sodium-hypochlorite and ferric-sulfate

Vital pulp therapy aims to treat reversible pulpal injury and includes 2 therapeutic approaches: (1) indirect pulp treatment for deep dentinal cavities and (2) direct pulp capping or pulpotomy in cases of pulp exposure. Indirect pulp treatment is recommended as the most appropriate procedure for treating primary teeth with deep caries and reversible pulp inflammation, provided that this diagnosis is based on a good history, a proper clinical and radiographic examination, and that the tooth has been sealed with a leakage-free restoration. Formocresol has been a popular pulpotomy medicament in the primary dentition and is still the most universally taught pulp treatment for primary teeth. Concerns have been raised over the use of formocresol in humans, and several alternatives have been proposed. Controlled clinical studies have been critically reviewed, and mineral trioxide aggregate and ferric sulfate have been considered appropriate alternatives to formocresol for pulpotomies in primary teeth with exposed pulps. In most of the studies reviewed, the caries removal method has not been described. The use of a high-speed handpiece or laser might result in an exposure of a "normal" pulp that would otherwise not be exposed.

Topics: Aluminum Compounds; Calcium Compounds; Calcium Hydroxide; Dental Caries; Dental Pulp Capping; Drug Combinations; Ferric Compounds; Formocresols; Humans; Laser Therapy; Oxides; Pulpitis; Pulpotomy; Randomized Controlled Trials as Topic; Root Canal Filling Materials; Silicates; Sodium Hypochlorite; Tooth, Deciduous

To evaluate the clinical and radiographical success of primary molar pulpotomies which used 15.5% ferric sulfate (FS) or 1.25% sodium hypochlorite (NaOCl) for hemostasis and zinc oxide-eugenol (ZOE) and calcium hydroxide (CH) pastes as base materials.. In 29 healthy children, 80 primary molars were randomly allocated to one of the study groups: Group 1: FS-ZOE, Group 2: FS-CH, Group 3: NaOCl-ZOE, and Group 4: NaOCl-CH. After hemostasis with the respective solutions, pulp stumps and floor of the pulp chambers were covered with either ZOE or CH pastes. All teeth were restored with stainless steel crowns. Follow-up examinations were carried out at 1, 3, 6, and 12 months.. One tooth in Group 1 and two teeth in Group 4 were extracted because of pain and periapial pathosis at sixth month. After 12 months, clinical success rates of pulpotomies in Groups 1-4 were 95%, 100%, 100%, and 89.5%, respectively. The differences were not significant (P = 0.548). Radiographic success rates for Groups 1-4 were 80%, 88.9%, 78.9%, and 84.2%, respectively. No statistically significant difference was found (P = 0.968). Pain on percussion was the most observed clinical finding. However, internal root resorption was the most common radiological finding and it was observed significantly more in mandibular primary molars (P < 0.05).. Both ZOE and CH can be preferred as base materials after hemostasis achieved by the use of 15.5% FS or 1.25% NaOCl in primary tooth pulpotomy.

Topics: Bone Cements; Calcium Hydroxide; Child; Child, Preschool; Dental Caries; Dental Pulp; Female; Ferric Compounds; Follow-Up Studies; Hemostatics; Humans; Male; Pulpotomy; Radiography, Dental; Root Canal Irrigants; Root Resorption; Sodium Hypochlorite; Tooth Resorption; Tooth, Deciduous; Treatment Outcome; Zinc Oxide-Eugenol Cement

Although multiple materials have been suggested for pulpotomized primary molars, there is no reliable evidence of the superiority of one particular type.. To compare the effectiveness of formocresol (FC), mineral trioxide aggregate (MTA), ferric sulphate, and sodium hypochlorite (NaOCl) as pulp dressing agents in primary molars after 2 years.. One hundred primary molars requiring pulp treatment were allocated randomly to the control (FC) and experimental groups (MTA, ferric sulphate, and NaOCl). Clinical and radiographic evaluations were performed at 6, 12, 18, and 24 months. Statistical analysis using Fischer's exact test was performed to determine the significant differences between groups.. In the FC and MTA groups, 100% of the available teeth were clinically successful at all follow-up appointments. In the NaOCl group, one clinical failure was found at 18 months, and two clinical failures in the ferric sulphate group were noted at 12 and 24 months, but no significant differences were found among the groups (P = 0.41). No significant differences in radiographic success were found among all the groups at 24 months of follow-up (P = 0.303).. No statistically significant differences among the four materials were found at 24 months suggesting that NaOCl may be an appropriate substitute for FC.

Topics: Adolescent; Aluminum Compounds; Calcium Compounds; Child; Drug Combinations; Female; Ferric Compounds; Follow-Up Studies; Formocresols; Humans; Male; Molar; Oxides; Pulpotomy; Radiography; Root Canal Filling Materials; Silicates; Sodium Hypochlorite; Tooth, Deciduous; Treatment Outcome

Several medicaments have been used as alternatives to formocresol (FC) for pulpotomy in primary molars with deep carious lesions. However, no prospective study has observed and compared the outcomes of different medicaments. The aim of this prospective study was to compare 12- and 24-month success rates among sodium hypochlorite (NaOCl), ferric sulfate (FS), and mineral trioxide aggregate (MTA) pulpotomies performed in primary molars.. A total of 108 primary molars in 27 children (18 boys and nine girls) were selected. All subjects exhibited one primary molar indicated for indirect pulp therapy (IPT; control group) and three carious primary molars indicated for pulpotomy with 5% NaOCl, 15.5% FS, and MTA. Clinical and radiographic assessments for determining success rates were performed using established criteria before and at 12 and 24 months after treatment. All data were analyzed using the chi-square test.. Clinical treatment success was observed for all teeth during the first 12 months. At 24 months, the clinical and radiographic success rates were both 100% in the control and MTA groups, both 92.6% in the NaOCl group, and 92.6% and 88.9%, respectively, in the FS group. There were no significant differences in the clinical (p = 0.328) and radiographic (p = 0.164) success rates among the four groups.. NaOCl is easily available and less expensive than MTA, and our results suggest that the outcomes of NaOCl pulpotomy and MTA pulpotomy are similar. Therefore, NaOCl may be a practical alternative to FC for pulpotomy in primary molars.

Topics: Aluminum Compounds; Calcium Compounds; Child; Drug Combinations; Female; Ferric Compounds; Humans; Male; Oxides; Prospective Studies; Pulpotomy; Silicates; Sodium Hypochlorite; Tooth, Deciduous; Treatment Outcome

Pulp therapy options in the primary dentition remain an area of debate and research. Current treatment options offer the ability to maintain many primary molars and prevent damage to the developing dentition. Proper diagnosis of the status of the primary pulp is essential to help the clinician chose the therapy that is most indicated for each child. It is important for clinicians to be familiar with current trends in this critical area of children's dentistry.

Topics: Calcium Hydroxide; Child; Child, Preschool; Dental Care for Children; Dental Pulp Capping; Dental Restoration, Permanent; Drug Combinations; Ferric Compounds; Formocresols; Humans; Molar; Pulpectomy; Pulpotomy; Root Canal Filling Materials; Silicones; Sodium Hypochlorite; Tooth, Deciduous; Zinc Oxide-Eugenol Cement