Current developments in pulp therapy for primary teeth (original) (raw)
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Clinical dentistry reviewed, 2020
Maintaining arch length and integrity by preserving the pulpally involved tooth, as a natural space maintainer is the main aim of primary tooth pulp therapy. Pulpotomy and pulpectomy, the two major procedures used to perform pulp therapy in primary teeth, have evolved over the years. This paper will discuss contemporary pediatric endodontic concepts and definitive indications and contraindications for primary tooth pulp therapy. It will include a step-by-step description of both the mineral trioxide aggregate pulpotomy and a single-visit pulpectomy using rotary files in primary posterior teeth. The high-resolution clinical pictures and the clinical tips will help the reader achieve predictable prognosis when carrying out these valuable procedures.
Current concepts in vital primary pulp therapy
European journal of paediatric dentistry : official journal of European Academy of Paediatric Dentistry, 2002
Recent progress in understanding the molecular and cellular changes during tooth development and how they are mimicked during tissue repair, offers the opportunity to assess the biologic validity of the various vital pulp treatments. Under this light, indirect pulp treatment can be an acceptable procedure for primary teeth with reversible pulp inflammation, provided that this diagnosis is based on a good history, a proper clinical and radiographic examination, and the tooth had been sealed with a leakage-free restoration. Several articles report the success of this technique of direct pulp capping (DPC) and calcium hydroxide has been widely used with high success rates in young permanent teeth, but the results in primary teeth are less satisfactory. Recent studies have reported successful results with direct adhesive capping of exposed pulps, while others showed pulp inflammation and unacceptable results using this technique. Thus, the traditional rationale for the use of calcium hy...
Vital Pulp Therapy in Primary Dentition: Pulpotomy—A 100-Year Challenge
Children
Pulpotomy has long been the most indicated vital pulp procedure in primary molars with extensive caries. The success of a pulpotomy is highly technique sensitive and it depends upon many factors, such as diagnosis accuracy, caries excavation method, pulp dressing material, quality of the final restoration and operator experience. This paper provides an overview of the pulpotomy procedure in primary teeth over a century, with reference to advances in technique, medication and restoration possibilities and challenges and controversies surrounding the subject as well as future directions.
A review on vital pulp therapy in primary teeth
Iranian endodontic journal, 2015
Maintaining deciduous teeth in function until their natural exfoliation is absolutely necessary. Vital pulp therapy (VPT) is a way of saving deciduous teeth. The most important factors in success of VPT are the early diagnosis of pulp and periradicular status, preservation of the pulp vitality and proper vascularization of the pulp. Development of new biomaterials with suitable biocompatibility and seal has changed the attitudes towards preserving the reversible pulp in cariously exposed teeth. Before exposure and irreversible involvement of the pulp, indirect pulp capping (IPC) is the treatment of choice, but after the spread of inflammation within the pulp chamber and establishment of irreversible pulpitis, removal of inflamed pulp tissue is recommended. In this review, new concepts in preservation of the healthy pulp tissue in deciduous teeth and induction of the reparative dentin formation with new biomaterials instead of devitalization and the consequent destruction of vital ti...
Pulp-dentin biology in restorative dentistry. Part 1: normal structure and physiology
Quintessence international (Berlin, Germany : 1985), 2001
Considerable knowledge has accumulated over the years on the structure and function of the dental pulp and dentin. Some of this knowledge has important clinical implications. This review, which is the first of seven articles, will be limited to those parts of the normal structure and physiology of the pulp and dentin that have been shown to result in, or are likely lead to, tissue reactions associated with the clinical treatment of these tissues. Although certain normal structures will be highlighted in some detail, a basic knowledge of pulpal and dentinal development and structure is a prerequisite for an understanding of this text.
Diagnosis and Concepts of Vital Pulp Therapy in Primary Teeth
2020
The pulp is the most important vital tissue of a tooth. Maintaining the vitality of pulp is important to maintain the primary teeth in function till their exfoliation. However, often due to dental caries and trauma these teeth become non-vital and are lost prematurely. Hence the only way to save these teeth is by means of Vital Pulp Therapy (VPT). This treatment modality includes Indirect Pulp Capping (IPC), Direct Pulp Capping (DPC) and Pulpotomy. The success of these treatment methods depend on early diagnosis of pulp and periradicular tissue status, maintenance of vitality of pulp and vascularization of pulp.
Primary molar pulp therapy--histological evaluation of failure
International journal of paediatric dentistry / the British Paedodontic Society [and] the International Association of Dentistry for Children, 2000
Qualitative comparison of the clinical, radiographic and histological outcomes in a small sample of cariously exposed primary molars, extracted after unsuccessful pulp treatment by two vital pulpotomy methods. The primary molars were extracted, because of treatment failure, during a longitudinal clinical investigation of the relative efficacy of 20% Buckley's Formocresol versus calcium hydroxide powder as pulp dressings in vital pulp therapy (in press). Fifty-two child patients were sequentially enrolled in the longitudinal clinical investigation, 26 boys and 26 girls. Primary molar teeth requiring vital pulp therapy were randomly allocated to either the formocresol group (F) or the calcium hydroxide group (C). Coronal pulp amputation was prescribed only in teeth with vital, cariously-exposed pulp tissue. All cases were reviewed using predefined clinical and radiological criteria. Seventy-nine cariously-exposed primary molars required vital pulp therapy. Forty-four teeth were in...
Indirect pulp treatment in primary teeth: 4-year results
American journal of dentistry, 2010
To evaluate clinical and radiographic outcomes of indirect pulp treatment (IPT) in primary molars after long-term function (up to 60 months). Teeth with deep carious lesions without signs and symptoms of irreversible pulpitis were divided by random allocation into two groups, according to the capping material utilized over demineralized dentin: experimental group (1): self-etching adhesive system (Clearfil SE Bond); and control group (2): calcium hydroxide liner (Dycal). Both groups were filled with resin composite (Z250) and submitted to a clinical and radiographic monitoring period until exfoliation. After the follow-up period (up to 60 months), no statistical difference was found between groups (P= 0.514). The overall success rate reached 78%. The failures occurred after the first year period recall.
American journal of dentistry
Purpose: To evaluate the clinical and radiographic changes in primary teeth submitted to indirect pulp treatment (IPT) over a 36-month period. Methods: Thirty-nine primary molars with deep caries, but without preoperative signs and symptoms of irreversible pulpits, received IPT. The teeth were randomly divided into two groups, according to the material used for protection of the dentin-pulp complex: (1) a calcium hydroxide liner (Hydro C) and