Case Report: Immediate pain relief after partial pulpotomy of cariously exposed young permanent molar using mineral trioxide aggregate and root maturation, with two years follow-up

Carious exposure of immature first permanent molar is a widespread issue faced in paediatric dentistry. This may be the result of the early eruption of this molar, so parents may think it is replicable to the rest of the deciduous teeth. Preserving pulp vitality is the primary goal in treating those teeth to allow maturation of roots both in length and width. Mineral trioxide aggregate (MTA) is considered a perfect dressing material for pulpotomy (both partial and complete) due to its bio computability and sealing property. We present a case that describes treatment and two years follow-up of a symptomatic immature first permanent molar with a deep carious lesion. For treatment, we started with anaesthesia and rubber dam isolation. After that, the carious lesion was removed, and we performed partial pulpotomy, then applied MTA-Angelos on the fresh wound. Moistened cotton then was lightly packed over MTA for 15 minutes to allow initial setting, followed by application of glass ionomer and final restoration with composite. The following day, the tooth was asymptomatic with the patient reporting pain relief. After three months follow-up, the tooth normally responds to thermal test. After 12 months, a periapical radiograph of the tooth showed root maturation, and after 24 months also, the tooth was clinically and radiographically successful. MTA partial pulpotomy should be considered in the treatment of symptomatic young permanent teeth.

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Evaluation of Success of Pulpotomy in Mature Permanent Teeth with Carious exposure using Mineral Trioxide

10.53350/pjmhs211561352 ◽

2021 ◽

Vol 15 (6) ◽

pp. 1352-1355

Author(s):

N. Shafe ◽

M. B. Munir ◽

M. Virda ◽

M. Anwar ◽

M. Ali ◽

...

Keyword(s):

Case Series ◽

Mineral Trioxide Aggregate ◽

Permanent Teeth ◽

P Value ◽

Dental Hospital ◽

And Gender ◽

Level Of Significance ◽

Age Range ◽

Carious Exposure

Aim: To evaluate the radiographical success of pulpotomy in cariously exposed mature permanent teeth using mineral trioxide aggregate. Methods:This Descriptive case series was conducted at the Department of Operative Dentistry, de’Montmorency College of Dentistry/ Punjab Dental Hospital, Lahore from December 2015 to December 2016.A total of 75 cases were included using non-probability consecutive sampling..Patients of both genders with age range from 15 to 26 years were considered. Performance of procedure and evaluation of success was done in terms of absence of periapical radiolucency on periapical radiographs.Data was entered and analyzed with IBM SPSS 20. Level of significance was kept at p-value ≤ 0.05 Results: Out of 75 patients, 41 were females and 34 were males.Mean age of patients included in this study was 20.5 ±3.60. Follow up at 6 months showed 92% success, with 69 cases showed absence of periapical radiolucency on periapical radiograph. There was no significant relation of success with age and gender of patient with p- value greater that 0.05. Conclusion: It is concluded from current study that the protocol of pulpotomy using Mineral trioxide Aggregate (MTA) in mature permanent teeth with carious exposure of pulp is encouraging and can be recommended for the treatment of mature permanent teeth with carious exposures. Keywords: Pulpotomy, Mineral trioxide aggregate, periapical radiolucency

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Prospective cohort study of regenerative potential of non vital immature permanent maxillary central incisors using platelet rich fibrin scaffold

Scientific Reports ◽

10.1038/s41598-021-93236-2 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Selvakumar Kritika ◽

V. Sujatha ◽

N. Srinivasan ◽

Senthil Kumar Renganathan ◽

Sekar Mahalaxmi

Keyword(s):

Gradual Increase ◽

Mineral Trioxide Aggregate ◽

Permanent Teeth ◽

Bonferroni Correction ◽

Platelet Rich Fibrin ◽

Triple Antibiotic Paste ◽

Fibrin Scaffold ◽

The Mean ◽

Post Hoc

AbstractRegenerative endodontic procedures have gained momentum as a treatment modality of young immature permanent teeth. Literature reports reveal that platelet-rich fibrin (PRF) stimulates growth factors and induces regeneration. This study was undertaken to assess the regenerative potential of non-vital immature permanent maxillary central incisors using PRF with a follow-up for 2 yrs. 19 patients in the age group of 9–25 yrs with immature, non-vital permanent maxillary central incisors (n = 23) with/without signs and/or symptoms of periapical pathosis and open apex were included in this study. In the first appointment, access opening, canal disinfection and triple antibiotic paste placement were done. In the subsequent visit, PRF was prepared and placed inside the canal. Access was sealed with Mineral trioxide aggregate plug and composite. The patient was reviewed up to 24 mths. The mean difference was statistically analyzed using Friedman test followed by Dunn post hoc test and adjusted by Bonferroni correction (p < 0.05). As per AAE guidelines, the primary and secondary goals were achieved. A significant (p < 0.001) gradual increase in the root length, thickness of dentinal walls and decrease in apical diameter were observed. Within the limitations of this study, PRF placement was clinically and radiographically effective in inducing regeneration of non-vital immature permanent teeth.

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Revascularization versus apical barrier technique with mineral trioxide aggregate plug: A systematic review

Giornale Italiano di Endodonzia ◽

10.4081/j.gien.2018.10 ◽

2018 ◽

Vol 32 (1) ◽

pp. 9-16 ◽

Cited By ~ 3

Author(s):

Luiz Alexandre Chisini ◽

Guillermo Grazioli ◽

Alejandro Francia ◽

Alissa Schmidt San Martin ◽

Flavio Fernando Demarco ◽

...

Keyword(s):

Clinical Success ◽

Mineral Trioxide Aggregate ◽

Clinical Success Rate ◽

Permanent Teeth ◽

Radiographic Outcomes ◽

Bias Risk ◽

Radiographic Measurements ◽

High Bias ◽

The Mean

Aim: To compare the clinical and radiographic outcomes observed in Necrotic Immature Permanent Teeth (NIPT) after revascularization or apexification with MTA-apical plug. Methodology: PubMed/MEDLINE, Web of science and Scopus were the databases used, up to July 30th, 2017, for article research. Independent reviewers read the titles and abstracts of all reports that met inclusion/exclusion criteria: prospective or retrospective clinical studies comparing the revascularization of root canal and apexification. Clinical success of therapies, deposition and thickening of lateral dentinal walls (root width) and the continuation of root development (root length) were investigated. Bias risk of included studies was assessed using the Cochrane risk of bias. Results: From 1642 records, five papers fulfilled all inclusion criteria. Overall, 91 teeth were submitted to revascularization and 64 teeth to apexification with MTA. The mean follow-up was 23.2 months in revascularization and 21.8 in apexification. Clinical success rate was of 87.9% in the revascularization group and 90.6% in the apexification group. An increase on lateral dentinal walls thickening was observed in most revascularization cases (13%) while MTA as apical plug suggest a mild resorption of the root (1.3%). High bias risk was observed on included studies. Conclusions: Apexification with MTA-apical plug provides similar clinical success to revascularization. However, radiographic measurements showed an improvement in thickening of lateral dentinal walls in most of the revascularization cases in addition to a higher dental development. However, these results should be interpreted with caution.

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A Delayed Hypersensitivity Reaction to a Stainless Steel Crown

Journal of Clinical Pediatric Dentistry ◽

10.17796/jcpd.36.3.d1327wn32361u04n ◽

2012 ◽

Vol 36 (3) ◽

pp. 235-238 ◽

Cited By ~ 4

Author(s):

A Yilmaz ◽

CE Ozdemir ◽

Y Yilmaz

Keyword(s):

Stainless Steel ◽

Hypersensitivity Reaction ◽

Delayed Hypersensitivity ◽

Permanent Teeth ◽

Restorative Dentistry ◽

Permanent Molar ◽

Caucasian Girl ◽

Decayed Tooth ◽

Delayed Hypersensitivity Reaction

Stainless steel crowns are commonly used to restore primary or permanent teeth in pediatric restorative dentistry. Here, we describe a case of a delayed hypersensitivity reaction, which manifested itself as perioral skin eruptions, after restoring the decayed first permanent molar tooth of a 13-year-old Caucasian girl with a preformed stainless steel crown. The eruptions completely healed within one week after removal of the stainless steel crown. The decayed tooth was then restored with a bis-acryl crown and bridge. Since no perioral skin eruptions occurred during the six-month follow-up, we presume that the cause of the perioral skin eruptions was a delayed hypersensitivity reaction, which was triggered by the nickel in the stainless steel crown.

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Dental trauma and itssequelae in deciduous and permanent teeth - Longitudinal study

Acta Scientiarum Health Sciences ◽

10.4025/actascihealthsci.v41i1.34030 ◽

2019 ◽

Vol 41 (1) ◽

pp. 34030

Author(s):

Graziele Martioli ◽

Helena Sandrini Venante ◽

Gabriela Cristina Santin ◽

Carlos Luiz Fernandes de Salles ◽

Sandra Mara Maciel ◽

...

Keyword(s):

Root Resorption ◽

Tissue Injury ◽

Dental Trauma ◽

Permanent Teeth ◽

Deciduous Teeth ◽

Chi Square ◽

Elapsed Time ◽

Chi Square Test ◽

Type Of Injury

Objective: This study evaluated the prevalence, clinical management and sequelae in deciduous teeth involved and permanent successors in 150 children (256 deciduous teeth. Of these, 63.3% were male, 24-35 months of age at the time of the trauma (37.9%) and the falls (78.1%) represented the major etiological factor. In relation to the type of injury, 24.6% was enamel fracture; 62.5% showed support tissue injury (lateral luxation, 22.3%). In the first and second assessments (T1 and T2), the average follow-up time was 14.5 and 26 months (256 and 131 teeth).We diagnosed clinical and radiographic sequels including discoloration of the crown (T1-15.6; T2-13.7%), inflammatory root resorption (T1-7.0; T2-8.4%); and in permanent successors, enamel hypoplasia (T1-1.2; T2-2.3%), eruption disturbances (T1-2.0; T2-1.5%).The chi-square test evidenced association, in T1, between injuries to the supporting tissues and clinical (p = 0.003) and radiographic (p = 0.004) sequelae in permanent successors; and between clinical sequelae and age at the time of trauma (p = 0.005). In T2, radiological sequelae in deciduous teeth with injuries to the tooth and supporting tissue (p = 0.035); as well as clinical sequelae with elapsed time of trauma in permanent teeth (p = 0.005). It is concluded that the follow-up of traumatized deciduous teeth is essential to prevent sequelae.

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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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Dental Prosthetic Treatments in Cleidocranial Dysplasia: Case Report and Literature Review

Case Reports in Dentistry ◽

10.1155/2020/8910798 ◽

2020 ◽

Vol 2020 ◽

pp. 1-8

Author(s):

Yosra Mabrouk ◽

Sinda Ammar ◽

Amel Labidi ◽

Lamia Mansour ◽

Sonia Ghoul

Keyword(s):

Dental Treatment ◽

Cone Beam ◽

Permanent Teeth ◽

Deciduous Teeth ◽

Cleidocranial Dysplasia ◽

Aged Patients ◽

Long Term Follow Up ◽

Prosthetic Implant

Cleidocranial dysplasia (CCD) is a rare inherited skeletal syndrome. There is no consensus regarding the dental treatment strategy. Objectives. To report a rare case of cleidocranial dysplasia and to summarize the current clinical and dental features and prosthetic treatment of similar CCD patients reported in the literature. Results. A 17-year-old girl was diagnosed with CCD. She had a short stature with the ability to bring the shoulders under the chest. All remaining teeth were deciduous except the four first molars were permanent. The maxilla was hypoplastic with a relative prognathism of the mandible. The cone-beam computed tomography examination showed a distorted and incomplete root formation of the permanent teeth. She was treated with both, complete and partial, removable overdentures. PubMed was used for the literature research using the following keys words “Cleidocranial Dysplasia”[Mesh], “Prosthodontics”[Mesh], “Dental Care”[Mesh], “cleidocranial dysostosis,” and “dental treatment.” The retention of deciduous teeth was described in the majority of cases. All the patients had supernumerary teeth. The most used treatments were dental prosthetics and orthodontics. The fixed prosthetic implant was the most used type of prosthetic treatment. Among the 15 cases who specified the type of prosthetic treatment, seven patients received removable dentures. Prosthetics was indicated especially for aged patients. Conclusion. Removable prostheses are a good solution that rapidly restores esthetics and functions. The use of implants for these patients needs to be validated by a long-term follow-up.

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Materials for pulpotomy in immature permanent teeth: a systematic review and meta-analysis

BMC Oral Health ◽

10.1186/s12903-019-0917-z ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 4

Author(s):

Yuan Chen ◽

Xinlei Chen ◽

Yali Zhang ◽

Fangjie Zhou ◽

Jiaxin Deng ◽

...

Keyword(s):

Systematic Review ◽

Success Rate ◽

Meta Analysis ◽

Mineral Trioxide Aggregate ◽

Systemic Review ◽

Permanent Teeth ◽

Cochrane Library ◽

Success Rates ◽

The Cochrane Library

Abstract Background Pulpotomy is one of the most widely used methods in preserving vital pulp in teeth, which is of great significance in achieving continue root formation in immature permanent teeth suffering from dental caries or trauma. The aim of this meta-analysis and systemic review is to synthesize the available evidences to compare different pulpotomy dressing agents for pulpotomy treatment in immature permanent teeth. Methods Electronic databases including MEDLINE (via Pubmed), EMBASE, the Cochrane library (CENTRAL) and the clinicaltrials.gov database were searched. The references of all included articles or relevant reviews were cross-checked. Only randomized controlled trials (RCTs) comparing two or more pulp dressing agent in permanent teeth with open apex would be included. Also, the studies should have at least 6 months of follow-up, report clinical and radiographic success in detail and publish in English. Results Five RCTs were included for a systematic review, and all of them had a high risk of bias. There is little difference in success rate between mineral trioxide aggregate (MTA) and calcium hydroxide (CH) at 6-month follow-up (risk ratio (RR) 1; 95% confidence interval (CI) 0.94 to 1.06) and 12-month follow-up (RR 1.04; 95% CI 0.96 to 1.13). There is no difference between MTA versus platelet-rich fibrin and MTA versus calcium-enriched mixture (CEM). There is only weak evidence of increased success rate in using MTA and triple antibiotic paste (TAP) rather than abscess remedy. Conclusions Based on the present evidence, similar success rates with MTA were found between the dressing agents CH, CEM, RPF and TAP as pulpotomy-dressing agents in the treatment of immature permanent teeth. More high-quality RCTs are needed in this field in future studies.

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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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Clinical Evaluation of FUJI VII Sealant Material:

Journal of Clinical Pediatric Dentistry ◽

10.17796/jcpd.31.1.w8532743883hw64n ◽

2007 ◽

Vol 31 (1) ◽

pp. 52-57 ◽

Cited By ~ 12

Author(s):

M Ganesh ◽

Shobha Tandon

Keyword(s):

Clinical Evaluation ◽

Age Groups ◽

Permanent Teeth ◽

Time Intervals ◽

Permanent Molar ◽

Molar Teeth ◽

Sealant Material

200 children of the age groups of 3-5 years and 6-7 years were selected for sealant application, each consisting of 100 children. The clinical retention of Fuji VII was tested in both primary and permanent molar teeth at time intervals of 6 months, 12 months and 24 months follow-up and compared with a resin based sealant, Concise. Results demonstrated that there was no difference in the performance of the materials in primary and permanent teeth.

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