeth in long-term follow-up, with no statistical differences between clinical factors.


2021 ◽  
Vol 2 ◽  
Author(s):  
Mark Shallal-Ayzin ◽  
Tam Trinh ◽  
William Yeung ◽  
Peter Z. Tawil ◽  
Carol L. Haggerty ◽  
...  

Vital pulp therapy (VPT) is a viable treatment option for carious teeth with exposed pulps. To our knowledge, no study has examined the correlation between postoperative pain and the outcome of VPT on asymptomatic permanent teeth. The aim of this study was to examine whether odontogenic pain experienced after VPT on asymptomatic teeth with a carious pulp exposures is correlated with the progression of pulpal disease into a more inflamed or necrotic state. Direct pulp caps or partial pulpotomies using a tricalcium silicate (MTA Angelus, Angelus, Londrina, Brazil) were performed on asymptomatic permanent teeth using a standardized protocol. Patients were contacted at 24 h, 1 week, and 3 months following treatment and data was collected on post-operative pain and analgesic intake using a standardized questionnaire. At 6 months after treatment, an in-person clinical exam was performed which included standard vitality tests along with exposure of a periapical radiograph. Success was defined as an asymptomatic, functional tooth without any clinical or radiographic pathology. Data was analyzed using logistic regression. VPT was successful in 84.3% of patients at the 6 months timepoint. The percentage of patients that experienced pain at 24-h, 1 week, and 3-month time periods was 38, 22, and 12%, respectively. Pain at 3 months was significantly correlated with decreased outcome (p = 0.028). This data suggests that postoperative pain in the first 3 months after VPT is predictive of a poor treatment outcome.


2019 ◽  
Vol 7 (1) ◽  
pp. 8
Author(s):  
Mohammad Hammo DDS ◽  
Mazen Doumani DDS. MSc. ◽  
Adnan Habib DDS. MSc. PhD

The main goal of vital pulp therapy is to preserve and maintain pulpal health in teeth that have been exposed to caries, trauma, and restorative procedures. This type of endodontic treatment is very important in young permanent teeth that have not reached their complete length and exhibit thin-walled roots and wide open apices. The developments in knowledge of pulpal physiology and immunology, beside to newly introduced dental materials, have changed the treatment approaches for teeth with involved pulps. This report describes a case of a young patient in whom maxillary right central incisor suffered crown fractures because of a traumatic accident. Pulpotomy with MTA were performed in order to achieve apexogenesis and the tooth was restored with a glass ionomer cement and composite resin. The patient was reviewed over 4years. 


2020 ◽  
Vol 9 (4) ◽  
pp. 984 ◽  
Author(s):  
Amina Munir ◽  
Matthias Zehnder ◽  
Dan-Krister Rechenberg

The aim of this study was to systematically review pulp wound lavage in vital pulp therapy (VPT). A search was conducted in six life science databases to identify clinical trials carried out on permanent teeth with a carious pulp exposure and a recall interval of at least six months. Twenty-seven trials of low to moderate risk of bias (RoB-2 and ROBINS-I) were included. Data was extracted and analyzed regarding study characteristics and methods used for pulp wound lavage. The agent used for pulp wound lavage was specified in all included trials. Most of the identified trials (23/27) randomized the pulp capping material. Many (14/27) reported the use of sodium hypochlorite (NaOCl); ten used only saline or water. One trial was identified that compared pulp wound lavage with 2.5% (NaOCl) to saline, another compared 5% glutaraldehyde to water, both in immature molar pulpotomies. Both studies were underpowered. Neither showed a significant difference between treatments. The use of NaOCl was positively correlated to recent year of publication and use of hydraulic calcium silicate cements for pulp capping (p < 0.05). In conclusion, despite a lack of well-designed trials on pulp wound lavage in VPT, a trend towards using NaOCl for this purpose was observed.


2022 ◽  
Vol 9 (1) ◽  
pp. 26
Author(s):  
Francesco Albanese ◽  
Francesca Abramo ◽  
Michele Marino ◽  
Maria Massaro ◽  
Laura Marconato ◽  
...  

Cutaneous lymphocytosis (CL) is an uncommon and controversial lymphoproliferative disorder described in dogs and cats. CL is generally characterized by a heterogeneous clinical presentation and histological features that may overlap with epitheliotropic lymphoma. Therefore, its neoplastic or reactive nature is still debated. Here, we describe clinicopathological, immunohistochemical, and clonality features of a retrospective case series of 19 cats and 10 dogs with lesions histologically compatible with CL. In both species, alopecia, erythema, and scales were the most frequent clinical signs. Histologically, a dermal infiltrate of small to medium-sized lymphocytes, occasionally extending to the subcutis, was always identified. Conversely, when present, epitheliotropism was generally mild. In cats, the infiltrate was consistently CD3+; in dogs, a mixture of CD3+ and CD20+ lymphocytes was observed only in 4 cases. The infiltrate was polyclonal in all cats, while BCR and TCR clonal rearrangements were identified in dogs. Overall, cats had a long-term survival (median overall survival = 1080 days) regardless of the treatment received, while dogs showed a shorter and variable clinical course, with no evident associations with clinicopathological features. In conclusion, our results support a reactive nature of the disease in cats, associated with prolonged survival; despite a similar histological picture, canine CL is associated with a more heterogeneous lymphocytic infiltrate, clonality results, and response to treatment, implying a more challenging discrimination between CL and CEL in this species. A complete diagnostic workup and detailed follow-up information on a higher number of cases is warrant for dogs.


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