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Pulp Therapy for Primary Teeth
Published in M S Duggal, M E J Curzon, S A Fayle, K J Toumba, A J Robertson, Restorative Techniques in Paediatric Dentistry, 2021
M S Duggal, M E J Curzon, S A Fayle, K J Toumba, A J Robertson
A pulpectomy procedure, which has been described in the paediatric dental literature for over 25 years, is the technique of choice. Pulpectomy is perhaps one of the most misunderstood techniques in paediatric dentistry. Many textbooks have described the pulp morphology of primary molars as complex, with many fine accessory root canals, which has led to the belief that a pulpectomy is difficult to perform. Nothing is further from the truth. It is true that some primary teeth do have a complex root morphology, but this does not contraindicate pulpectomy. This technique has been used successfully to retain non-vital and abscessed primary teeth for over two decades in the USA.
Mesenchymal Stem Cells from Dental Tissues
Published in Vincenzo Guarino, Marco Antonio Alvarez-Pérez, Current Advances in Oral and Craniofacial Tissue Engineering, 2020
Febe Carolina Vázquez Vázquez, Jael Adrián Vergara-Lope Núñez, Juan José Montesinos, Patricia González-Alva
Pulp tissue has the potential to self-regenerate lost dentin (Huang 2011). However, the majority of dental infections is difficult to eliminate, and the entire pulp tissue is often needed to be removed (pulpectomy). Consequently, in order to thoroughly disinfect and fill the canal root with gutta-percha, the root canal space must be significantly enlarged, thereby, causing further tooth structure loss (Huang 2011; Zhang and Yelick 2010).
Radiosurgical Techniques
Published in Jeffrey A Sherman, Oral Radiosurgery, 2020
A pulpotomy is the amputation of the coronal portion of the pulpal tissue of a vital tooth. A pulpectomy is the complete removal of pulpal tissue when the tooth is non-vital. Radiosurgery can be used to remove part or all of the pulpal tissue to perform a pulpotomy or pulpectomy effectively.
Cost-effectiveness of pulp capping and root canal treatment of young permanent teeth
Published in Acta Odontologica Scandinavica, 2019
Joséphine Brodén, Thomas Davidson, Helena Fransson
Despite the accepted approach of minimally invasive restorative dentistry, excavation of deep caries can lead to a pulp exposure, even with stepwise excavation [1]. In a Scandinavian randomized clinical trial comparing stepwise and immediate complete caries excavation, pulpal exposure was recorded in 17.5% of the 156 teeth randomized to stepwise excavation [2]. The aim of treatment of carious exposures in the permanent teeth of children should ideally be to retain the tooth in a healthy state throughout life. In clinical practice, there are two main approaches to the treatment of an exposed vital pulp: pulp capping (direct pulp capping and partial pulpotomy) and root canal treatment (also referred to as a pulpectomy). Pulp capping is the less invasive approach: the aim is to maintain the vitality of the tooth by application of a capping material to the exposed pulp. Pulpectomy is more invasive: the vital pulp tissue is extirpated, the walls are mechanically debrided and the root canal space is obturated. At present, little is known about the relative cost-effectiveness of these two treatment options in cariously exposed young permanent teeth in Scandinavian conditions.
The effect of different irrigation protocols on smear layer removal in root canals of primary teeth: a SEM study
Published in Acta Odontologica Scandinavica, 2019
Akif Demirel, Burcu Nihan Yüksel, Meryem Ziya, Hüsniye Gümüş, Salih Doğan, Şaziye Sari
Although it is reported that the presence of the smear layer has negative effects on the root canal of primary teeth in in vitro studies, the detection of high success rates in various clinical studies where the smear layer has not been removed makes the necessity of removing the smear layer contradictory [36,37]. Similarly, in a 3-year follow-up in vivo study, the effect of removing smear layer on the success of pulpectomy was 82% in the group that they removed the smear layer and 88% in the group without removal [9]. In contrast to those findings, high success rates were also reported with the smear layer removal [32]. Therefore, further clinical studies are needed to clarify the survival effect of the smear layer removal in the root canal treatment of primary teeth.
Effectiveness of iodoform-based filling materials in root canal treatment of deciduous teeth: a systematic review and meta-analysis
Published in Biomaterial Investigations in Dentistry, 2022
Manoelito Ferreira Silva Junior, Leticia Maíra Wambier, Mayara Vitorino Gevert, Ana Cláudia Rodrigues Chibinski
Endodontic treatment with complete pulp removal—pulpectomy—is commonly used in deciduous teeth with irreversible pulpitis or necrotic pulp [1,2]. Usually, after the chemomechanical preparation of the root canals, an absorbable and biocompatible material must be used to favor repair and allow the permanence of the tooth in the mouth till its physiological exfoliation [1]. In an attempt to simplify the steps, Lesion Sterilization and Tissue Repair (LSTR) therapy has been investigated for the treatment of primary tooth canals. This technique implies nonmechanical preparation of the root canals and placement of a paste made of a mixture of antibiotics at the entrance of the root canals [3].