pulp treatment in primary teeth

Accuracy of an electronic apex locator: a clinical evaluation in primary molars with and without resorption. The primary objective of pulp therapy is to maintain the integrity and health of the teeth and their supporting tissues. Berlin: Quintessence; 2011. p. 173–83. Your teeth are made up of a hard outer layer of enamel, which covers a softer, bulky material called dentin. The only time the AAPD recommends a direct pulp cap on a primary tooth is when the pulp is exposed due to mechanical trauma. Pulp interventions are indicated for extensive tooth decay. Abstract. 2011;35(3):255–8. The two major procedures used to perform pulp therapy in primary teeth, pulpotomy and pulpectomy, have evolved over the years. Treatment is necessary if cavity removal results in exposure of the pulp or in a primary tooth with reversible pulpitis, which means the tooth can still be saved. Future trials to evaluate which healing agents are best for the three pulp treatments would require a very large sample size and should follow up the participants of a minimum of one year. 2018;5:CD003220. This is an update of a Cochrane review first published in 2003. Pediatric dentists perform pulp therapy on both primary (baby) teeth and permanent teeth. 86. The risk of long-term complications such as pulp necrosis, infection related resorption or ankylosis related resorption may – if left untreated – affect the formation of the permanent teeth. Treatment. 144.76.84.133. Pulp treatment in primary teeth has been a topic of great interest in pediatric dentistry and it has gener-ated many opinions and controversial concepts. Yacobi R, Kenny DJ, Judd PL, Johnston DH. A protective liner is a thinly-applied liquid placed on the pulpal surface of a deep cavity preparation, covering exposed dentin tubules, to act as a protective barrier between the restorative material or cement and the pulp. 2011;44(5):402–6. Beltrame AP, Triches TC, Sartori N, Bolan M. Electronic determination of root canal working length in primary molar teeth: an in vivo and ex vivo study. This service is more advanced with JavaScript available, Contemporary Treatment Techniques in Pediatric Dentistry Pulpitis is inflammation of the dental pulp. Oral Health Prev Dent 2003;1(3):201-7. of formocresol pulpotomy and indirect pulp therapy in 23. Indirect pulp treatment in primary teeth 35 Fig. Research could be undertaken to confirm if ZOE paste is more effective than Vitapex and to evaluate other alternatives. Nurko C, Ranly DM, García-Godoy F, Lakshmyya KN. Background: In children, dental caries (tooth decay) is among the most prevalent chronic diseases worldwide. We assessed the quality of the evidence as low or very low for all comparisons. and primary teeth, maintaining pulp vitality and function(1). No restrictions were placed on the language or date of publication when searching the electronic databases. According to the American Academy of Pediatric Den-tistry (AAPD) Guidelines, the primary objective of pulp therapy is to maintain the integrity and health of Pulpal treatment of primary teeth The preservation of the primary teeth whose pulp has been endangered by deep carious lesions or trauma is a major problem in primary teeth dental treatment. Cochrane Database Syst Rev. The primary objective of pulp therapy is to maintain the integ- rity and health of the teeth and their supporting tissues. Complicated crown fracture and crown-root fracture with pulp involvement expose dental pulp to the oral environment. There was low-quality evidence of a difference in failure at 12 months that suggested ZOE paste may be better than Vitapex (calcium hydroxide/iodoform) paste (two trials, 161 participants). It is a treatment objective to maintain the vitality of the pulp of a tooth affected by caries, traumatic injury, or other causes. When the pulp has become irreversibly infected or necrotic, a root canal treatment is indicated [2, 3]. Pulpotomy is a dental procedure used to save decayed, infected teeth. This material should not prevent the resorption of the primary tooth's root, to let the permanent tooth to grow in. Pulp treatment for extensive decay in primary teeth is generally successful. Compared with calcium hydroxide, MTA reduced both clinical and radiological failures, with statistically significant differences for clinical failure at 12 and 24 months. Pulp treatment for extensive decay in primary teeth. Pulp interventions are indicated for extensive tooth decay. Hutcheson C, Seale NS, McWhorter A, Kerins C, Wright J. Multi-surface composite vs stainless steel crown restorations after mineral trioxide aggregate pulpotomy: a randomized controlled trial. We use cookies to improve your experience on our site. Myers DR, Pashley DH, Whitford GM, McKinney RV. Flaitz CM, Barr ES, Hicks MJ. High-resolution clinical pictures of every step along with long-term follow-ups and clinical tips will help the reader achieve predictable prognosis when carrying out these valuable procedures. The evidence is current up to August 2017. This is a multicenter, randomized, double-blind (patient), controlled and non-inferiority clinical study on 174 primary molars and 174 primary incisors of 3-6 years-old children with carious lesions with pulp involvement. After treatment, the cavity is filled with a medicament.This is an update of a Cochrane review first published in 2003. Abstract. Regarding direct pulp capping, the small number of studies undertaking the same comparison limits any interpretation. Pediatric endodontics: current concepts in pulp therapy for primary and young permanent teeth. 1983;5(1):6–8. Resorption of a calcium hydroxide/iodoform paste (Vitapex) in root canal therapy for primary teeth: a case report. Pulp capping in permanent teeth, ending with revascularization and MTA apexification. The trials were published between 1989 and 2017 and provided 125 comparisons of different treatment options. Mutluay M, Arikan V, Sari S, Kisa U. 2. For deep lesions on teeth with vital pulp, dentists should have as main objective to avoid pulpal exposure by leaving the leathery dentine on the pulp wall.1 Within this concept emerged the selective carious tissue removal (SCTR). Pediatr Dent. Dentists often have to perform one of three pulp treatment techniques: direct pulp capping (where a healing agent is placed directly over the exposed pulp), pulpotomy (removal of a portion of the pulp) or pulpectomy (removal of all of the pulp in the pulp chamber and root canal of a tooth). The primary goal of pulp therapy is to treat, restore, and save the affected tooth. It is a treatment objective to maintain the vitality of the pulp of a tooth affected by caries, traumatic injury, or other causes. .Pulpless tooth with stomas. Pulp interventions are indicated for extensive tooth decay. Pulp therapy for baby teeth, also known as root canal, pulpotomy, pulpectomy, or nerve treatment, works to treat inflamed pulp in order to restore and save the affected tooth. Not affiliated View Academics in Pulp treatment of primary teeth on Academia.edu. Ochoa-Romero T, Mendez-Gonzalez V, Flores-Reyes H, Pozos-Guillen AJ. In recent years, … J Clin Pediatr Dent. Pulpotomy: is MTA/Portland cement the future? After treatment, the cavity is filled with a medicament. Does Achievement of Hemostasis After Pulp Exposure Provide an Accurate Assessment of Pulp Inflammation? The evidence showed it to be less likely to fail than either calcium hydroxide or formocresol. Protective liner. After pulpectomy, it is not clear whether any medicament is superior to another. Materials commonly used include mineral trioxide aggregate (MTA), calcium hydroxide, formocresol or ferric sulphate. Oper Dent. 2000;22(6):517–20. Review authors working with Cochrane Oral Health carried out this review of randomised controlled trials. A recent systematic review and meta-analysis on primary tooth vital pulp therapy 74 demonstrated that the “highest level of success and quality of evidence supported IPT and the pulpotomy techniques of MTA and FC for the treatment of deep caries in primary teeth after 24 months. Regarding pulpectomy, we found moderate-quality evidence for two comparisons. Compared with formocresol, MTA reduced both clinical and radiological failures, with a statistically significant difference at 12 months for clinical failure and at six, 12 and 24 months for radiological failure (12 trials, 740 participants). Pulp treatment for extensive decay in primary teeth is generally successful. Indirect pulp treatment. J Am Dent Assoc. Cochrane Database of Systematic Reviews 2018, Issue 5. Background: In children, dental caries is among the most prevalent chronic diseases worldwide. Third, primary teeth are space maintainers for permanent successor eruption, maintain arch length and help to guide permanent dentition into place. .Pulpless primary molars holding orthodontic appliance . Two review authors independently extracted data and assessed 'Risk of bias'. For deep lesions on teeth with vital pulp, dentists should have as main objective to avoid pulpal exposure by leaving the leathery dentine on the pulp wall.1 Within this concept emerged the selective carious tissue removal (SCTR). The main aim of primary tooth pulp therapy is to maintain arch length and integrity by preserving the pulpally involved tooth as a natural space maintainer. Stringhini Junior E, dos Santos MGC, Oliveira LB, Mercadé M. MTA and biodentine for primary teeth pulpotomy: a systematic review and meta-analysis of clinical trials. Background: In children, dental caries is among the most prevalent chronic diseases worldwide. Carla Cohn, DMD. Treatment planning The first treatment decision for the young patient with one or more extensively carious primary molars is whether to retain or extract these teeth… Many included trials had no clinical or radiological failures in either trial arm, and the overall proportion of failures was low. The trials were published between 1989 and 2017 and provided 125 comparisons of different treatment options. We contacted authors of RCTs for additional information when necessary. Prevent the Need for Pulp Capping It is how a dentist might describe ‘toothache.’ The pulp inside a tooth consists of vascular tissues, blood supply, nerves, and connective tissue. ): E146–E159, Lakshmyya KN therapy on both primary ( baby ) teeth and permanent teeth with... Large sample size and follow up of a tooth and its supporting tissues KN. Arıkan V, Sari s, editors generally successful contemporary treatment techniques pulp treatment in primary teeth with! Published in 2003 expose dental pulp to the oral cavity and area of furcation suggesting... Hargreaves KM, Cohen s, Kisa U pulp stones are foci of calcification or discrete in... Pulp has become irreversibly infected or necrotic, a root canal endodontics: current concepts in pulp therapy is... 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Instrumentation and obturation times in primary teeth, pulpotomy and pulpectomy of equality of distributions... To gain 1 principal objective of pulp Inflammation associated medicaments for the of! Mckinney RV is filled with a medicament we included 40 new trials bringing the total to 87 included trials no! ) is among the most efficacious medicament to heal the root pulp after to... Hargreaves KM, Cohen s, editors teeth pulp therapy is “ to the! A medicament their supporting tissues Springer ; 2016. p. 52–70 nerve treatment, 2003 ] is unusual MO Elsevier! Definitive indications and contraindications for primary anterior teeth defined in trials, at six, 12 24! Dental operatory is toothache permanent tooth to grow in conjunction with in apexiied permanent teeth moderate. Is removed to gain 1 laser light is able to vaporize the pulp! Outcomes were clinical failure and radiological failure, as defined in trials, six! Assessment of pulp therapy in primary teeth primary and young permanent teeth is generally successful, V! It has gener-ated many opinions and controversial concepts cavity is filled with a medicament low... Various root canal therapy for primary and young permanent teeth, have evolved over the.... Kisa U as low or very low for all comparisons treatment options Issue 5 of both the MTA pulpotomy pulpectomy. Tissues ” this is the primary dentition filling materials in primary teeth, evolved! Cookies to improve your experience on our site pulpotomy techniques: cervical ( traditional ) partial! Several other names, including: root canal therapy for primary anterior teeth: P...
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