Coronal Pulpotomy Technique Analysis as an Alternative to Pulpectomy for Preserving the Tooth Vitality, in the Context of Tissue Regeneration: A Correlated Clinical Study across 4 Adult Permanent Molars

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.

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

Journal of Evolution of Medical and Dental Sciences ◽

10.14260/jemds/2021/332 ◽

2021 ◽

Vol 10 (21) ◽

pp. 1593-1597

Author(s):

Amith Adyanthaya ◽

Prathyusha P ◽

Risana K ◽

Aparna Sivaraman ◽

Nazreen Ayub K ◽

...

Keyword(s):

Treatment Options ◽

Clinical Signs ◽

Effective Alternative ◽

Permanent Teeth ◽

Pulp Tissue ◽

Term Survival ◽

Pulp Therapy ◽

Vital Pulp Therapy ◽

Permanent Molars

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

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The Role of Hydraulic Silicate Cements on Long-Term Properties and Biocompatibility of Partial Pulpotomy in Permanent Teeth

Materials ◽

10.3390/ma14020305 ◽

2021 ◽

Vol 14 (2) ◽

pp. 305

Author(s):

Chung-Min Kang ◽

Saemi Seong ◽

Je Seon Song ◽

Yooseok Shin

Keyword(s):

Regression Analysis ◽

Cox Regression ◽

Antimicrobial Properties ◽

Permanent Teeth ◽

Success Rates ◽

Pulp Tissue ◽

Cox Regression Analysis ◽

Clinical Variables

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.

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Case Report: Dilemma To Save Or Not To Save A Tooth

IIUM Medical Journal Malaysia ◽

10.31436/imjm.v16i2.1054 ◽

2017 ◽

Vol 16 (2) ◽

Author(s):

Yee Woo Yap ◽

Azillah Mohd Ali

Keyword(s):

Case Report ◽

Root Formation ◽

Dentigerous Cyst ◽

Permanent Teeth ◽

Treatment Modalities ◽

Successful Outcome ◽

Odontogenic Cysts ◽

Standard Assessment ◽

Good Healing

Introduction: Dentigerous cyst is the most common odontogenic cysts that are associated with the crowns of permanent teeth. Treatment modalities normally include enucleation or marsupialization of the cyst. However, currently there are no standard assessment criteria to dictate which kind of treatment for certain cases. The purpose of this report is to describe the successful outcome of conservative surgical management of a large dentigerous cyst associated with an unerupted right maxillary permanent canine in an 8-year-old boy. The cyst was enucleated partially but leaving the cystic lining surrounding the unerupted canine in order to preserve the tooth. 3-year follow up revealed good healing with significant root formation and tooth eruption.

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Human amniotic membrane as therapeutic agent in pulpotomy of permanent molars

BMJ Case Reports ◽

10.1136/bcr-2021-243414 ◽

2021 ◽

Vol 14 (10) ◽

pp. e243414

Author(s):

Saumya Johri ◽

Promila Verma ◽

Rhythm Bains ◽

Aseem Praksh Tikku

Keyword(s):

Amniotic Membrane ◽

Glass Ionomer Cement ◽

Permanent Teeth ◽

Human Amniotic Membrane ◽

Glass Ionomer ◽

Present Case Report ◽

Mandibular Molar ◽

Permanent Molars ◽

Irreversible Pulpitis ◽

Ionomer Cement

A 22-year-old woman reported with a cariously exposed mandibular molar. Pulpotomy was planned rather than routine root canal treatment, which was otherwise indicated. Amniotic membrane (AM) that has been extensively researched in different fields of medicine was used as the pulpotomy agent. After gaining coronal access to the root orifices, bleeding was arrested and activated AM was placed over the root stumps. Glass ionomer cement(GIC) was placed over the membrane and temporary restoration was done. One week later, permanent restoration with composite resin was done. The patient’s symptoms resolved, and the tooth started responding normally to vitality tests at subsequent follow-ups. The present case report is an attempt to use human AM as a natural pulpotomy agent for treating irreversible pulpitis in permanent teeth. Understanding of innumerable beneficial properties of the AM and its application in preserving vitality of permanent teeth is the main learning objective.

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Regenerating the Pulp–Dentine Complex Using Autologous Platelet Concentrates: A Critical Appraisal of the Current Histological Evidence

Tissue Engineering and Regenerative Medicine ◽

10.1007/s13770-020-00291-3 ◽

2020 ◽

Author(s):

Amna Riaz ◽

Furqan A. Shah

Keyword(s):

De Novo ◽

Platelet Rich Plasma ◽

Blood Clot ◽

Permanent Teeth ◽

Morphological Evidence ◽

Wall Thickening ◽

Platelet Concentrates ◽

Pulp Tissue ◽

True Nature ◽

Autologous Platelet

Background: Autologous platelet concentrates such as platelet-rich plasma (PRP) and platelet-rich fibrin (PRF) have gained overwhelming popularity in regenerative endodontics. Clinical evidence reveals the lack of a particular advantage of using PRP or PRF over an evoked blood clot in promoting canal wall thickening and/or continued root development in immature necrotic teeth. Moreover, despite stimulating tissue repair and repopulating the root canals of immature and mature permanent teeth, the new vital tissue may not possess the functional activity of the native pulp tissue. Methods: To better understand the origin, nature, and long-term fate of the tissue types found within the pulp space, we critically examine all available histo-/morphological evidence for pulp–dentine complex regeneration using PRP and/or PRF, alone or together with an evoked blood clot, specialised or unspecialised primary cells, and other biomaterials. Results: Histological data from clinical studies is scant. Reportedly, the inner dentinal surface supports cementum-like tissue formation, but this interface likely deviates in structure and function from the native cementodentinal junction. Presence of bone-like tissue within the pulp space is intriguing since de novo osteogenesis requires closely coordinated recruitment and differentiation of osteoprogenitor cells. Compared to untreated necrotic teeth, an evoked blood clot (with/without PRF) improves fracture resistance. Tooth regeneration using PRF and dental bud cells is unreliable and the constituent neoformed tissues are poorly organised. Conclusion: PRP/PRF fail to demonstrate a significant advantage over an induced blood clot, alone. The true nature of neoformed tissues remains poorly characterised while their response to subsequent insult/injury is unexplored.

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Clinical and Radiographic Evaluation of Mineral Trioxide Aggregate Pulpotomy in Permanent Teeth

Dental Journal of Advance Studies ◽

10.1055/s-0038-1672067 ◽

2016 ◽

Vol 04 (03) ◽

pp. 183-188

Author(s):

Neha Verma ◽

Avninder Kaur ◽

Shivesh Acharya ◽

Sunila Sharma

Keyword(s):

Root Canal ◽

Mineral Trioxide Aggregate ◽

Root Canal Treatment ◽

Permanent Teeth ◽

Radiographic Evaluation ◽

Future Research ◽

Standard Protocol ◽

Radiographic Outcome ◽

Irreversible Pulpitis

Abstract Aim and objective: The aim of the present study was to evaluate clinical and radiographic outcome of MTA as a pulpotomy agent in permanent teeth as an alternative to conventional root canal treatment. Materials and Methods: Ten permanent teeth with symptoms of irreversible pulpitis with vital pulp were selected for the study. MTAPulpotomy procedure was done in all the cases using standard protocol. Teeth were evaluated for various clinical and radiographic parameters at 3, 6, 9 and 12 months of follow up. Results: None of the patients reported any kind of clinical discomfort or radiographic abnormality during the follow up period of 3, 6, 9 and 12 months. All the teeth responded positive on electric pulp test at all successive follow ups. Conclusions: MTA Pulpotomy may be used as an alternative treatment modality to root canal treatment in permanent teeth with irreversible pulpitis, if future research continues to show promising results.

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Successful Application of Atelocollagen for Treatment of Perforated Teeth

Journal of Clinical Pediatric Dentistry ◽

10.17796/jcpd.36.1.u3u603545u127w7r ◽

2011 ◽

Vol 36 (1) ◽

pp. 1-4 ◽

Cited By ~ 1

Author(s):

Katsuhiko Masuda ◽

Kazuhiko Nakano ◽

Rena Okawa ◽

Shuhei Naka ◽

Michiyo Matsumoto ◽

...

Keyword(s):

Primary Teeth ◽

Clinical Problem ◽

Treatment Method ◽

Permanent Teeth ◽

Treatment Modalities ◽

Clinical Evaluations ◽

Novel Method ◽

Early Tooth Loss ◽

Clinical Problems

Objective: Cervical or furcal root perforation is a serious clinical problem and one of its treatment modalities is perforation repair with composite resin. However, many cases still progress in inevitable extraction. When primary teeth are affected, early tooth loss can cause problems related to the eruption space for the permanent successors. The aim of the present study was to evaluate a novel clinical treatment method for perforated teeth. Study design: Atelocollagen was applied to perforated furcal and cervical areas of 13 primary teeth in 13 children aged 4-9 years and 8 permanent teeth in 8 adults aged 35-69 years after debridement with an electric knife. Thereafter, the final restorations were performed after confirming good tooth conditions. Clinical evaluations were performed at follow-up examinations at approximately 3-month intervals.Results: None of the treated primary teeth showed any clinical problems throughout the observation period, with eruption of the permanent successors noted in 7 cases. In the permanent teeth, no clinical problems were identified in any of the cases during follow-up periods of 10-60 months. Conclusion: This novel method may enable preservation of perforated primary teeth for a longer duration.

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Biodentine™ Partial Pulpotomy of a Young Permanent Molar with Signs and Symptoms Indicative of Irreversible Pulpitis and Periapical Lesion: A Case Report of a Five-Year Follow-Up

Case Reports in Dentistry ◽

10.1155/2019/8153250 ◽

2019 ◽

Vol 2019 ◽

pp. 1-5

Author(s):

W. Chinadet ◽

T. Sutharaphan ◽

P. Chompu-inwai

Keyword(s):

Signs And Symptoms ◽

Carious Lesion ◽

Periapical Lesion ◽

Pulp Tissue ◽

Permanent Molar ◽

Exposure Site ◽

Patient Reported ◽

Periapical Healing ◽

Irreversible Pulpitis

The purpose of this paper was to report the five-year success of Biodentine™ partial pulpotomy in a young permanent molar, with signs and symptoms indicative of irreversible pulpitis and periapical lesion, in a nine-year-old girl. Preoperative clinical examination revealed a large carious lesion of the left mandibular permanent first molar. The patient reported pain on percussion. The tooth responded positively to the electric pulp test and had lingering pain after cold testing. A periapical radiograph showed a deep carious lesion and periapical lesion. Based on the clinical and radiographical examination, the tooth had signs and symptoms indicative of irreversible pulpitis and periapical lesion. During caries removal, pulp exposure occurred, and 2-3 mm in depth of pulp tissue at the exposure site was removed. Haemorrhage was controlled within four minutes with 2.5% sodium hypochlorite-moistened cotton pellets. Biodentine™ was then applied as both a pulp dressing and a temporary restoration. At the following visit, composite resin was placed over the Biodentine™ as a final restoration. During a five-year follow-up, the tooth was asymptomatic, had positive responses to sensibility tests, and had no discolouration. Follow-up radiographs showed a dentine bridge and periapical healing.

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“A COMPARATIVE CLINICAL STUDY TO EVALUATE THE EFFICACY OF SHEETALA JALA NASYA AND MASHA TAILA NASYA WITH RASNADI GUGGULU IN THE MANAGEMENT OF AVABAHUKA WITH SPECIAL REFERENCE TO FROZEN SHOULDER”

November 2020 - International Ayurvedic Medical Journal ◽

10.46607/iamj1608102020 ◽

2020 ◽

Vol 8 (10) ◽

pp. 4669-4676

Author(s):

Maitradevi 1 ◽

Uma Patil

Keyword(s):

Clinical Study ◽

Shoulder Joint ◽

Frozen Shoulder ◽

Treatment Modalities ◽

Daily Routine ◽

Routine Work ◽

Comparative Clinical Study ◽

Group A ◽

Group B

Avabahuka is a disease of Amsa Sandhi (shoulder joint) and it has been described under eighty types of Vata Vyadhi by Acharya Sushruta. Being a disease of shoulder joint, which has greatest range of motion, is of vital importance to the activities of daily routine work. This disease is a hindrance in one’s productivity. Various effective treatment modalities have been mentioned in our classics regarding this disease. In order to reverse the pathogenesis, Shodhana is advised initially followed by Shamana therapies. In the present study 40 patients were selected incidentally and placed randomly into two groups- A and B, with 20 sub-jects in each group. Group- A received Nasya with Sheetala Jala and Group- B received Nasya with Ma-sha Taila followed by Rasnadi Guggulu as Shamanoushadhi for both groups A and B. In both the groups after 7th day of Nasya Karma follow up was done. Assessment was done on the bases of symptomatology. Nasya Karma provided highly significant results in all the symptoms of Avabahuka. In the present study as per the clinical data, ‘Nasya with Masha Taila is found to be more effective than Nasya with Sheetala Jala’.

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Pulp therapy in immature traumatized incisor using tricalcium silicate cement – a case report

Pomeranian Journal of Life Sciences ◽

10.21164/pomjlifesci.697 ◽

2020 ◽

Vol 66 (2) ◽

Author(s):

Magdalena Gońda-Domin ◽

Alicja Nowicka ◽

Karolina Węsierska ◽

Anna Jarząbek

Keyword(s):

Present Report ◽

Tricalcium Silicate ◽

Endodontic Treatment ◽

Permanent Teeth ◽

Timely Manner ◽

Traumatic Injuries ◽

Tooth Structure ◽

Sensitivity Tests ◽

Irreversible Pulpitis

Introduction: Traumatic injuries to immature permanent teeth are one of the most recurrent and urgent emergency treatment cases in pediatric dental practice. In many instances, the protocol for responding to this kind of emergency is not correct, and is not performed in a timely manner. Delays in seeking treatment following a complicated crown fracture in young individuals can result in irreversible pulpitis or pulp necrosis. It can leave a wide-open apex and brittle dentinal walls that are unfavorable to manage with conventional endodontic treatment (apexification).Materials and methods: The present report describes the clinical case of a complicated crown fracture in young permanent central incisor, with 18 months of clinical and radiographic follow-up. The traumatized incisor was successfully treated using a coronal pulpotomy technique and tricalcium silicate cement – BiodentineTM.Results: The presented treatment approach provided elimination of the symptoms, an absence of pain episodes, and positive reactions to pulp sensitivity tests. The follow up radiological assessment revealed evidence of a dentin bridge formation and continuation of root maturation.Conclusions: Coronal pulpotomies using tricalcium silicate cement are quick and easy to perform, and unlike endodontic treatment, preserve the tooth structure for the reattached tooth fragment. The restorative technique, the reattachment of fractured tooth fragment, and tooth restoration with a composite resin, represents an aesthetic, functional approach, and is an excellent and easy restorative option for clinicians and young impatient patients.Keywords: BiodentineTM; complicated crown fracture; immature permanent teeth; pulpotomy.

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