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Pediatric dentistry is the field responsible for the care and treatment of oral health in children and adolescents. Pulpotomy emerges as an important conservative technique used in the treatment of deciduous teeth affected by pulp lesions. Deciduous teeth play a crucial role in facial development, as well as serving as guides for the eruption of permanent teeth and maintaining space for proper occlusion. It is essential to preserve them when possible, avoiding the need for extraction or more invasive procedures. Pulpotomy is indicated when there is inflammation in the coronal pulp caused by caries or trauma but with preservation of radicular pulp vitality. The procedure involves the partial removal of the affected pulp, the application of medication in the cavity, and subsequent restoration, with the aim of maintaining pulp vitality, relieving pain, and preventing future complications. This research aims to analyze pulpotomy as an efficient treatment option in pediatric dentistry. The study is based on the methodology of narrative literature review. The results obtained by analyzing pulpotomy in pediatric dentistry demonstrate its effectiveness in preserving the pulp vitality, function, and aesthetics of affected deciduous teeth, with the technique providing a less traumatic treatment for children. The choice of obturating materials used in pulpotomy is a crucial aspect for the success of the treatment. Various materials, such as formocresol, calcium hydroxide, and biodentine, have been studied and applied in clinical practice. The selection of the appropriate material should take into account characteristics such as biocompatibility, non-irritation of the tooth, ease of manipulation, hermetic sealing, and mechanical resistance. Thus, when performed correctly and with the use of appropriate obturating materials, it offers an effective and safe treatment, respecting the principles of preserving dental integrity and promoting long-term oral health., La odontopediatría es el campo responsable del cuidado y tratamiento de la salud oral en niños y adolescentes. La pulpotomía emerge como una importante técnica conservadora utilizada en el tratamiento de dientes deciduos afectados por lesiones pulpares. Los dientes deciduos juegan un papel crucial en el desarrollo facial, además de servir como guías para la erupción de los dientes permanentes y mantener el espacio para la oclusión adecuada. Es esencial preservarlos cuando sea posible, evitando la necesidad de extracción o procedimientos más invasivos. La pulpotomía está indicada cuando hay inflamación en la pulpa coronal causada por caries o traumatismos pero con preservación de la vitalidad de la pulpa radicular. El procedimiento implica la extirpación parcial de la pulpa afectada, la aplicación de medicamentos en la cavidad y la restauración posterior, con el objetivo de mantener la vitalidad de la pulpa, aliviar el dolor y prevenir complicaciones futuras. Esta investigación tiene como objetivo analizar la pulpotomía como una opción de tratamiento eficiente en odontopediatría. El estudio se basa en la metodología de revisión narrativa de la literatura. Los resultados obtenidos mediante el análisis de pulpotomía en odontopediatría demuestran su eficacia en la preservación de la vitalidad, función y estética de la pulpa de los dientes deciduos afectados, con la técnica proporcionando un tratamiento menos traumático para los niños. La elección de los materiales obturantes utilizados en la pulpotomía es un aspecto crucial para el éxito del tratamiento. Varios materiales, como formocresol, hidróxido de calcio y biodentina, se han estudiado y aplicado en la práctica clínica. La selección del material apropiado debe tener en cuenta características como la biocompatibilidad, la no irritación del diente, la facilidad de manipulación, el sellado hermético y la resistencia mecánica. Por lo tanto, cuando se realiza correctamente y con el uso de materiales obturantes adecuados, A odontopediatria é a área responsável pelo cuidado e tratamento da saúde bucal de crianças e adolescentes. A pulpotomia surge como uma importante técnica conservadora utilizada no tratamento de decíduos afetados por lesões pulpares. Os decíduos possuem uma função crucial no desenvolvimento facial, além de servirem como guias para a irrupção dos permanentes e manutenção do espaço para a correta oclusão. É fundamental que sejam preservados quando possível, evitando a necessidade de extração ou procedimentos mais invasivos. A pulpotomia é indicada quando há uma inflamação na polpa coronária, causada por cárie ou trauma, mas ainda com a preservação da vitalidade da polpa radicular. O procedimento envolve a remoção parcial da polpa afetada, a aplicação de medicação na cavidade e posterior restauração, com o objetivo de manter a vitalidade pulpar, aliviar dor e prevenir complicações futuras. Esta pesquisa tem como objetivo analisar a pulpotomia como uma opção de tratamento eficiente na odontopediatria. Para a realização do estudo, parte-se da metodologia da revisão de literatura narrativa. Os resultados obtidos ao analisar a pulpotomia na odontopediatria demonstraram sua eficiência na preservação da vitalidade pulpar, função e estética dos decíduos afetados, sendo que a técnica proporciona um tratamento menos traumático para crianças. A escolha dos materiais obturadores utilizados na pulpotomia é um aspecto crucial para o sucesso do tratamento. Diversos materiais, como formocresol, hidróxido de cálcio e biodentine, têm sido estudados e aplicados na prática clínica. A seleção do material apropriado deve levar em conta características como biocompatibilidade, não irritabilidade do elemento, fácil manipulação, selamento hermético e resistência mecânica. Dessa forma, quando realizada corretamente e com a utilização de materiais obturadores adequados, oferece um tratamento eficaz e seguro, respeitando os princípios de preservação da integridade dentária e promoção da saúde or

Pediatric dentistry is the field responsible for the care and treatment of oral health in children and adolescents. Pulpotomy emerges as an important conservative technique used in the treatment of deciduous teeth affected by pulp lesions. Deciduous teeth play a crucial role in facial development, as well as serving as guides for the eruption of permanent teeth and maintaining space for proper occlusion. It is essential to preserve them when possible, avoiding the need for extraction or more invasive procedures. Pulpotomy is indicated when there is inflammation in the coronal pulp caused by caries or trauma but with preservation of radicular pulp vitality. The procedure involves the partial removal of the affected pulp, the application of medication in the cavity, and subsequent restoration, with the aim of maintaining pulp vitality, relieving pain, and preventing future complications. This research aims to analyze pulpotomy as an efficient treatment option in pediatric dentistry. The study is based on the methodology of narrative literature review. The results obtained by analyzing pulpotomy in pediatric dentistry demonstrate its effectiveness in preserving the pulp vitality, function, and aesthetics of affected deciduous teeth, with the technique providing a less traumatic treatment for children. The choice of obturating materials used in pulpotomy is a crucial aspect for the success of the treatment. Various materials, such as formocresol, calcium hydroxide, and biodentine, have been studied and applied in clinical practice. The selection of the appropriate material should take into account characteristics such as biocompatibility, non-irritation of the tooth, ease of manipulation, hermetic sealing, and mechanical resistance. Thus, when performed correctly and with the use of appropriate obturating materials, it offers an effective and safe treatment, respecting the principles of preserving dental integrity and promoting long-term oral health., La odontopediatría es el campo responsable del cuidado y tratamiento de la salud oral en niños y adolescentes. La pulpotomía emerge como una importante técnica conservadora utilizada en el tratamiento de dientes deciduos afectados por lesiones pulpares. Los dientes deciduos juegan un papel crucial en el desarrollo facial, además de servir como guías para la erupción de los dientes permanentes y mantener el espacio para la oclusión adecuada. Es esencial preservarlos cuando sea posible, evitando la necesidad de extracción o procedimientos más invasivos. La pulpotomía está indicada cuando hay inflamación en la pulpa coronal causada por caries o traumatismos pero con preservación de la vitalidad de la pulpa radicular. El procedimiento implica la extirpación parcial de la pulpa afectada, la aplicación de medicamentos en la cavidad y la restauración posterior, con el objetivo de mantener la vitalidad de la pulpa, aliviar el dolor y prevenir complicaciones futuras. Esta investigación tiene como objetivo analizar la pulpotomía como una opción de tratamiento eficiente en odontopediatría. El estudio se basa en la metodología de revisión narrativa de la literatura. Los resultados obtenidos mediante el análisis de pulpotomía en odontopediatría demuestran su eficacia en la preservación de la vitalidad, función y estética de la pulpa de los dientes deciduos afectados, con la técnica proporcionando un tratamiento menos traumático para los niños. La elección de los materiales obturantes utilizados en la pulpotomía es un aspecto crucial para el éxito del tratamiento. Varios materiales, como formocresol, hidróxido de calcio y biodentina, se han estudiado y aplicado en la práctica clínica. La selección del material apropiado debe tener en cuenta características como la biocompatibilidad, la no irritación del diente, la facilidad de manipulación, el sellado hermético y la resistencia mecánica. Por lo tanto, cuando se realiza correctamente y con el uso de materiales obturantes adecuados, A odontopediatria é a área responsável pelo cuidado e tratamento da saúde bucal de crianças e adolescentes. A pulpotomia surge como uma importante técnica conservadora utilizada no tratamento de decíduos afetados por lesões pulpares. Os decíduos possuem uma função crucial no desenvolvimento facial, além de servirem como guias para a irrupção dos permanentes e manutenção do espaço para a correta oclusão. É fundamental que sejam preservados quando possível, evitando a necessidade de extração ou procedimentos mais invasivos. A pulpotomia é indicada quando há uma inflamação na polpa coronária, causada por cárie ou trauma, mas ainda com a preservação da vitalidade da polpa radicular. O procedimento envolve a remoção parcial da polpa afetada, a aplicação de medicação na cavidade e posterior restauração, com o objetivo de manter a vitalidade pulpar, aliviar dor e prevenir complicações futuras. Esta pesquisa tem como objetivo analisar a pulpotomia como uma opção de tratamento eficiente na odontopediatria. Para a realização do estudo, parte-se da metodologia da revisão de literatura narrativa. Os resultados obtidos ao analisar a pulpotomia na odontopediatria demonstraram sua eficiência na preservação da vitalidade pulpar, função e estética dos decíduos afetados, sendo que a técnica proporciona um tratamento menos traumático para crianças. A escolha dos materiais obturadores utilizados na pulpotomia é um aspecto crucial para o sucesso do tratamento. Diversos materiais, como formocresol, hidróxido de cálcio e biodentine, têm sido estudados e aplicados na prática clínica. A seleção do material apropriado deve levar em conta características como biocompatibilidade, não irritabilidade do elemento, fácil manipulação, selamento hermético e resistência mecânica. Dessa forma, quando realizada corretamente e com a utilização de materiais obturadores adequados, oferece um tratamento eficaz e seguro, respeitando os princípios de preservação da integridade dentária e promoção da saúde or

The objective of this work was to evaluate (1) the short-term evolution of pain and (2) the treatment success of full pulpotomy as permanent treatment of irreversible pulpitis in mature molars. The study consisted of a non-randomized comparison between a test group ( = 44)-full pulpotomy performed by non-specialist junior practitioners, and a control group ( = 40)-root canal treatments performed by specialized endodontists. Short-term pain score (Heft-Parker scale) was recorded pre-operatively, then at 24 h and 7 days post-operatively. Three outcomes were considered for treatment success: , and success. For short-term evolution of pain, a non-parametric Wilcoxon test was performed (significance level = 0.05). For treatment success, a Pearson Chi square or Fisher test were performed (significance level = 0.017-Bonferroni correction). There was no significant difference between and control groups neither regarding short term evolution of pain at each time point, nor regarding (80% and 90%, respectively) or success (77% and 67%, respectively). However, a significant difference in success was observed (94% and 69%, respectively). The present work adds to the existing literature to support that pulpotomy as permanent treatment could be considered as an acceptable and conservative treatment option, potentially applied by a larger population of dentists.

The management of dental emergencies is a central and essential issue in the daily practice of dentists. Through two clinical studies, we were able to identify new perspectives: 1/ The strategy of emergency management based on triage with the establishment of recommendations allowed to find an effective compromise between limiting the admission of patients and ensuring the control of their pain and the relief of their symptoms. 2/ More conservative management of irreversible pulpitis. Our data tend to support pulpotomy as an acceptable and more conservative permanent treatment option for irreversible pulpitis of mature molars. Our strategies could be considered as first-line treatments, thus providing additional steps in the therapeutic gradient., (DENT - Sciences dentaires) -- UCL, 2022

Bioactive molecules present the potential to be used along with biomaterials in vital pulp therapy and regenerative endodontic treatment. Objective: The aim of this study was to assess the effects of the combined use of bone morphogenetic protein-7 (BMP-7) and mineral trioxide aggregate (MTA) on the proliferation, migration, and differentiation of human dental pulp stem cells (DPSCs). Methodology: For the proliferation analysis, DPSCs were incubated with a growth medium and treated with MTA and/or BMP-7 at different concentrations. For the following analyses, DPSCs were incubated with a differentiation medium and treated with MTA and/ or BMP-7. Moreover, there were groups in which DPSCs were incubated with the growth medium (control), the differentiation medium, or DMEM/F12 containing fetal bovine serum, and not treated with MTA or BMP-7. Cell proliferation was analyzed using the WST-1 assay. The odontogenic/osteogenic differentiation was evaluated by immunocytochemistry, alkaline phosphatase (ALP) activity assay, alizarin red staining, and reverse transcription-quantitative polymerase chain reaction (RT-qPCR). Cell migration was evaluated using a wound-healing assay. Data were analyzed using analysis of variance and Tukey test (p=0.05). Results: The use of BMP-7 with MTA presented no significant effect on cell proliferation in comparison with the treatment with MTA alone (p>0.05), but showed higher ALP activity, increased mineralization, and higher expression of DMP1 and DSPP when compared with other groups (p0.05). Nestin expression was higher in the control group than in groups treated with MTA and/or BMP-7 (p0.05). The cell migration rate increased after treatment with MTA when compared with other groups in all periods of time (p0.05). At 72 hours, the wound area was smaller in groups treated with MTA and/ or BMP-7 than in the control group (p0.05). Conclusion: The use of BMP-7 with MTA increased odontogenic/osteogenic differentiation without adversely affecting, Hacettepe University Scientific Research Projects Coordination Unit [THD-2020-18625], The authors declare no conflict of interest related to this study. This study was supported by the Hacettepe University Scientific Research Projects Coordination Unit (THD-2020-18625).

Background: This study aimed to evaluate the area of dentin growth in rabbit incisors after pulp capping with plasma rich in growth factors (PRGF) compared with mineral trioxide aggregate (MTA) by fluorescence. Methods: twenty-seven upper and lower incisors of rabbits were divided into 4 groups: poor PRGF (F1) (n = 9 teeth), rich PRGF (F2) (n = 8 teeth), ProRoot MTA (positive control, n = 5 teeth), and untreated (NC) (negative control, n = 5). Fluorochrome markers were injected 24 h before surgery and the day before euthanasia, 28 days after the vital pulp therapy (VPT). Two transverse cuts were performed to every tooth: the first cut (A), 1 mm incisal to the gingival margin, and the second cut (B), 5 mm apical to the first cut. The sections were assessed with histomorphometric evaluation by fluorescence microscopy, comparing the dentin area between fluorescence marks and the total mineralized area. Results: The higher percentage of dentin growth was observed in the F2 group (B = 63.25%, A = 36.52%), followed by F1 (B = 57.63%, A = 30,12%) and MTA (B = 38.64%, A = 15.74%). The group with lowest percentage of dentin growth was the NC group (B = 29.22%, A = 7.82%). Significant difference (p < 0.05) was found between F2 group and MTA, also statistically significant difference has been observed comparing dentin growth areas of NC group with F1 and F2 groups. Conclusions: The application of PRGF rich and poor fraction as a pulp capping material stimulated dentin formation more intensively than MTA and NC.

Background: This study aimed to evaluate the area of dentin growth in rabbit incisors after pulp capping with plasma rich in growth factors (PRGF) compared with mineral trioxide aggregate (MTA) by fluorescence. Methods: twenty-seven upper and lower incisors of rabbits were divided into 4 groups: poor PRGF (F1) (n = 9 teeth), rich PRGF (F2) (n = 8 teeth), ProRoot MTA (positive control, n = 5 teeth), and untreated (NC) (negative control, n = 5). Fluorochrome markers were injected 24 h before surgery and the day before euthanasia, 28 days after the vital pulp therapy (VPT). Two transverse cuts were performed to every tooth: the first cut (A), 1 mm incisal to the gingival margin, and the second cut (B), 5 mm apical to the first cut. The sections were assessed with histomorphometric evaluation by fluorescence microscopy, comparing the dentin area between fluorescence marks and the total mineralized area. Results: The higher percentage of dentin growth was observed in the F2 group (B = 63.25%, A = 36.52%), followed by F1 (B = 57.63%, A = 30,12%) and MTA (B = 38.64%, A = 15.74%). The group with lowest percentage of dentin growth was the NC group (B = 29.22%, A = 7.82%). Significant difference (p < 0.05) was found between F2 group and MTA, also statistically significant difference has been observed comparing dentin growth areas of NC group with F1 and F2 groups. Conclusions: The application of PRGF rich and poor fraction as a pulp capping material stimulated dentin formation more intensively than MTA and NC.

Pulp treatments are one of the types of procedures most performed in pediatric patients, whose primary objective is to restore the masticatory, aesthetic and phonetic function. The objective of this study was to determine the frequency of pulp treatments performed in patients from 3 to 11 years of age treated at the Pediatric Dentistry Service of the Centro Dental Docente Cayetano Heredia from January 2015 to December 2019. The search for the medical records of patients treated at the Pediatric Dentistry Service who have met the inclusion and exclusion criteria. Data were collected on age, sex, type of dentition and tooth, for the elaboration of a database, and later tables of contents. Of a sample of 514 virtual medical records, with 1166 pulp treatments performed, indirect pulp treatment was the most performed for both sexes, 41.17% (n=247) for females and 34.98% (n=198) for males. According to age range, 3 to 5 years of age are the patients who received more indirect pulp treatment with 39.06% (n=359). The majority of patients with deciduous dentition underwent indirect pulp treatment with 39.32% (n=326). Being the tooth most treated with indirect pulp treatment 84 with 41.18% (n=70). The pulp treatment that was most performed in our study was indirect pulp treatment followed by pulpectomy and pulpotomy. The female sex, age group 3 to 5 years and deciduous dentition were the ones that received the most pulp treatments. The teeth with the highest frequency of pulp treatments were the second lower left molar and the first lower right molar, and those with the least frequency were the lower right and left canines., Los tratamientos pulpares constituyen uno de los tipos de procedimientos más realizados en pacientes pediátricos, cuyo objetivo primordial es devolver la función masticatoria, estética y fonética. El objetivo del presente estudio fue determinar la frecuencia de los tratamientos pulpares realizados en pacientes de 3 a 11 años de edad atendidos en el Servicio de Odontopediatría del Centro Dental Docente Cayetano Heredia desde enero de 2015 hasta diciembre de 2019. Se realizó la búsqueda de las historias clínicas de pacientes atendidos en el Servicio de Odontopediatría que hayan contado con los criterios de inclusión y exclusión. Se recogieron datos sobre edad, sexo, tipo de dentición y pieza dentaria, para la elaboración de una base de datos, y posteriormente tablas de contenido. De una muestra de 514 historias clínicas virtuales, con 1166 tratamientos pulpares realizados, el tratamiento pulpar indirecto fue el más realizado para ambos sexos, 41.17% (n=247) para el sexo femenino y 34.98% (n=198) para el sexo masculino. Según rango de edad, 3 a 5 años de edad son los pacientes que más tratamiento pulpar indirecto se realizaron con 39.06% (n=359). La mayoría de pacientes que presentaban dentición decidua se les realizaron el tratamiento de tratamiento pulpar indirecto con 39.32% (n=326). Siendo la pieza dental mayormente tratada con tratamiento pulpar indirecto la 84 con 41.18 % (n=70). El tratamiento pulpar que más se realizó dentro de nuestro estudio fue el tratamiento pulpar indirecto seguido de la pulpectomía y pulpotomía. El sexo femenino, grupo etario de 3 a 5 años y dentición decidua fueron los que más recibieron tratamientos pulpares. Los dientes con mayor frecuencia de tratamientos pulpares fueron la segunda molar inferior izquierda y la primera molar inferior derecha, y las que de menor frecuencia fueron las caninos inferiores derecho e izquierdo.

Objectives: To assess long-term survival of pulpotomized primary molars and factors related to the survival of the teeth. Materials and methods: This retrospective longitudinal study was based on electronic dental health records of children who attended public health service. Eligible children were <12 years and had a pulpotomy procedure code in their dental treatment history. Data were obtained in the period between 2002 and 2016. Chi-squared test, t-test, and one-way ANOVA were used to assess for statistical differences. Kaplan–Meier analyses were performed to create survival estimates, and the log-rank test was performed to compare differences in survival distributions. A multivariate Cox regression was conducted, and hazard ratios were calculated to estimate the hazard rate for failure. Results: Of interventions, 40% were registered in children 3–6 years of age; 56% were boys. Mean estimated survival of such molars was 82 months (SEM = 0.6) and differed by dental operator’s work setting and choice of restorative materials used after pulpotomy intervention. Using a stainless steel crown (SSC) to restore pulp-intervened primary molars had the strongest effect on survival (111 months with SEM = 1.8), followed by if the intervention was performed by a specialist or specializing dentist in paediatric dentistry (99 months with SEM = 2.6). Conclusions: The estimated survival time of pulpotomized primary molars is affected by dental operator-related factors, which should be considered in management of extensively carious primary molars of paediatric patients, both at the clinical and organizational decision-making levels. An increased focus on the use of SSC is recommended to be in the learning objectives of dental education programs.

Background: This study aimed to evaluate the area of dentin growth in rabbit incisors after pulp capping with plasma rich in growth factors (PRGF) compared with mineral trioxide aggregate (MTA) by fluorescence. Methods: twenty-seven upper and lower incisors of rabbits were divided into 4 groups: poor PRGF (F1) (n = 9 teeth), rich PRGF (F2) (n = 8 teeth), ProRoot MTA (positive control, n = 5 teeth), and untreated (NC) (negative control, n = 5). Fluorochrome markers were injected 24 h before surgery and the day before euthanasia, 28 days after the vital pulp therapy (VPT). Two transverse cuts were performed to every tooth: the first cut (A), 1 mm incisal to the gingival margin, and the second cut (B), 5 mm apical to the first cut. The sections were assessed with histomorphometric evaluation by fluorescence microscopy, comparing the dentin area between fluorescence marks and the total mineralized area. Results: The higher percentage of dentin growth was observed in the F2 group (B = 63.25%, A = 36.52%), followed by F1 (B = 57.63%, A = 30,12%) and MTA (B = 38.64%, A = 15.74%). The group with lowest percentage of dentin growth was the NC group (B = 29.22%, A = 7.82%). Significant difference (p < 0.05) was found between F2 group and MTA, also statistically significant difference has been observed comparing dentin growth areas of NC group with F1 and F2 groups. Conclusions: The application of PRGF rich and poor fraction as a pulp capping material stimulated dentin formation more intensively than MTA and NC.

Formocresol is one of the most widely used drugs for the treatment of pulpotomy for the reason in Pediatric Dentistry; due to its toxic, genotoxic and mutagenic effects, it is constantly searching for alternatives with other substances or drugs. This is a basic experimental study in twenty samples collected from dental organs of patients with ages ranging from three to nine years of the Pediatric Dentistry Clinic of the Faculty of Stomatology of the UASLP met the inclusion criteria for the treatment of pulpotomies. The treatment was performed according to those established by AAPD with the exception that hydroalcoholic extract 70:30 of oregano was used and its ability to eliminate microorganisms was measured in the laboratory., El formocresol es uno de las sustancias más empleadas para la terapia dental de la pulpotomía en la Odontpediatría debido a sus efectos tóxicos, genotóxicos y mutagénicos; por dicha razón es que se está constantemente buscando nuevas alternativas para dicho tratamiento con el uso de distintas sustancias o medicamentos. Este es un estudio experimental básico en donde se recolectaron 20 muestras de órganos dentarios de pacientes con edades que oscilaban entre los tres y nueve años de la Clínica de Odontopediatría de Pregrado de la Facultad de Estomatología de la U. A. S. L. P. que cumplieron con los criterios de inclusión para el tratamiento de pulpotomías. El tratamiento se realizó de acuerdo con los lineamientos de la AAPD, con excepción de que se utilizó extracto hidroalcohólico 70:30 de orégano y se midió en el laboratorio su capacidad para eliminar microorganismos.

Formocresol is one of the most widely used drugs for the treatment of pulpotomy for the reason in Pediatric Dentistry; due to its toxic, genotoxic and mutagenic effects, it is constantly searching for alternatives with other substances or drugs. This is a basic experimental study in twenty samples collected from dental organs of patients with ages ranging from three to nine years of the Pediatric Dentistry Clinic of the Faculty of Stomatology of the UASLP met the inclusion criteria for the treatment of pulpotomies. The treatment was performed according to those established by AAPD with the exception that hydroalcoholic extract 70:30 of oregano was used and its ability to eliminate microorganisms was measured in the laboratory., El formocresol es uno de las sustancias más empleadas para la terapia dental de la pulpotomía en la Odontpediatría debido a sus efectos tóxicos, genotóxicos y mutagénicos; por dicha razón es que se está constantemente buscando nuevas alternativas para dicho tratamiento con el uso de distintas sustancias o medicamentos. Este es un estudio experimental básico en donde se recolectaron 20 muestras de órganos dentarios de pacientes con edades que oscilaban entre los tres y nueve años de la Clínica de Odontopediatría de Pregrado de la Facultad de Estomatología de la U. A. S. L. P. que cumplieron con los criterios de inclusión para el tratamiento de pulpotomías. El tratamiento se realizó de acuerdo con los lineamientos de la AAPD, con excepción de que se utilizó extracto hidroalcohólico 70:30 de orégano y se midió en el laboratorio su capacidad para eliminar microorganismos.

This position statement on the management of deep caries and the exposed pulp represents the consensus of an expert committee, convened by the European Society of Endodontology (ESE). Preserving the pulp in a healthy state with sustained vitality, preventing apical periodontitis and developing minimally invasive biologically based therapies are key themes within contemporary clinical endodontics. The aim of this statement is to summarise current best evidence on the diagnosis and classification of deep caries and caries-induced pulpal disease, as well as indicating appropriate clinical management strategies for avoiding and treating pulp exposure in permanent teeth with deep or extremely deep caries. In presenting these findings, areas of controversy, low-quality evidence and uncertainties are highlighted, prior to recommendations for each area of interest. A recently published review article provides more detailed information, and was the basis for this position statement (Bjørndal et al. 2019, International Endodontic Journal). The intention of this position statement is to provide the practitioner with relevant clinical guidance in this rapidly developing area. An update will be provided within 5 years as further evidence emerges. This article is protected by copyright. All rights reserved.

This position statement on the management of deep caries and the exposed pulp represents the consensus of an expert committee, convened by the European Society of Endodontology (ESE). Preserving the pulp in a healthy state with sustained vitality, preventing apical periodontitis and developing minimally invasive biologically based therapies are key themes within contemporary clinical endodontics. The aim of this statement is to summarise current best evidence on the diagnosis and classification of deep caries and caries-induced pulpal disease, as well as indicating appropriate clinical management strategies for avoiding and treating pulp exposure in permanent teeth with deep or extremely deep caries. In presenting these findings, areas of controversy, low-quality evidence and uncertainties are highlighted, prior to recommendations for each area of interest. A recently published review article provides more detailed information, and was the basis for this position statement (Bjørndal et al. 2019, International Endodontic Journal). The intention of this position statement is to provide the practitioner with relevant clinical guidance in this rapidly developing area. An update will be provided within 5 years as further evidence emerges. This article is protected by copyright. All rights reserved.

INTRODUCTION: The preservation of the integrity and health of primary teeth and their supporting tissues is of great importance in maintaining arch length space, mastication, speech, and esthetics. A pulpotomy is a common therapy performed on a primary tooth presenting reversible pulpitis or a traumatic pulp exposure, allowing its conservation on the arch until its loss. AIM: The study aims to clinically and radiographically evaluate the rates of success and efficacy of Biodentine™ as pulpotomy medicament exclusively on deciduous molars with complete roots formation (stage 2). MATERIALS AND METHODS: A total number of 75 primary molars in stage 2 of formation were selected to undergo pulpotomy treatment. All teeth were restored with a stainless-steel crown.The clinical success was evaluated at 1, 3, 6 and 12-month intervals. The radiographic follow-up evaluations were at 6 and 12 months. The resulting data were tabulated and statistically analyzed. RESULTS: Among the 75 teeth treated with Biodentine™, one tooth revealed abnormal mobility and tenderness to percussion at the end of the 1st month. PLS widening and the bone lesion was not seen in any of the 74 remaining cases. Forty teeth (54.1%) showed pulp canal obliteration (PCO), and none of the cases developed a draining sinus or had increased mobility. At the end of the 1-year follow-up, the clinical and radiographic success rates were 98.7% and 100%, respectively. CONCLUSION: Pulpotomies performed with Biodentine™ on stage 2 primary molars were generally very satisfactory and fulfilled all requirements, covering all needs. This innovative bioactive medicament seems to be a "heroic" material. The excellent outcomes of the present study are indicative that Biodentine™ is a promising biomaterial to promote pulp repair after pulpotomy in clinical practice. HOW TO CITE THIS ARTICLE: Nasrallah H, El Noueiri B, Pilipili C, Ayoub F. Clinical and Radiographic Evaluations of Biodentine™ Pulpotomies in Mature Primary Molars

INTRODUCTION: Conservation of primary dentition is essential for maintenance of arch length, esthetic, mastication, speech and prevention of abnormal habits. The commonly supported treatment for retaining carious primary molars with affected pulp is pulpotomy. AIM: The study aims to evaluate clinically and radiographically the rates of success and efficacy of Biodentine™ as pulpotomy medicament exclusively on primary molars with physiological root resorption. MATERIALS AND METHODS: A total number of 35 primary molars in stage three of formation were selected to undergo pulpotomy treatment. All teeth were restored with pediatric stainless-steel crowns.The clinical findings were evaluated at 1, 3, 6 and 12-month intervals and the radiographic follow-ups evaluations were done at 6 and 12 months. The resulting data were tabulated and statistically analyzed using IBM SPSS© for Windows version 20.0 (SPSS, Chicago, IL, USA). Mc Nemar test was conducted to evaluate the differences in results between months 6 and 12. RESULTS: Periodontal ligament space (PLS) widening and alveolar bone lesion were not seen in any of the 35 cases, 9 teeth (25.7%) manifested pulp canal obliteration (PCO), and none of the cases showed signs of pathologic root resorption. The clinical and radiographic success rates in pulpotomy using Biodentine™ at 6 and 12 months were 100%. CONCLUSION: Pulpotomies performed with Biodentine™ were entirely successful. This dressing material appears to be a serious pulpotomy agent in primary molars with root resorption.How to cite this article: Nasseh HN, Noueiri BE, Pilipili C, Ayoub F. Evaluation of Biodentine Pulpotomies in Deciduous Molars with Physiological Root Resorption (Stage 3).

Aims and Objectives: The aim of this study was to assess the correlation between the remaining dentin thickness (RDT) in deep decayed primary molars and the inflammatory status and bacterial composition of the corresponding coronal pulp. We hypothesized that RDT could be used as a reference for clinicians in assigning the indication for pulpotomy. Materials and Methods: Pulpotomies were conducted on the cameral pulp of 48 primary molars. Microorganisms, such as Lactobacillus sp. Streptococcus sp. and Prevotella sp. were identified and quantified and levels of tumor necrosis factor-Alpha (TNF-α) and interlukin-6 (IL-6) were assessed. The correlation between the pre-operative RDT based on radiographic images and inflammatory-microbial profiles in vitro was evaluated using Spearman's rho correlation coefficient. All data analysis was performed using a statistical software program (SPSS 20.0, SPSS Inc. Chicago, IL, USA). Results: Immunological and microbiological studies revealed elevated levels of TNF-α and IL-6 cytokines, and Lactobacillus sp. Streptococcus sp. and Prevotella sp. in the cameral pulp with an RDT measuring up to 1.1 mm. No significant relationship could be established between RDT, inflammatory status and microbial content of the pulps. Conclusion: The RDT remains a key clinical factor that needs to be assessed when establishing the indication for pulpotomy. Additional parameters that can improve this therapy should be investigated in the future., SCOPUS: ar.j, info:eu-repo/semantics/published

Regular dental recall intervals are widely recommended by dentists in the U.S. to prevent caries and improve periodontal health. However, there is some debate on whether or not compliance with six-month or more frequent recall intervals results in reduced incidence of dental caries. This study examines whether compliance with regular recall and receipt of cleanings, exams and patient education reduces rates of new decay in underserved children and finds a positive impact.

学位の種類: 博士（歯学）. 報告番号: 甲第4003号. 学位記番号: 新大院博（歯）甲第316号. 学位授与年月日: 平成27年3月23日, Journal of endodontics. 2014, 40(12), 1983-1988., Introduction: M2 (alternatively-activated) macrophages are known to participate in wound healing and tissue repair. This study aimed to analyze the temporospatial changes in the distribution and density of M2 macrophage-associated molecule-expressing cells after pulpotomy with mineral trioxide aggregate (MTA) in rat molars, in order to ascertain the role played by M2 macrophages in the healing of MTA-capped pulp tissue. Methods: The maxillary first molars of 8-week-old Wistar rats were pulpotomized and capped with MTA. After 1-14 days, the teeth were examined after hematoxylin-eosin staining or immunoperoxidase staining of CD68 (a general macrophage marker) and M2 macrophage markers (CD163 and CD204). The density of positively-stained cells was enumerated in the surface and inner regions (0 -100 µm and 300-400 µm, respectively, from the wound surface). Results: MTA-capping initially caused mild inflammatory changes and the formation of a degenerative layer, followed by progressive new matrix formation and calcified bridging. At 1-2 days, CD68-, CD163-, and CD204-positive cells started to accumulate beneath the degenerative layer, and the density of these cells was significantly higher in the surface region than in the inner region (P < 0.05). From 7 days onwards, the three types of cells displayed an almost normal distribution beneath the newly dentin-like matrix. Conclusions: After the pulpotomy of rat molars with MTA, M2 macrophage-associated molecule-expressing cells transiently accumulated beneath the degenerative layer under the MTA. This suggests that M2 macrophages participate in the initial phases of the healing of MTA-capped pulp tissue., 博士（歯学）, 新潟大学

Regular dental recall intervals are widely recommended by dentists in the U.S. to prevent caries and improve periodontal health. However, there is some debate on whether or not compliance with six-month or more frequent recall intervals results in reduced incidence of dental caries. This study examines whether compliance with regular recall and receipt of cleanings, exams and patient education reduces rates of new decay in underserved children and finds a positive impact.

Background. Traumatic injuries of permanent teeth with incomplete root formation are frequent during childhood. Adequate therapy is important for the further destiny of teeth with damaged pulp. Objectives. To evaluate the effect of pulpotomy and high pulpotomy on the pulp and on root development, and the effect of platelet rich plasma (PRP) with hydroxyapatite (HAP) as a carrier and hydroxyapatite alone on apexogenesis. Material and Methods. The study included eight monkeys (Cercopithecus aethiops) in which high pulpotomies were performed on the mandibular lateral incisors and canines, and pulpotomies were performed on the mandibular central incisors and premolars. The materials used in the study were commercial HAP (Apatec (R), Stomygen) and PR? (prepared at the Torlak Institute of Immunology and Virology, Belgrade, Serbia). Histological and radiological evaluations were done six months after the treatment. Results. Considering the differences between HAP+PRP treated teeth in the pulpotomy group and teeth in the high pulpotomy group, two times more root growth retardation was observed in the high pulpotomy group. In the high pulpotomy group, root growth retardation was less common in HAP+PRP treated teeth (42.9%) than in HAP treated teeth (50%). In the pulpotomy group, retardation of root development was also less common in HAP+PRP treated teeth (25%) compared to HAP treated teeth (50%). There were differences between the pulpotomy and high pulpotomy groups, but without statistical significance. Conclusions. The application of endogenous growth factors in conjunction with the preservation of dental pulp vitality can result in a good outcome for pulp therapy of injured teeth, which means successfully completed apexogenesis

Background. Traumatic injuries of permanent teeth with incomplete root formation are frequent during childhood. Adequate therapy is important for the further destiny of teeth with damaged pulp. Objectives. To evaluate the effect of pulpotomy and high pulpotomy on the pulp and on root development, and the effect of platelet rich plasma (PRP) with hydroxyapatite (HAP) as a carrier and hydroxyapatite alone on apexogenesis. Material and Methods. The study included eight monkeys (Cercopithecus aethiops) in which high pulpotomies were performed on the mandibular lateral incisors and canines, and pulpotomies were performed on the mandibular central incisors and premolars. The materials used in the study were commercial HAP (Apatec (R), Stomygen) and PR? (prepared at the Torlak Institute of Immunology and Virology, Belgrade, Serbia). Histological and radiological evaluations were done six months after the treatment. Results. Considering the differences between HAP+PRP treated teeth in the pulpotomy group and teeth in the high pulpotomy group, two times more root growth retardation was observed in the high pulpotomy group. In the high pulpotomy group, root growth retardation was less common in HAP+PRP treated teeth (42.9%) than in HAP treated teeth (50%). In the pulpotomy group, retardation of root development was also less common in HAP+PRP treated teeth (25%) compared to HAP treated teeth (50%). There were differences between the pulpotomy and high pulpotomy groups, but without statistical significance. Conclusions. The application of endogenous growth factors in conjunction with the preservation of dental pulp vitality can result in a good outcome for pulp therapy of injured teeth, which means successfully completed apexogenesis

In adult patients with caries and pulpal involvement, will pulpotomy with a simple operative restoration (amalgam), compared to root canal with crown, provide longer restoration?

Recently, a fully Nanocrystalline Hydroxyapatie (NHA) paste has been introduced for augmentation procedures in osseous defects and is attracting increasing interest in medicine and dentistry. The purpose of the present study was to assess and compare the pulp response of pig primary teeth after capping with NHA and formocresol in pulpotomy and NHA and calcium hydroxide in direct pulp capping., Comparative Study, Journal Article, SCOPUS: ar.j, info:eu-repo/semantics/published

Recently, a fully Nanocrystalline Hydroxyapatie (NHA) paste has been introduced for augmentation procedures in osseous defects and is attracting increasing interest in medicine and dentistry. The purpose of the present study was to assess and compare the pulp response of pig primary teeth after capping with NHA and formocresol in pulpotomy and NHA and calcium hydroxide in direct pulp capping., Comparative Study, Journal Article, SCOPUS: ar.j, info:eu-repo/semantics/published

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.

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.

La pulpotomie des dents temporaires est un acte simple,très courant en odontologie pédiatrique, mais sa réussite est tributaire du respect du protocole opératoire. Le devenir du moignon pulpaire résiduel dépend du produit de coiffage utilisé. Le choix entre produits de fixation, produits dentinogènes et substances hémostatiques est toujours à l’origine d’une controverse : chacun ayant des avantages et des inconvénients. Actuellement, la recherche s’oriente vers les molécules bioactives., [Failor and success factors of the pulpotomy of tempory teeth] The pulpotomy of temporary teeth is an easy and very current act in pediatric dentistry, but its success depends on the respect of the operating protocol. The becoming of residual stub pulp depends also on the product of capping. The choice between binding products, dentinogenes products and haemostatic substances is always subject of controversy: each having advantages and inconveniences. At present, researches turn to bioactive molecules

Pulpotomy is the most performed and controversial therapeutic in pediatric dentistry. Since formocresol is known to have a toxic effect on living tissues, plus a mutagenic and carcinogenic potential with a systemic uptake of formocresol via pulpotomized teeth, other alternative products have been investigated. Twenty-five decayed primary canines and twenty-five healthy primary canines necessitating disking for orthodontic purposes were pulpotomized using non modified Zinc Oxide Eugenol. The effects of this material were evaluated both clinically and radiographically. Post operative control examinations were performed at 1, 6, 12 and 24 months trying to detect spontaneous or stimulated pain, pathological tooth mobility, abscesses or fistulas, internal or external pathological tooth resorption, periapical bone destruction, or canal obliteration. Pain was absent at 24 months post operatively. Half of the treated canines presented with a mobility, while internal and external resorptions were more frequent in decayed teeth and their number increased with time. On the other hand, abscesses and fistulas were equally found in both treated groups. The observations were compared to others related to formocresol ferric sulfate, MTA, and laser pulpotomies, using the binominal law, or the comparative test of an observed proportion to a reference proportion. In this study, and based on the excessive negative results in both groups, we demonstrated that non fixative pulpotomies on temporary canines were a promising technique, La pulpotomie, est la thérapeutique pulpaire la plus couramment réalisée et la plus controversée en médecine dentaire pédiatrique. Les craintes concernant la diffusion systématique et la potentielle toxicité, allergénicité, carcinogénicité, en mutagénicité du formaldéhyde ont conduit à rechercher des alternatives à ce produit. Afin d’évaluer, selon des critères cliniques et radiologiques, l’action de l’oxyde de zinc-eugénol non modifié, l’une des alternatives au formocrésol, 25 canines temporaires cariées et 25 canines temporaires nécesitant un meulage dimensionnel dans le cadre de traitements interceptifs de dysharmonies dento-maxillaires (DDM) mineures du secteur antérieur, ont subi une pulpotomie à l’aide de ce matériau. Les contrôles post-opératoires ont été réalisés à 1, 6, 12 et 24 mois, à la recherche de douleur spontanée ou provoquée, de mobilité dentaire pathologique, d’abcès ou de fistule, de résorption radiculaire interne ou externe pathologique, de destruction osseuse péripicale ou d’oblitération canalaire. La douleur était inexistante à 24 mois. La moitié des canines traitées présentaient une mobilité alors que les résorptions internes et externes ont été rencontrées plus fréquemment dans le groupe « Carie » où le nombre augmentait avec le temps. Par ailleurs, le nombre d’abcès sans fistule s’observait de la même façon dans les deux groupes. Ces observations ont été comparées à celles relatives à la pulpotomie au formocrésol, au sulfate ferrique, au MTA et au laser, en utilisant le test de la loi binomiale ou le test de la comparaison d’une proportion observées à une proportion de référence. L’abondance de résultats négatifs dans les deux groupes démontre fortement que la pulpotomie non fixatrices sur des canines temporaires n’est pas une technique prometteuse.

Pulpotomy is the most performed and controversial therapeutic in pediatric dentistry. Since formocresol is known to have a toxic effect on living tissues, plus a mutagenic and carcinogenic potential with a systemic uptake of formocresol via pulpotomized teeth, other alternative products have been investigated. Twenty-five decayed primary canines and twenty-five healthy primary canines necessitating disking for orthodontic purposes were pulpotomized using non modified Zinc Oxide Eugenol. The effects of this material were evaluated both clinically and radiographically. Post operative control examinations were performed at 1, 6, 12, and 24 months trying to detect spontaneous or stimulated pain, pathological tooth mobility, abscesses or fistulas, internal or external pathological tooth resorption, periapical bone destruction, or canal obliteration. Pain was absent at 24 months post operatively. Half of the treated canines presented with a mobility, while internal and external resorptions were more frequent in decayed teeth and their number increased with time. On the other hand, abscesses and fistulas were equally found in both treated groups. The observations were compared to others related to formocresol ferric sulfate, MTA, and laser pulpotomies, using the binominal law, or the comparative test of an observed proportion to a reference proportion. In this study, and based on the excessive negative results in both groups, we demonstrated that non fixative pulpotomies on temporary canines were not a promising technique.

Couramment réalisé au niveau de la dent primaire, la pulpotomie est devenue un traitement fort controversé depuis la mise en évidence du potentiel toxique du formaldéhyde. Afin d’évaluer, selon des critères cliniques et radiologiques, l’action de l’oxyde de zinc-eugénol non modifié, l’une des alternatives au formocrésol, 25 canines primaires cariées et 25 nécessitant un meulage dimensionnel dans le cadre de traitements interceptifs de dysharmonies dentoalvéolaires (DDM) mineures du secteur antérieur, ont subi une pulpotomie à l’aide de ce matériau. Les contrôles post-opératoires ont été réalisés à 1, 3, 6 et 12 mois, à la recherche de douleur spontanée ou provoquée, d’abcès ou de fistule, de mobilité dentaire pathologique, de résorption radiculaire interne ou externe pathologique, de destruction osseuse périapicale ou d’oblitération canalaire. La douleur n’a été relevée qu’une seule fois simultanément dans les deux groupes à 12 mois, et la présence de mobilité dentaire y a été notée de manière progressive. Les abcès sans fistules ont été le plus souvent rencontrés dans le groupe DDM que dans le groupe Carie. Les résorptions internes et pathologiques radiculaires se sont rencontrées, par contre, plus fréquemment dans le groupe Carie, où leur nombre était plus important avec le temps. Ces résorptions ont été relevées rapidement dès le troisième mois après le traitement et leur évolution a été rapide. Ces observations ont été comparées à celles relatives à la pulpotomie au formocrésol, en utilisant le test de la loi binomiale ou le test de la comparaison d’une proportion observée à une proportion de référence. Il se dégage de cette analyse que, pour les deux groupes et pour chacune des observations cliniques et radiologiques, le taux d’échec est supérieur au taux d’échec de référence. Cette étude confirme le fait que l’oxyde de zinc non modifié ne peut constituer une alternative au formocrésol dans la pulpotomie des canines primaires., Commonly performed in deciduous teeth, a pulopotomy has become a controversial treatment due to evidence of the potential toxicity of formaldehyde. In order to evaluate the performance of non-modified zinc oxide eugenol, one of the alternatives to formacresol, using clinical and radiographical evidence, 25 primary decayed canine teeth and 25 teeth requiring interproximal disking in order to reduce a minor dento-alveolar discrepancy in the anterior region were subjected to pulpotomies sing this material. Post-operative control visits were performed at 1, 3, 6 and 12 months, searching for spontaneous or provoked pain, an abscess or fistula, pathological dental mobility, pathological internal or external root resorption, periapical boney destruction or canal obliteration. Pain was only observed on one occasion simultaneously in both groups at the 12 month follow-up, and the presence of dental mobility was noted in a progressive manner. Abscesses without a fistula present were observed more frequently in teeth that were disked compared to the group of decayed teeth. On the other hand, internal and pathological root resorptions were seen more frequently in the group of decayed teeth and their numbers grew with time. These resorptions were observed as early as 3 months following treatment and they evolved rapidly. These observations were compared to pulpotomies performed with formocresol using different statistical analysis comparing observed results to control results. The analysis reveals that for both groups and for each of the clinical and radiographical observations, the rate of failure is superior to the rate of failure in the control group. This study confirms that non-modified zinc oxide eugenol cannot be used as an alternative to formocresol when performing pulpotmies in primary canine teeth

Rather easy to perform, pulpotomy of the deciduous teeth is the most frequent endodontic treatment performed on children, but also the most controversial. Based on the amputation of the pulp chamber and the conservation of the inflammation-free root canals, the clinical results can be good, depending on the materials used. In this, calcium hydroxide (Ca(OH)2) as well as zinc-oxide-eugenol (ZOE) have been proven very inflammatory whereas Formocresol (FC) remains the reference even if its clinical toxicity is still reported in literature on a very controversial way. Nevertheless, this was sufficient to trigger and stimulate a search for alternatives, and led to the proposition to use ferric sulfate and even more recently MTA as new bases for the treatment of the pulp stumps after pulp chamber amputation.

BackgroundThe purpose of this research was to evaluate the factors affecting the outcome of localized laser pulp surgery in the canine model.Study design/materials and methodsPulpal exposures 2 mm and 5 mm in diameter were prepared in eight healthy teeth in each of five dogs. The total of 40 teeth were left open to infection from the oral cavity for 3 hours or 72 hours; 2-3 mm of surface pulpal tissue were then removed using a fresh diamond bur or a CO2 laser emitting@9.3 microns, at 3.5 W average power in the Superpulse mode. Teeth were monitored clinically and radiographically by one blinded, pre-standardized clinician for 3 months.ResultsChi-square test and Fisher's Exact test (2-tail) results associated laser treatment with significantly better clinical and radiographic outcome (P < 0.001). Using regression analysis, duration of pulpal exposure to contamination by the oral environment was identified as primary determinant for treatment outcome within the laser-treated and control groups (P = 0.0018).ConclusionClinical preconditions significantly affect the outcome of pulp surgery treatments.

BackgroundThe purpose of this research was to evaluate the factors affecting the outcome of localized laser pulp surgery in the canine model.Study design/materials and methodsPulpal exposures 2 mm and 5 mm in diameter were prepared in eight healthy teeth in each of five dogs. The total of 40 teeth were left open to infection from the oral cavity for 3 hours or 72 hours; 2-3 mm of surface pulpal tissue were then removed using a fresh diamond bur or a CO2 laser emitting@9.3 microns, at 3.5 W average power in the Superpulse mode. Teeth were monitored clinically and radiographically by one blinded, pre-standardized clinician for 3 months.ResultsChi-square test and Fisher's Exact test (2-tail) results associated laser treatment with significantly better clinical and radiographic outcome (P < 0.001). Using regression analysis, duration of pulpal exposure to contamination by the oral environment was identified as primary determinant for treatment outcome within the laser-treated and control groups (P = 0.0018).ConclusionClinical preconditions significantly affect the outcome of pulp surgery treatments.

The objective of this study was to evaluate carbon-dioxide laser surgical treatment of pulpal exposures in canine patients. Seventeen permanent teeth with exposures of less than or equal to 48 h were randomly allocated to receive either (1) localized laser pulp surgery to remove all compromised soft tissues or (2) localized pulp surgery using a large round sterile bur under sterile saline irrigation. Single laser pulses were used at 0.01 s pulse duration, 1.0 s pulse interval, a spot size of 0.004 cm2 and an energy density of 276 J/cm2. Exposures were dressed with CaOH and glass ionomer. Clinical and radiographic evaluations were performed by one blinded clinician 4, 12, 24 and 52 weeks after treatment using standard scales of 0-(-1). Fifteen/seventeen laser-treated teeth assessed over greater than or equal to 1 year post-treatment remained clinically and radiographically healthy. ©2005 Copyright SPIE - The International Society for Optical Engineering.

The objective of this study was to evaluate carbon-dioxide laser surgical treatment of pulpal exposures in canine patients. Seventeen permanent teeth with exposures of less than or equal to 48 h were randomly allocated to receive either (1) localized laser pulp surgery to remove all compromised soft tissues or (2) localized pulp surgery using a large round sterile bur under sterile saline irrigation. Single laser pulses were used at 0.01 s pulse duration, 1.0 s pulse interval, a spot size of 0.004 cm2 and an energy density of 276 J/cm2. Exposures were dressed with CaOH and glass ionomer. Clinical and radiographic evaluations were performed by one blinded clinician 4, 12, 24 and 52 weeks after treatment using standard scales of 0-(-1). Fifteen/seventeen laser-treated teeth assessed over greater than or equal to 1 year post-treatment remained clinically and radiographically healthy. ©2005 Copyright SPIE - The International Society for Optical Engineering.

This descriptive study compared pulpal reaction to ferric sulphate and formocresol.- The sample consisted of 10 cats which were treated with pulpotomies on all four canine teeth. Teeth on one side were treated with ferric sulphate and the ones on the contra-lateral si de with formocresol. Histological evaluations were performed 15 and 45 days postoperatively.- Teeth treated with fomocresol initially presented an acute inflammation which turned into a chronic process while those treated with ferric sulphate presented a chronic inflammation two weeks afterwards and absence of an inflammatory process 45 days later. Focal coronal necrosis sites were more frequent with formocresol., Este es un estudio descriptivo que se realizó con el fin de evaluar y comparar histológicamente dos sustancias, el formocresol y el sulfato férrico (solución de Monsel), que tienen la cualidad de detener la hemorragia pul par cuando se realiza una pulpotomía. Se seleccionó una muestra de 10 gatos, a los cuales se les realizó terapia pulpar en los dientes caninos: a los del lado derecho con formocresol y a los del lado izquierdo con sulfato férrico. Los dientes se evaluaron a los 15 y a los 45 días para apreciar los diferentes estados de inflamación pulpar que pudieran presentar.- Se pudo observar que el formocresol pasa de una etapa de inflamación aguda a una crónica, a diferencia del sulfato férrico que a los 15 días causó inflamación crónica y a los 45 no provocó ninguna. Con el formocresol fueron más frecuentes las necrosis focales coronales. A corto plazo, 9 de 10 pulpas mostraron vitalidad apical, tanto con el formocresol como con el sulfato férrico. A largo plazo, 5 de 8 pulpas tratadas con formocresol tenían vitalidad apical; lo mismo ocurriócon el sulfato férrico

This descriptive study compared pulpal reaction to ferric sulphate and formocresol.- The sample consisted of 10 cats which were treated with pulpotomies on all four canine teeth. Teeth on one side were treated with ferric sulphate and the ones on the contra-lateral si de with formocresol. Histological evaluations were performed 15 and 45 days postoperatively.- Teeth treated with fomocresol initially presented an acute inflammation which turned into a chronic process while those treated with ferric sulphate presented a chronic inflammation two weeks afterwards and absence of an inflammatory process 45 days later. Focal coronal necrosis sites were more frequent with formocresol., Este es un estudio descriptivo que se realizó con el fin de evaluar y comparar histológicamente dos sustancias, el formocresol y el sulfato férrico (solución de Monsel), que tienen la cualidad de detener la hemorragia pul par cuando se realiza una pulpotomía. Se seleccionó una muestra de 10 gatos, a los cuales se les realizó terapia pulpar en los dientes caninos: a los del lado derecho con formocresol y a los del lado izquierdo con sulfato férrico. Los dientes se evaluaron a los 15 y a los 45 días para apreciar los diferentes estados de inflamación pulpar que pudieran presentar.- Se pudo observar que el formocresol pasa de una etapa de inflamación aguda a una crónica, a diferencia del sulfato férrico que a los 15 días causó inflamación crónica y a los 45 no provocó ninguna. Con el formocresol fueron más frecuentes las necrosis focales coronales. A corto plazo, 9 de 10 pulpas mostraron vitalidad apical, tanto con el formocresol como con el sulfato férrico. A largo plazo, 5 de 8 pulpas tratadas con formocresol tenían vitalidad apical; lo mismo ocurriócon el sulfato férrico

The anatomical and physiological properties of deciduous teeth make them susceptible to caries and inflammatory and infectious complications. This specificity, the proximity of the germ of the underlaying permanent tooth, and the relation of the last one to the deciduous tooth, make delicate its conservation by endodontal therapeutics after a pulpal or pulpo-periodontal affection. The success of this attempt is related to a good case-selection, based on the general condition of the child, his and his parents motivation, the condition of cariogenicity of the mouth, the analysis of the unity deciduous tooth/germ of the underlaying permanent tooth, the follow-up of the case. A success spares young children extraction of the deciduous teeth before the physiological period of permutation.