Summary. Objectives.(1) To present a narrative review of the currently available alternative interventions and materials to formocresol pulpotomy for the management of extensive caries in the primary molar, and (2) to produce a clinical protocol for pulp therapy techniques in the extensively carious primary molar. Introduction. The International Agency for Research on Cancer has recently classified formaldehyde as carcinogenic to human beings. Since Buckley's Formocresol contains 19% formaldehyde in its full strength and, therefore, 1% in a 20% dilution, a safer alternative should be identified. Methods. A narrative review of the published literature for primary molar pulp therapy techniques was undertaken following an extensive and appropriate literature search. A specialist group of paediatric dentists was formed to arrive at a consensus and establish an evidence-based protocol for the management of extensively carious primary molar teeth. Part I of this paper explores the currently available alternative interventions and materials to formocresol in the form of a narrative review. The second part of the paper will present the formation of a specialist group to arrive at a consensus and establish an evidence-based protocol for the management of the extensively carious primary molar. Conclusions. After consideration of a review of extensively searched literature, a protocol and key points document have been developed to assist clinicians in their treatment planning. Further long-term studies with the highest level of evidence (i.e. randomized controlled trials) are required to enable us to identify acceptable alternatives which can replace formocresol.
Paediatric dentists have successfully employed MTA in a variety of endodontic/restorative applications since the late 1990s. Clinical impressions have generally been favourable and support the findings of laboratory and animal-based investigations. Very few clinical studies have been reported so far in humans, and although these have been positive, the body of research is currently insufficient to enable a meaningful systematic review and meta-analysis.
Summary.
Objectives. To study barrier formation in nonvital, immature permanent incisors being treated using the apexification technique in two centres, and to establish the effect of the frequency of change of calcium hydroxide (CaOH) on barrier detection times.
Design. A retrospective study of the time of detection and the position of barriers.
Results. There were no significant differences between the two centres in terms of the average frequency of change of each CaOH dressing, the distribution of barrier detection times or the position of barriers (P > 0·05). There was a total of 107 teeth and the time of barrier detection was significantly earlier in more frequently dressed teeth (P = 0·013). Of the teeth with a barrier detection time of less than 9 months, 60.7% were dressed more frequently than every 3 months, as opposed to 39·1% of teeth with longer barrier times (P = 0·027). The mean time of barrier detection for all cases was 43·3 weeks. The majority of barriers were located at or near the apex.
Conclusion. The frequency of change of CaOH can increase the speed of barrier detection but does not appear to affect the position.
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