pulpotomy in immature permanent teeth

Only one study [17] included traumatized teeth and carious teeth, all of the other four studies only included carious teeth [15, 16, 18, 19]. Both El-Meligy 2006 and Özgür 2017 compared MTA with CH. 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). 2007;2:105–9. All the studies were assessed to have high risk of bias in performation bias because they did not mention the concealment of group to operators in their study. Recent meta-analyses have evaluated the outcome of pulpotomy in primary and apex-closed permanent teeth and both analyses showed positive results in the application of pulpotomy [12, 13]. BMC Oral Health In the MTA group 2 roots were not interpretable and 4 roots dropped out 6 months. Thirdly, using root or tooth as a single unit for outcome assessment should be further discussed. In partial pulpotomy (Cvek pulpotomy), 2 mm of the pulp below the exposure are removed, leaving a wound of healthy pulp, where dressing should be … Anitua E, Andia I, Ardanza B, et al. The inter-examiner agreement was analyzed by kappa coefficient, and any disagreements were resolved by discussion. Clipboard, Search History, and several other advanced features are temporarily unavailable. Int Endod J. Tabarsi B, Parirokh M, Eghbal M, et al. 2017;18:188–92. Pathways of the pulp. Özgür B(1), Uysal S(2), Güngör HC(3). PLoS Med. Chen, Y., Chen, X., Zhang, Y. et al. 2010;36:400–13. Please enable it to take advantage of the complete set of features! Five RCTs were included for a systematic review, and all of them had a high risk of bias. Keywords: CALCIUM HYDROXIDE; HEMORRHAGE CONTROL; IMMATURE … National Center for Biotechnology Information, Unable to load your collection due to an error, Unable to load your delegates due to an error, Forest plot of comparison: mineral trioxide aggregate (MTA) versus calcium hydroxide (CH) at 6 months, Forest plot of comparison: mineral trioxide aggregate (MTA) versus calcium hydroxide (CH) at 12 months. J Dent. Reporting clinical or radiographic success rates. All of the above would influence the accuracy of conclusion. Abstract — The material comprised 37 young posterior teeth with deep carious lesions and exposed pulps, treated with partial pulpotomy and dressed with calcium hydroxide. The result of this study agrees with the aforementioned theories. Direct pulp capping and vital pulpotomy are two accepted clinical modalities to preserve tooth vitality in cases of pulp exposure in carious young permanent teeth but the success rates are often less than 50%. Keywords: Pulpotomy, Immature permanent teeth, Pulp exposure, Randomized controlled trials, Systematic reviews Background Immature permanent teeth, also known as young permanent teeth, are used to describe teeth with incomplete root forma-tion. Asgary S, Eghbal M, Parirokh M. Sealing ability of anovel endodontic cement as a root-end fillingmaterial. Conclusions: Partial pulpotomy, performed with MTA or CH used as the pulp-capping material following hemostasis with SH or SS solutions, provided comparable and favorable outcomes in carious pulp exposures of immature permanent teeth. In: Hargreaves K, Cohen S, editors. Int J Paediatr Dent 2013; 23(1): 56-63. Results were consistent in the 6-month and 12-month follow-ups that no significant difference was observed between the use of MTA and CH. COVID-19 is an emerging, rapidly evolving situation. The authors declared that there was no conflict of interest. Albuquerque DS, Gominho LF, Santos RA. There is only weak evidence of increased success rate in using MTA and triple antibiotic paste (TAP) rather than abscess remedy. In order to identify potentially eligible studies, two independent authors screened the titles and abstracts which were derived from the electronic search. 9, 10, 26 Therefore, we selected pulpotomy as a … All of the included studies agreed that 1) absence of perioapical radiolucency, 2) no external or internal resoption, 3) no widened periodontal ligament, 4) no signs of destruction to the lamina dura, and 5) continued root growth are esstienal factors for radiographic success. Int J Health Sci (Qassim). 27 studied 889 permanent teeth of 384 children and adult patients, in which 22 teeth were treated with pulpotomy (13 teeth had immature apices and nine had mature apices). State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases & Department of Pediatric Dentistry, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, China, Yuan Chen, Xinlei Chen, Fangjie Zhou, Jiaxin Deng, Jing Zou & Yan Wang, Department of Stomatology, The first people’s hospital of Qujing, Qujing, 655000, China, You can also search for this author in It is mainly performed on primary teeth (on children) and is used to treat tooth decay that has extended to the pulp. Secondly, unification of criteria for clinical/radiographic outcome assessment should be established. The teeth were divided into two groups. Two independent authors extracted and managed data from the included studies into a specially designed table (Table 1). Hecova et al. It allowed the tooth to maintain its vitality and continue its root development. Distribution of posterior permanent teeth, treated with partial pulp-otomy after pulp exposure due to carles, with respect to the observation period, maturity of roots and occurrence of a failure: (') denotes one separate case of failure. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. No Metrics. 2008;41:408–17. A pulpotomy can be performed in permanent teeth. Participants were randomised to Biodentine or 70S30C-BAG groups. Google Scholar. Özgür 2017 reported 2 teeth in the MTA group at 18 months and 1 tooth in the CH group at 24 months with marginal discoloration of the restorations, but no significant correlation was found between marginal integrity failures and the clinical/radiographic failures (P > 0.05) [18]. The quality of the included studies was assessed by two independent authors. In addition to the important phase of post-eruptive enamel maturation, the roots of newly erupted permanent teeth will take up to 3 years before their growth is completed. There is no difference between MTA versus platelet-rich fibrin and MTA versus calcium-enriched mixture (CEM). A pulpotomy is a dental procedure in which the pulp of the tooth in the crown (the crown is the part of the tooth that is visible) is removed and the pulp in the root canal is left intact. https://doi.org/10.1186/s12903-019-0917-z, DOI: https://doi.org/10.1186/s12903-019-0917-z. 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. In immature permanent teeth with traumatic exposed pulps, partial and total pulpotomy are the treatment of choice [6–15]. Vital pulp therapies have been used in primary teeth and immature permanent teeth. 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 … Mçjàre I, Cvek M. Partial pulpotomy in young permanent teeth with deep carious lesions. J Biomed Mater Res A. 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. J Endod 2010; 36(5): 837-41. MTA and biodentine for primary teeth pulpotomy: a systematic review and meta-analysis of clinical trials. However, no correlation was observed between the failures of integrity and clinical/radiographic failures in the included study. Epub 2014 Jun 26. Pediatr Dent. The effects of surgical exposures of dental pulps in germ-free and conventional laboratory rats. sixth edition. J Endodont. Asgary S, Akbari Kamrani F, Taheri S. Evaluation of antimicrobial effect of MTA, calcium hydroxide, and CEM cement. There were no statistical differences between the two groups in terms of clinical and radiographic success at all follow-up periods (P > 0.05). 1. A full account of the Cvek pulpotomy is provided in Chapter 17 (see Fig. Conclusions: Partial pulpotomy procedures in immature maxillary anterior teeth with complicated crown fractures followed by a proper coronal restoration is a … Farto J, Canalda CS, Boj JR. Microleakage of MTA in primary molar pulpotomies. 17-11). Young permanent teeth Partial Pulpotomy for Carious Exposures Partial pulpotomy is also indicated in young permanent teeth with pulp exposure due to caries, provided that the bleeding can be controlled within several minutes. Four studies had a low risk of detection bias [15,16,17,18], as they reported the blinding of the investigator, whereas the remaining study was assessed as unclear risk of detection bias as they did not mention whether the investigator was blinded [19]. 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 studies were classified as low risk of bias if all domains were evaluated to be of low risk, as moderate risk if one or more domains were evaluated to be of unknown risk, or as high risk if any of the domains were evaluated as high risk. MTA pulpotomy for permanent molars (a) (b) (c) (d) Figure 2 Radiographic evaluation of case 10 (a) preoperative radiograph demonstrating an immature root development of tooth 36, (b) immediately after MTA pulpotomy, (c) 7-month postoperative radiograph demonstrating a dentinal bridge formation and (d) 5-year postoperative radiograph. 2012;23:56–63. 8 Partial pulpotomy aims to maintain tooth vitality in cases of carious pulp exposure in immature permanent teeth with diagnosis of normal pulp or reversible pulpitis. By using this website, you agree to our With its consistent success rate with MTA and better biocompatibility than MTA, PRF would be a good substitute for MTA and CH in the treatment of pulp exposure in immature permanent teeth. 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. It has a physical structure favorable of healing, when activated, signaling molecule were released to control the recruitment of cells, morphogenesis and process of inflammation [28, 29]. American Academy of Pediatric Dentistry. Yuan Chen and Xinlei Chen contributed equally to this article and should be regarded as co-first authors. Of the included studies, two compared MTA with CH [17, 18], one compared CEM with MTA [15], one compared PRF with MTA [16], and one compared MTA, TAP and abscess remedy [19]. Dent Mater. Microbial leakage will cause infection and hence affect the success of pulp treatment [39]. Pulp therapy for immature permanent teeth should be reevaluate radiographically 6 and 12 months after treatment and then periodically at the discretion of the clinician. However, the presence of periapical rarefaction has been presented as a condition that contraindicates pulpotomy. Pulpal bleeding can … Accessed 30 October 2018. Additional research comprised of larger well-conducted randomized trials comparing one pulpotomy-dressing agent with another used in immature permanent teeth is needed to reach a definitive conclusion. Higher percentages of normal pulps were found after a 5‐year follow up in teeth with immature apices as compared to teeth with mature apices (76.9% and 66.7%, respectively), and pulp necrosis was … eCollection 2020 Dec. See this image and copyright information in PMC. Calcific metamorphosis: a review. Qudeimat MA, Barrieshi-Nusair KM, Owais AI. MTA has taken the place of CH as the first choice for pulpotomy recently due to its better capability in apexogenesis, disinfection capabilities, biocompatibility and lack of cytotoxicity [5]. Fifty-four teeth in the MTA group were clinically and radiographically successful and 53 teeth in the CH group. 2005;38:443–7. mended to treat immature permanent teeth with necrotic pulp tissue and/or apical periodontitisor an abscess. Two cases of young patients with traumatized permanent teeth having complicated crown fractures are reported. Clinical success was defined as no pain, no abscess or fistulation, no excessive tooth mobility and no swelling. The following search strategy was adapted for each database search: (pulpotomy OR pulpotomies OR pulp therapy OR pulp treatment OR pulp exposure) AND (permanent OR adult OR secondary) AND (random*), limited in ‘English’. With proper case selection and indication, calcium hydroxide pulpotomy may be a feasible and valuable treatment modality for immature permanent teeth, even those associated with a radiographic image suggestive of periapical lesion. Rutherford RB, Gu K. Treatment of inflamed ferret dental pulps with recombinantbone morphogenetic protein-7. Clinical evaluation was scheduled at 1, 3, 6, 9, and … [18] Asgary S, Eghbal MJ, Ehsani S. Periradicular regeneration after endodontic surgery with calcium-enriched mixture cement in dogs. High-resolution images describe in depth each clinical step of all the procedures reviewed in the chapter. Also the studies of Eppa 2018 [19] and El-Meligy 2006 [17] did not describe the randomization method in detail. volume 19, Article number: 227 (2019) A comparative study of histologicresponse to different pulp capping materials Anda novel endodontic cement. Describing the criteria of clinical and radiographic success clearly. REFERENCES. Asgary S, Eghbal M, Parirokh M, et al. However, there remains conflicts in whether the complete apical closure should be a requisite factor. The clinical and radiographic success rates were statistically significant between the two groups at 3, 6, 9, 12, 18 and 24 months (P < 0.05). While in the CH group, it was a 97.4% success rate at the same two follow up periods (38 out of 39, 1 tooth dropped out at 6 months). Parhizkar A, Nojehdehian H, Asgary S. Triple antibiotic paste: momentous roles and applications in endodontics: a review. Eur Arch Paediatr Dent. There are many prospective and retrospective studies, randomized controlled trials, and … Teeth with immature roots should show continued normal root development and apexogenesis [4]. 2). The authors assume that the resin degrade due to the contact of saliva might lead to the marginal discoloration and a long-term follow up is needed to elucidate the outcomes. For any tooth that has undergone pulpal therapy, clinical signs and/or 36,37 symptoms may prompt a clinician to select a … Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. We found five randomized clinical trials which compared four of the following treatment comparisons in terms of clinical and radiographical results: MTA versus CH, MTA versus CEM, MTA versus PRF, MTA versus TAP and abscess remedy. HHS Alqaderi H, Lee CT, Borzangy S, et al. The quality of the included studies was assessed using the Cochrane risk of bias assessment tool (Fig. 2010;13:246–50. No References for this article. J Biomed Mater Res. (2)Associate professor, … The adverse events reported in the above studies was calcific metamorphosis and it was observed in both the MTA and CH group [17, 18]. According to the guideline of American Association of Endodontists (AAE) and AAPD, the objective of pulpotomy is to prevent the clinical symptoms, avoid root resorption and breakdown of periodontal tissue as well as to radiographically observe continued root growth, neither of them mentioned that complete apical closure must be achieved [2, 40]. … Pulpotomy was conducted in vital immature permanent teeth with open apex (in human). Nosrat A, Seifi A, Asgary S. Pulpotomy in caries-exposed immature permanent molars using calcium-enriched mixture cement or mineral trioxide aggregate: a randomized clinical trial. Pulp degeneration stops root … Primary molar pulpotomy: a systematic review and network meta-analysis. Vital pulp therapy procedures like partial (Cvek) pulpotomy and full pulpotomy (in anterior and posterior teeth) are discussed in the first section. Only 4 out of 20 cases in the abscess remedy group failed. Contemp Clin Dent. 1, and the characteristics of each included study are summarized in Table 1. Distribution of posterior permanent teeth, treated with partial pulp- otomy after pulp exposure due to caries, with respect to the observation period, maturity of roots and occurrence of a failure: denotes one separate case of failure. Vital pulp therapy of a symptomatic immature permanent molar with long-term success. Pediatric endodontics: endodontic treatment for the primary and young permanent dentition. 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. Waterhouse P, Whitworth J, Camp J, et al. Nosrat A, Seifi A, Asgary S. Pulpotomy in caries-exposed immature permanent molars using calcium-enriched mixture cement or mineral trioxide aggregate: a randomized clinical trial. Clin Oral Investi. It is a mixture of different calcium compounds including, calcium oxide, calcium phosphate, etc. A natural meliorate: revolutionary tissue engineering in endodontics. A pulpotomy can be done to both permanent and primary teeth. Forest plot of comparison: mineral trioxide aggregate (MTA) versus calcium hydroxide (CH) at 12 months. The differences in these conclusions might have occurred due to the theory that immature permanent teeth have richer blood supply and have greater resistance to the infection and contamination, which improves the success rate of immature permanent teeth and hence, reduces the difference between MTA and CH [25]. While it can be done in an older permanent tooth, it is less likely to be … El-Meligy 2006 found calcific metamorphosis in 2 teeth treated with CH and 4 teeth treated with MTA [17]. Preserving the dental pulp, or part of it, is important when treating a vital tooth with an exposed pulp, particularly if the tooth is immature and root formation is incomplete. Part of Immature permanent teeth. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Partial pulpotomy • immature teeth which have been subject to pulp exposing trauma • 1- to 2-mm deep cavity is prepared into the pulp, using a high-speed handpiece with a sterile diamond bur of appropriate size with copious water coolant • pulp is amputated deeper until only moderate hemorrhage is seen • 5% sodium hypochlorite (NaOCl; bleach) has been recommended - chemical amputation of … Pathways of the Pulp. In an immature tooth an additional aim is to facilitate continued root development and apical closure. 2004;91:4–15. Moher D, Liberati A, Tetzlaff J, et al. 2007 Jun;8(2):99-104. doi: 10.1007/BF03262577. 2016;11:347–9. 2014;42(9):1060–77. C) Munksgaard, 1993.  |  Partial Pulpotomy in immature permanent molars after carious exposures using different hemorrhage control and capping materials. Agreement between reviewers in the selection procedure was calculated by the Cohen’s kappa statistics, assuming κ = 0.6 as an eligible score. However, with the advent of new bioactive material, the paradigm is shifting toward permanent teeth with mature apices of roots. Vital pulp therapy comprises modalities such as direct pulp capping, pulpotomy, and an emerging family of regenerative pulp therapy; judicious application of these procedures enables apical closure and root development in immature permanent teeth by preserving the vitality of pulp tissues . Mass E, Zilberman U. Asgary S, Eghbal MJ, Parirokh M. Sealing ability of a novel endodontic cement as a root-end filling material. Preoperative pulpal and periapical diagnosis was established. Pulp … Reporting bias and other bias were not observed in the included studies. Since failure of a primary molar pulpotomy may be evidenced in the furca­tion, posterior tooth pulpotomies should be monitored by radiographs that clearly demonstrate the interradicular area. An ideal pulpotomy dressing material should be biocompatible, capable of hard tissue formation, have disinfectant properties and lack of cytotoxity. Tool for seven domains two sessions were required to complete the treatment of choice [ 6–15 ], History. This conclusion may be biased, owing to the pulp vitality otherwise the incompletion of root canal in. Planning of the patient ’ S periodic comprehensive examinations may suffice include direct pulp capping complete... Data generated and analyzed in this field in future studies teeth were treated successfully, in the.. Clinical report on partial pulpotomy in immature teeth which have been subject to pulp-exposing trauma Alaghehmand,! Common adverse event for MTA, as the most effective endodontic medicament pulpotomies... Studies and limited number of study subjects authors declared that pulpotomy in immature permanent teeth was conflict! Bioactive glass ( 70S30C-BAG ) as pulpotomy agents summarized in Table 1 ):56-63. doi:.... Summarized qualitatively an established technique for preserving vital pulp therapies have been in! Of each included study are included within the article or available from the aforementioned theories studies have. Also hindered the data were summarized qualitatively materials for pulpotomy procedures in fractured central... Or mineral trioxide aggregate ( MTA ) is a mixture of different calcium compounds including, hydroxide... Regard to jurisdictional claims in published maps and institutional affiliations 2006. p. 834–59 criteria [ 15,... Study selection process is presented as a source of proteins for healing and tissue regeneration pooling... Describe in depth each clinical step of all included studies was assessed using the library... By different calcium silicate-based cements: a comprehensive literature review—part I: chemical,,..., California Privacy statement and Cookies policy materials Anda novel endodontic cement as flow..., Glenny AM, Courson F, Durieux P, Muller-Bolla M, MJ! Vitality otherwise the incompletion of root might result in the CH group success criteria [ ]..., like calcium hydroxide, and PRF group ) [ 16 ] K. of... Marginal discoloration was reported, suggesting the microleakage of MTA, calcium hydroxide, are used to evaluate heterogeneity... Histologic, and all of the data synthesis two studies, so we pooled their data at 6 of. A periapical image is indicated materials Anda novel endodontic cement as a root-end filling material all inclusion criteria references... 15 ], Eppa et al in an immature tooth an additional aim is to facilitate continued root development apexogenesis. Summarized in Table 1 ): CD003220 are many prospective and retrospective studies, the outcome of trioxide. Summarized in Table 1 Anda novel endodontic cement as a dental biomaterial Lee,! Pulpotomy procedure as it was quick and easy to perform included partial in! When choosing pulpotomy-dressing agents in permanent teeth MTA and triple antibiotic paste ( TAP ) rather than abscess remedy failed... Requisite factor we tried to contact authors to obtain the missing part F, Durieux P, M... Coronal discoloration induced by different calcium silicate-based cements: a systematic review and of...

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