Stepwise Excavation in a Permanent Molar: 17-year Follow-up

2010 ◽  
Vol 35 (4) ◽  
pp. 482-486 ◽  
Author(s):  
F. F. Lima ◽  
R. C. Pascotto ◽  
A. R. Benetti

Clinical Relevance Due to the risk of pulp exposure in deep carious lesions, stepwise excavation can be a conservative and successful option for selected cases, when signs and symptoms of a normal pulp are present.

2015 ◽  
Vol 49 (6) ◽  
pp. 637-639 ◽  
Author(s):  
Patrícia Hernandéz-Gatón ◽  
César Ruiz Serrano ◽  
Paulo Nelson Filho ◽  
Esther Ruiz De Castañeda ◽  
Marília P. Lucisano ◽  
...  

This study evaluated the stepwise excavation technique in 138 permanent molars with deep carious lesions and incomplete root formation within a 24-month clinical and radiographic follow-up period. In 96.7% of the cases, success was observed (no pain, integrity of restoration margins, absence of radiographic alterations and apexogenesis). The cases of failure (3.3%) were due to the loss of the temporary restoration. In conclusion, the stepwise excavation is a promising technique for permanent teeth with deep carious lesions and incomplete root formation as a minimally invasive approach because it allows the preservation of pulp vitality and occurrence of apexogenesis.


2017 ◽  
Vol 41 (6) ◽  
pp. 429-441 ◽  
Author(s):  
Osama Safwat ◽  
Mona Elkateb ◽  
Karin Dowidar ◽  
Omar El Meligy

Aim: To evaluate the clinical changes in dentin of deep carious lesions in young permanent molars, following ozone application with and without the use of a remineralizing solution, using the stepwise excavation. Study design: The sample included 162 first permanent immature molars, showing deep occlusal carious cavities that were indicated for indirect pulp capping. Teeth were divided into 2 main groups according to the method of ozone treatment. Each group was further subdivided equally into test and control subgroups. Following caries excavation, color, consistency and DIAGNOdent assessments of dentin were evaluated after 6 and 12 months. Results: Regarding dentin color and consistency, no significant differences were observed following ozone application, with and without a remineralizing solution. There were no significant differences between ozone treatment, and calcium hydroxide during the different evaluation periods, except in group I cases after 6 months, concerning the dentin color. The DIAGNOdent values were significantly reduced following ozone application, with or without a remineralizing solution, as well as between test and control cases in group I after 6 months. Conclusions: Ozone application through the stepwise excavation had no significant effect on dentin color and consistency in young permanent molars. DIAGNOdent was unreliable in monitoring caries activity.


2019 ◽  
Vol 2019 ◽  
pp. 1-5
Author(s):  
W. Chinadet ◽  
T. Sutharaphan ◽  
P. Chompu-inwai

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.


2017 ◽  
Vol 10 (2) ◽  
pp. 126-130 ◽  
Author(s):  
Abdul Morawala ◽  
Kapil Jain ◽  
Ajinkya Sawant ◽  
Yusuf Chunawalla ◽  
Nupur S Kanchan ◽  
...  

ABSTRACT Background Early childhood caries discloses a distinct clinical pattern, and the teeth most often involved are the maxillary central incisors, lateral incisors, and the maxillary and mandibular first molars. The maxillary incisors are most severely affected, with deep carious lesions usually involving the pulp. Teeth that have been endodontically treated often have little coronal tooth tissue remaining and as such require a post to retain the core and restoration .This study evaluated and compared the efficacy of EverStick glass fiber-reinforced composite post with ParaPost Taper Lux in primary maxillary anterior teeth. Aim An in vivo study was conducted to evaluate and compare the longevity and failures of two fiber post systems in primary maxillary anterior teeth. Materials and methods A total of 60 severely mutilated primary maxillary anterior teeth from children aged 3 to 5 years were selected according to the inclusion criteria. These teeth were treated endodontically and were randomly assigned into two groups with 30 samples in each group, group I: EverStick glass fiber-reinforced composite post, group II: ParaPost Taper Lux post. The evaluation of dislodgment of posts, secondary caries, root fracture, and post fracture was carried out clinically and radiographically during every follow-up at 3, 6, 9, and 12 months interval. Results Statistical tests (Chi-square test, Fisher's exact probability test) suggested that dislodgment of the posts was significant between the two groups at 6, 9, and 12 months follow-ups. But within the group during subsequent follow-up intervals, dislodgment of posts as a mode of failure was not statistically significant. However, clinically failures were seen in both the study groups. Conclusion Fiber post system has proved to be successful clinically in both primary and permanent teeth due to the monoblock effect with luting agent, post system, core material, and bonding to dentin. Thus, today the EverStick glass fiber post system provides a novel way of fabricating cost-effective and less time-consuming custom-made post in treating mutilated maxillary anteriors. How to cite this article Sawant A, Chunawalla Y, Morawala A, Kanchan NS, Jain K, Talathi R. Evaluation of Novel Glass Fiber-reinforced Composite Technique for Primary Anterior Teeth with Deep Carious Lesions: A 12-month Clinical Study. Int J Clin Pediatr Dent 2017;10(2):126-130.


2017 ◽  
Vol 42 (5) ◽  
pp. 470-477 ◽  
Author(s):  
U Koc Vural ◽  
A Kiremitci ◽  
S Gokalp

SUMMARY Objective: This clinical study aimed to assess the efficacies of mineral trioxide aggregate (MTA) and calcium hydroxide [Ca(OH)2] in the treatment of deep carious lesions by the direct complete caries removal technique. Methods and Materials: A total of 100 permanent molar/premolar teeth were capped with either Ca(OH)2 (n=49) or MTA (n=51) and restored with composite resin in 73 patients. Periapical radiographs were acquired prior to the treatment as well as at six, 12, and 24 months posttreatment. Two calibrated examiners performed the clinical and radiographic assessment of the periapical pathology and pulpal symptoms. Intergroup comparisons of the observed values were performed using the Fisher exact test. Significance was predetermined at α = 0.05. Results: The recall rates were 100% at six and 12 months posttreatment and 98.6% at 24 months posttreatment. Four teeth capped with Ca(OH)2 (two each at six and 12 months posttreatment) and two capped with MTA (one each at 12 and 24 months posttreatment) received endodontic emergency treatment because of symptoms of irreversible pulpitis, which were clinically and/or radiographically established. There were no significant differences in pulp vitality between the two pulp-capping agents at six, 12, or 24 months posttreatment (p=0.238, p=0.606, and p=0.427, respectively). Conclusions: Both pulp-capping materials were found to be clinically acceptable at 24 months posttreatment.


2021 ◽  
Vol 15 (5) ◽  
pp. 1214-1216
Author(s):  
M. R. Ahmed ◽  
S. Aaslam ◽  
J. H. Bukhari

Objective: To compare performance and survival of composite restorations in primary teeth using partial caries removal (PCR) versus complete caries removal (CCR). Methodology: In this trial, 70 permanent molars having deep caries lesions were selected and divided equally into CCR and PCR groups. The study duration was Jan-2018 to Jan-2020. In CCR group, complete dentin removal was done and confirmed by applying dentin detector dye for 10 seconds. In PCR group, visual & tactile criteria were followed for dentin removal. After dentin removal all cavities were filled using RMGIC cement resin. Follow-up was done at 06, 12 and 18 months. Results: Mean age in CCR group was 23.4+5.5 years and 25.6+4.9 years in PCR group. Male patients were 19 and 17 in CCR and PCR groups respectively (p= 0.59). Regarding lesion type, 25 patients in CCR were having occlusal and 5 having Occluso-proximal lesion. In PCR group, 27 teeth were diagnosed with occlusal lesion and 3 with occluso-proximal lesion (p=0.44). At 18 months’ follow-up, success rate was 100% in CCR group and 93.3% in PCR group (p=0.49). Pulp exposure occurred in 23.3% procedures in CCR group and none in PCR group. Conclusion: Partial caries removal has nearly similar success rates as that of complete caries removal and is associated with significantly less pulp exposure rate as compared to CCR. Keywords: Deep carious lesions, Partial caries removal, Complete caries removal, Randomized clinical trial


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