Background: Early childhood caries is a serious public health problem in both developing and industrialized countries. When caries extend to involve the pulp, various forms of pulp treatment are tried to stimulate tooth repair. Although pulpotomy is the treatment of choice for vital primary tooth pulp exposure but there is a trend among many dentists to perform pulpectomies for pulp treatment of vital primary anterior teeth. This study aimed to assess the effect of pulpotomy and pulpecomy in treatment of carious vital pulp exposure in primary incisors. Methods: We searched Pubmed and Cochrane library databases up to March, 2018, OpenGrey for grey literature and ClinicalTrials.gov for ongoing trials. Randomized controlled trials comparing between pulpotomy and pulpectomy in treatment of vital pulp exposure in primary incisors were included. Primary outcomes were clinical failure and radiological failure. Results: Four trials were identified for qualitative assessment, only three trials were included in meta-analysis after exclusion of one trial due to its high risk of bias. The pooled results of the longest follow up period for clinical failure showed no statistically significant difference between pulpotomy and pulpectomy. The relative risk (RR) was e 2.69, 95% CI 0.76 to 9.58 for clinical failure. For radiographic failure, the sensitivity analysis showed RR 0.45, 95% CI 0.25 to 0.83 with a higher risk for radiographic failure in pulpectomy. The evidence was limited by the small number of trials included in the meta-analysis. Conclusions: Both pulpotomy and pulpectomy can be used successfully in the treatment of vital pulp exposure in primary incisors. Further high quality studies comparing between pulpotomy and pulpectomy in primary incisors with longer follow up period till exfoliation time are needed.
Background: Early childhood caries is a serious public health problem. When caries extend to involve the pulp, various forms of pulp treatment are tried to stimulate tooth repair. Although pulpotomy is the treatment of choice for vital primary tooth pulp exposure but there is a trend among many dentists to perform pulpectomies in vital primary incisors. This study aimed to assess the effect of pulpotomy and pulpecomy in treatment of carious vital pulp exposure in primary incisors. Methods: We searched Pubmed and Cochrane library databases up to March, 2018, OpenGrey for grey literature and ClinicalTrials.gov for ongoing trials. Randomized controlled trials were included and assessed with Cochrane risk of bias tool . Primary outcomes were clinical failure and radiological failure. The effect sizes were calculated as risk ratios with 95%CI using the Mantel-Haenszel method. Results: Four trials were identified for qualitative assessment, only three trials were included in meta-analysis after exclusion of one trial due to its high risk of bias. The pooled results of the longest follow up period for clinical failure showed no statistically significant difference between pulpotomy and pulpectomy. The relative risk (RR) was e 2.69, 95% CI 0.76 to 9.58 for clinical failure. For radiographic failure, the sensitivity analysis showed RR 0.45, 95% CI 0.25 to 0.83 with a higher risk for radiographic failure in pulpectomy. The evidence was limited by the small number of trials included in the meta-analysis. Conclusions: Both pulpotomy and pulpectomy can be used successfully in the treatment of vital pulp exposure in primary incisors. Further high quality studies comparing between pulpotomy and pulpectomy in primary incisors with longer follow up period till exfoliation time are needed.
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.
Aim:To assess impact of COVID-19 on pediatric dental practice during first, second and third wave among a group of pediatric dentists. Methodology: This study is based on a closed-ended questionnaire that directed to pediatric dentists who work in Egypt. The survey included questions that evaluate Pediatric Dentists' financial status and their attitude regarding pediatric dental care during first, second and third wave of pandemic COVID-19. Results: Overall, 345 pediatric dentists contributed to this study. More than two thirds of participants (n=274, 79.4%) changed their working time and dental practice. Regarding income; more than three quarters of participants (n=284, 82.3%) suffered decreased income, two thirds (n=230, 66.7%) have encountered financial problems. However; nearly one quarter of participants (n=93, 27%) had another source of income for daily expenditure. Conclusions: COVID-19 has a major impact on the practice of paediatric dentistry. Egyptian pediatric dentists preferred to lower their work hours and limit dental procedures to emergency treatments until the end of the pandemic. So, approximately three quarters of participants faced a decrease in income and also encounter financial problems.
Aim: The aim of this study is to evaluate the postoperative pain of mineral trioxide aggregate (MTA) and propolis after pulpotomy in carious lower primary molars. Methodology: 28 Healthy children aging 5-8 years old with at least one carious primary molar at each side. Each child received MTA in right or left side and Propolis in the other side. Clinical follow up was done at 3, 6, and 9 months. Radiographic follow up was done at 6 and 9 months. Results: All cases were free of pain along the follow up period except one case in propolis group showed pain after 6 months then disappeared at 9 months. Sinus tract appeared in 3.85% in propolis group at 6 months and 4% in both groups at 9 months. Regarding periapical radiolucency, in MTA group, 3 cases (11.54%) were affected after 6 months and 4 cases (16%) after 9 months. In propolis, 4 (15.38%) of cases were affected after 6 months, and 6 (24%) of cases after 9 months. Furcation Involvement, appeared in MTA group, in 2 (7.69%) cases were affected after 6 months. While in propolis group, 6 (23.08%) cases were affected after 6 months. Conclusions: The clinical outcome of propolis is comparable to that of MTA at both 6 and 9 months follow up period. On the other hand, MTA showed better results in all radiographic outcomes when compared to propolis.
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