Healing process of dog dental pulp after pulpotomy and pulp covering with mineral trioxide aggregate or Portland cement.

Considering several reports about the similarity between the chemical compositions of the mineral trioxide aggregate (MTA) and Portland cement (PC), the subject of this investigation was to analyze the behavior of dog dental pulp after pulpotomy and direct pulp protection with these materials. After pulpotomy, the pulp stumps of 26 roots of dog teeth were protected with MTA or PC. Sixty days after treatment, the animal was sacrificed and the specimens removed and prepared for histomorphological analysis. There was a complete tubular hard tissue bridge in almost all specimens. In conclusion, MTA and PC show similar comparative results when used in direct pulp protection after pulpotomy.

Evaluation of 2 endodontic techniques used to treat human primary molars with furcation radiolucency area: A 48-month radiographic study

Objective: To evaluate 2 techniques for the treatment of human primary molars with necrotic Pulp and bifurcation bone loss by means of radiographic examination for 48 months. Method and Materials: Fifty-one mandibular primary molars were evaluated in children ranging from 4.5 to 6.5 years of age. The teeth with necrotic pulp and bifurcation bone loss were diagnosed by radiographic examination. The teeth were divided into 2 groups: group 1 (28 teeth)-pulpotomy technique using formocresol as a temporary dressing between sessions and coronal chamber obturation with zinc oxide-eugenol cement; and group 2 (23 teeth)-pulpectomy technique with calcium hydroxide paste as a temporary dressing between sessions and root canal obturation with a dense Calcium hydroxide paste. Standardized radiographs were taken immediately after the fillings were completed and after 12, 24, 36, and 48 months. The radiographs were digitized and analyzed with software that outlined and measured the bifurcation radiolucency. Results: Bifurcation radiolucency reduced significantly or repaired completely for both treatnients in the first 12 months. Minor radiographic reduction of the lesion was observed from 12 to 24 months, and no significant reduction of the remaining radioulcent area was observed from 24 to 48 months after treatment. Conclusion: The 2 endodontic techniques evaluated showed similar results. The main effect of treatment on the lesion repair was obtained in the first year after treatment.

Scanning electron microscopy evaluation of the hard tissue barrier after pulp capping with calcium hydroxide, mineral trioxide aggregate (MTA) or ProRoot MTA

The aim of this study was to investigate the morphology and localisation of calcium hydroxide- and mineral trioxide aggregate (MTA)-induced hard tissue barriers after pulpotomy in dogs' teeth. Pulpotomies were performed on maxillary and mandibular premolars of five dogs. The teeth were assigned into three groups according to the pulp-capping agent used. The pulpal wounds were capped with calcium hydroxide (Ca(OH)(2) - control), MTA or ProRoot MTA, and the cavities were restored with amalgam. After a 90-day follow-up period, the dogs were euthanised and the teeth were examined under scanning electron microscopy (SEM). An image-processing and analysis software was used to delimit the perimeters of the root canal area and the hard tissue barrier to determine the percentage of root canal obliteration. SEM data were used to assess the morphology, localisation and extension of the reparative hard tissue barriers. ProRoot MTA was statistically different from MTA and Ca(OH)(2) (P < 0.05) regarding tissue barrier morphology. Localisation data showed that ProRoot MTA was significantly different from Ca(OH)(2) (P < 0.05) and similar to MTA (P > 0.01; P > 0.05). No statistically significant difference (P > 0.01; P > 0.05) was observed between MTA and Ca(OH)(2). A larger number of complete (centroperipheral) hard tissue barriers with predominance of dentinal tubules was observed to the ProRoot MTA when compared with the Ca(OH)(2) group.

Cytotoxic effects and pulpal response caused by a mineral trioxide aggregate formulation and calcium hydroxide

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Biological response of pulps submitted to different capping materials

Pulp capping is a procedure that comprises adequate protection of the pulp tissue exposed to the oral environment, aiming at the preservation of its vitality and functions. This study evaluated the response of the dental pulps of dog teeth to capping with mineral trioxide aggregate (MTA) or calcium hydroxide P.A. For that purpose, 37 teeth were divided into two groups, according to the capping material employed. Two dogs were anesthetized and, after placement of a rubber dam, their pulps were exposed in a standardized manner and protected with the experimental capping materials. The cavities were then sealed with resin-modified glass ionomer cement and restored with composite resin. After sixty days, the animals were killed and the specimens were processed in order to be analyzed with optic microscopy. It was observed that MTA presented a higher success rate compared to calcium hydroxide, presenting a lower occurrence of infection and pulp necrosis.

Clinical and radiographic evaluation of pulpotomies employing calcium hydroxide and trioxide mineral aggregate

This study utilized clinical and radiographic examinations to compare the effectiveness of calcium hydroxide paste and mineral trioxide aggregate (MTA) for pulpotomies of primary molars in children. Ninety primary molars that showed clinical and radiographic indications for pulpotomy treatment were selected. The pulpotomies were performed in two sessions, using a corticosteroid/ antibiotic solution as therapeutic dressing. The sample was divided into two groups of 45 teeth, in which the pulpal remains were protected with either calcium hydroxide paste (Group 1) or MTA (Group 2). Radiographs were taken immediately and at 3-, 6-, and 12-month follow-up appointments. Three teeth in Group 1 failed after three months, while two cases failed after six months and one more failed at one year. Two failures were found in Group 2 at the 12-month follow-up. These results indicate that both materials may be utilized for pulpotomies in primary teeth.

Response of human dental pulp to calcium hydroxide paste preceded by a corticosteroid/antibiotic dressing agent

Aim: To evaluate the treatment with corticosteroid/antibiotic dressing in pulpotomy with calcium hydroxide. Methods: Forty-six premolars were pulpotomized and randomly assigned into 3 groups. In Group I pulpal wound was directly capped with calcium hydroxide, and Group II and Group III received corticosteroid/antibiotic dressing for 10 min or 48 h, respectively, before pulp capping. Teeth were processed for histological analysis after 7, 30 or 60 days to determine inflammatory cell response, tissue disorganization, dentin bridge formation and presence of bacteria. Attributed scores were analyzed by Kruskal-Wallis and Mann-Whitney tests (α=0.05). Results: On the 7th day, all groups exhibited dilated and congested blood vessels in the tissue adjacent to pulpal wound. The inflammatory cell response was significantly greater in Group III (p<0.05). On the 30th day, in all groups, a thin dentin matrix layer was deposited adjacent to the pulpal wound and a continuous odontoblast-like cell layer underlying the dentin matrix was observed. On the 60th day, all groups presented a thick hard barrier characterized by an outer zone of dystrophic calcification and an inner zone of tubular dentin matrix underlined by a defined odontoblast-like cell layer. Conclusions: Within the limitations of present study, considering that the treatment was performed in healthy teeth, it may be concluded that the use of a corticosteroid/antibiotic dressing before remaining tissue protection with calcium hydroxide had no influence on pulp tissue healing.

Espessura do assoalho da câmara pulpar de molares decíduos inferiores tratados pelo TRA, pulpotomia e pulpectomia

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Implantes osseointegráveis instalados sobre raízes reimplantadas tardiamente

Pós-graduação em Odontologia - FOA

Estudo in vivo da formação de barreira de tecido duro após pulpotomia com diferentes materiais empregando variados métodos de avaliação

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Cárie oculta extensa: relato de caso clínico

The pattern of caries lesions has been modified over decades. If the presence or absence of a caries lesion is based upon only a visual examination, its diagnosis might become underestimated since dentinal lesions underneath non cavitated or minimally demineralized enamel is highly frequent in dental clinics. The aim of this paper is to report a clinical case of a child with an upper molar with questionable occlusal aspect, presenting asymptomatic pulpal hyperplasia on the distolingual pit. Periapical radiographic examination was essential for diagnosing hidden caries and elaborating the treatment plan. As part of the approach, removal of the decayed tissue and pulpotomy with calcium hydroxide were performed. The association of an accurate visual examination to an adequate oral radiographyis is extremely important in cases which the presence of hidden caries is doubtful. As a result, an early diagnosis and the reduction of more invasive interventions related to the oral health care of pediatric patients can be achieved as well.

Terapia pulpar em dentes decíduos: possibilidades terapêuticas baseadas em evidências

Introduction: Pulpotomy of primary teeth has been the treatment of choice in cases of inflammation of the coronal pulp caused by caries or trauma with no involvement of the radicular pulp, thus avoiding the premature loss of the teeth. Not only is the diagnosis of the inflamed dental pulp required for this therapy to succeed, but also the selection of an effective and biocompatible medicament. However, none of the drugs available and recommended for pulpotomy therapy present all the requirements of an ideal pulp capping agent. Objective: Through a systematic literature review, between the years of 2000 and 2011, focusing in randomized clinical trials, systematic reviews and meta-analysis, aiming to analyze and discuss based on alternatives for the treatment of pulpotomy in human deciduous teeth. Conclusion: Scientific evidences showed that the medicaments and techniques influence were few. Thus, further and well-designed studies are suggested for clarification. The information generated in such experiments may contribute to a better understanding of the mechanisms of pulp therapy to new therapeutic approaches aimed at improving pulp therapy in deciduous teeth.

Clinical, radiographic and histologic analysis of the effects of pulp capping materials used in pulpotomies of human primary teeth

Aim: To compare the clinical, radiographic and histological responses of the pulp to mineral trioxide aggregate (MTA), calcium hydroxide (CH) and Portland cement (PC) when used as a pulpotomy agent in human primary teeth. Study design: Forty-five mandibular primary molar teeth were randomly assigned to CH, MTA or PC groups and treated by pulpotomy technique. Methods: The teeth were treated by conventional pulpotomy technique, differing only in the capping material for each group. Clinical and radiographic evaluations were recorded at 6-, 12- and 24-month follow-up. Teeth in the regular exfoliation period were further processed for histologic analysis. Statistics: The teeth were treated by conventional pulpotomy technique, differing only in the capping material for each group. Clinical and radiographic evaluations were recorded at 6-, 12- and 24-month follow-up. Teeth in the regular exfoliation period were further processed for histologic analysis. Statistics: Clinically and radiographically, the MTA and PC groups showed 100 % success rates at 6, 12 and 24 months. In CH group, several teeth presented clinical and radiographic failures detected throughout the follow-up period, and internal resorption was a frequent radiographic finding. Histologic analysis revealed the presence of dentine-like mineralised material deposition obliterating the root canal in the PC and MTA groups. CH group presented, in most of the sections, necrotic areas in the root canals. Conclusions: MTA and PC may serve as effective materials for pulpotomies of primary teeth as compared to CH. Although our results are very encouraging, further studies and longer follow-up assessments are needed in order to determine the safe clinical indication of Portland cement.