Decision-Making and Management of Immature Permanent Teeth with Crown Fractures in Small Animals—A Review

2021 ◽  
pp. 089875642110463
Author(s):  
Amalia Zacher ◽  
Sandra Manfra Marretta
Keyword(s):  
Treatment Options ◽  
Mineral Trioxide Aggregate ◽  
Permanent Teeth ◽  
Small Animals ◽  
Unique Challenge ◽  
Pulp Capping ◽  
Pulp Therapy ◽  
Vital Pulp Therapy ◽  
Pulp Vitality ◽  
And Function

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

scholarly journals Dentist-related factors influencing the use of vital pulp therapy: a survey among dental practitioners in China

2019 ◽  
Vol 47 (6) ◽  
pp. 2381-2393
Author(s):  
Mengjie Li ◽  
Xiaoli Hu ◽  
Xiaolan Li ◽  
Shuxiang Lei ◽  
Ming Cai ◽  
...  
Keyword(s):  
Mineral Trioxide Aggregate ◽  
Permanent Teeth ◽  
Direct Pulp Capping ◽  
Online Questionnaire ◽  
Related Factors ◽  
Pulp Capping ◽  
Factors Associated ◽  
Pulp Therapy ◽  
Vital Pulp Therapy ◽  
Dental Practitioners

Objective To evaluate dentist-related factors associated with the use of vital pulp therapy (VPT) for the treatment of pulp exposures in permanent teeth. Methods This survey-based study sent an online questionnaire to collect data on the demographics of the respondents, the use of VPT and the choice of materials for VPT, to all members of the Society of Endodontology of Guangdong, China. Results A total 183 of 380 members responded (48.2%). The majority (89.6%; 164 of 183) had performed direct pulp capping (DPC) while 55.2% (101 of 183) had performed partial pulpotomy (PP) at least once. The most-cited reason for not performing VPT was unfamiliarity with the technique. Mineral trioxide aggregate was the most commonly used material for both DPC (67.1%; 110 of 164) and PP (73.3%; 74 of 101). Endodontists, compared with general practitioners, preferred to perform DPC and chose calcium silicate materials (CSMs) for VPT (odds ratios 5.81 and 8.07, respectively). DPC and CSMs for VPT were also favoured more by respondents who had practised for > 5 years. Senior respondents were more likely to use PP. Conclusions Speciality, years of practise and age of dentists influenced the decision making and the choice of materials for VPT. Continuing education is essential to promote the clinical use of VPT.

scholarly journals Wound Lavage in Studies on Vital Pulp Therapy of Permanent Teeth with Carious Exposures: A Qualitative Systematic Review

2020 ◽  
Vol 9 (4) ◽  
pp. 984 ◽  
Author(s):  
Amina Munir ◽  
Matthias Zehnder ◽  
Dan-Krister Rechenberg
Keyword(s):  
Permanent Teeth ◽  
Pulp Capping ◽  
Recall Interval ◽  
Pulp Therapy ◽  
Vital Pulp Therapy ◽  
Qualitative Systematic Review ◽  
Significant Difference ◽  
Study Characteristics ◽  
Pulp Exposure ◽  
Calcium Silicate Cements

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

scholarly journals Evaluation of clinical and radiological outcomes of mineral trioxide aggregate and calcium hydroxide as indirect pulp capping agents in the treatment of deep carious lesion of permanent teeth

2016 ◽  
Vol 9 (3) ◽  
pp. 140 ◽  
Author(s):  
Rafeza Sultana ◽  
Mozammal Hossain ◽  
Md. Shamsul Alam
Keyword(s):  
Calcium Hydroxide ◽  
Mineral Trioxide Aggregate ◽  
Permanent Teeth ◽  
Capping Agents ◽  
Pulp Capping ◽  
Carious Lesions ◽  
Reparative Dentin ◽  
Deep Carious Lesions ◽  
Pulp Vitality ◽  
Indirect Pulp Capping

<p>The maintenance of pulp vitality and conduction of reparative dentin can be possible by indirect pulp capping with mineral trioxide aggregate (MTA) and calcium hydroxide as pulp capping agents. The objective of the study is to assess the clinical and radiological outcomes of MTA and calcium hydroxide as indirect pulp capping agents in deep carious lesions of permanent teeth. The present study included 50 permanent teeth having deep carious lesions with reversible pulp status were selected and then randomly divided into two groups of 25 teeth in a group. Standard indirect pulp capping procedures were followed. Patients were recalled at 3, 6 and 12 months interval to assess postoperative pain, the vitality of the pulp and formation of reparative dentin. In all observation periods, MTA showed more capable of reducing pain and maintain pulp vitality which was statistically significant than that of calcium hydroxide. At 12 months observation period, 24 teeth (96%) of MTA and 19 teeth (76%) of calcium hydroxide showed reparative dentin formation. It can be concluded that MTA is more effective than that of calcium hydroxide.</p><p> </p>

scholarly journals Knowledge and practice of vital pulp therapy in young permanent teeth among general dental practitioners in Kerman, Iran

2018 ◽  
Vol 6 (1) ◽  
pp. 29
Author(s):  
Lida Pishbin ◽  
Fatemeh Sadat Sajadi ◽  
Maryam Mahmoudi ◽  
Hassan Shahabinejad
Keyword(s):  
Material Selection ◽  
Permanent Teeth ◽  
Average Score ◽  
Cross Sectional ◽  
Pulp Capping ◽  
Pulp Therapy ◽  
Vital Pulp Therapy ◽  
Dental Practitioners ◽  
Knowledge And Practice ◽  
The University

The dental pulp is the living tissue of the tooth and its vitality is essential for long-term tooth survival. The vitality or non-vitality of the pulp as well as the presence or absences of a radicular pathology determine the type of pulp therapy. The knowledge of the dentist is important in selecting and carrying out a proper complete treatment. Therefore, this study was conducted to assess general dental practitioner`s (GDP) knowledge of indication, methods and prognosis of vital pulp therapy (VPT) for young permanent teeth (YPT).Method A total of 160 GDPs from dental clinics and offices in Kerman participated in this descriptive cross-sectional study. Data were collected using an initial questionnaire consisted of 15 items examining the knowledge and practice of indication, methods and prognosis of VPT for YPT among GDPs. The participants were asked to choose from the provided answers.Result of 160 questionnaires 154 were used for final evaluation.The overall obtained average score of the total items of the questionnaire was 4.53 ± 3.56. There was not any significant correlation between the knowledge of indication, examination, diagnosis, patients selection, effective factors in success of treatment and gender, number of the years since graduation and the university where the degree was obtained for VPT among GDPs. While knowledge of selecting the right materials for pulp-capping was significantly correlated with the number of the years since graduation and the university where the degree was obtained.Conclusion Although GDPs' level of knowledge in regard to VPT is not favorable, the time since graduation and place of education influenced the suitable material selection for pulp capping. Hence, GDPs, who perform pulp therapy , need to keep themselves updated with these procedures.

scholarly journals The Mineral Trioxide Aggregate in Vital Pulp Therapy of Permanent Teeth - A Systematic Review

2021 ◽  
Vol 10 (1) ◽  
pp. 34-38
Author(s):  
Manoj Chandak ◽  
Madhulika Shyam Sundar Chandak ◽  
Chanchal Harikishor Rathi ◽  
Pooja Chandak ◽  
Kajol Relan
Keyword(s):  
Systematic Review ◽  
Mineral Trioxide Aggregate ◽  
Permanent Teeth ◽  
Pulp Therapy ◽  
Vital Pulp Therapy

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

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

Vital Pulp Therapy Current Trends and Future Perspectives

2021 ◽  
Author(s):  
Iris Slutzky-Goldberg
Keyword(s):  
Root Development ◽  
Future Perspectives ◽  
Direct Pulp Capping ◽  
Pulp Capping ◽  
Pulp Therapy ◽  
Immature Teeth ◽  
Current Trends ◽  
Vital Pulp Therapy ◽  
Irreversible Pulpitis

Vital pulp therapy (VPT), including direct pulp capping, partial and cervical Pulpotomy, was suggested for the treatment of young teeth, with reversible or irreversible pulpitis [1]. Maintaining the vitality of immature teeth enables continued root development, maturogenesis, and a better prognosis

scholarly journals A Prospective Analysis of the Correlation Between Postoperative Pain and Vital Pulp Therapy

2021 ◽  
Vol 2 ◽  
Author(s):  
Mark Shallal-Ayzin ◽  
Tam Trinh ◽  
William Yeung ◽  
Peter Z. Tawil ◽  
Carol L. Haggerty ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Permanent Teeth ◽  
Pulp Therapy ◽  
Standardized Protocol ◽  
Vital Pulp Therapy ◽  
Post Operative Pain ◽  
Experienced Pain ◽  
Functional Tooth ◽  
Poor Treatment ◽  
Poor Treatment Outcome

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

Crown Reduction and Vital Pulp Therapy in a Dog With Malocclusion

2018 ◽  
Vol 35 (3) ◽  
pp. 217-220
Author(s):  
Kari Blanchard ◽  
John Koehm
Keyword(s):  
Mineral Trioxide Aggregate ◽  
Pulp Therapy ◽  
Vital Pulp Therapy ◽  
Mandibular Canine

Crown reduction and vital pulp therapy is an accepted treatment for abnormal occlusion resulting in palatal trauma caused by malpositioned mandibular canine teeth in dogs and cats. This article describes use of mineral trioxide aggregate for vital pulp therapy after crown reduction. A list of materials and commonly used equipment is provided.

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