formocresol and Dental-Pulp-Exposure

(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.. 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.. 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.. 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.

Topics: Aluminum Compounds; Animals; Bone Morphogenetic Proteins; Calcium Compounds; Calcium Hydroxide; Camphor; Collagen; Demeclocycline; Dental Pulp Capping; Dental Pulp Devitalization; Dental Pulp Exposure; Drug Combinations; Electrosurgery; Ferric Compounds; Formocresols; Glutaral; Humans; Hydrocarbons, Iodinated; Laser Therapy; Oxides; Pulpectomy; Pulpotomy; Root Canal Filling Materials; Silicates; Silicones; Tooth Remineralization; Triamcinolone Acetonide; Zinc Oxide-Eugenol Cement

Topics: Child, Preschool; Contraindications; Dental Pulp Capping; Dental Pulp Devitalization; Dental Pulp Exposure; Endodontics; Formocresols; Humans; Pediatric Dentistry; Pulpectomy; Pulpotomy; Societies, Dental; Tooth, Deciduous; United Kingdom

A pulpotomy is the therapy for management of pulp exposures due to caries in symptom-free primary molars. The aim was to longitudinally compare the relative effectiveness of the Er:YAG laser, calcium hydroxide and ferric sulphate techniques with dilute formocresol in retaining symptom-free molars. Two hundred primary molars in 107 healthy children were included and randomly allocated to one technique. The treated teeth were blindly reevaluated after 6, 12, 18, 24 and 36 months. Descriptive data analysis and logistic regression analysis accounting for multiple observations per patient by generalised estimating equation were used. Additionally, various influences including tooth type, upper and lower jaws, type of anaesthesia, operator and the final restoration on treatment success were evaluated (Wald chi-square test). After 36 months, the following total (considering clinical and clinically symptom-free radiographic failures) and clinical success rates were determined (in percent): Formocresol 72 (92), laser 73 (89), calcium hydroxide 46 (75), ferric sulphate 76 (97). No significant differences were detected between formocresol and any other technique after 36 months. However, the odds ratio of failure appeared to be three times higher for calcium hydroxide than for formocresol. No significant differences in total success rates were seen regarding the aforementioned influencing clinical parameters. The correct diagnosis of the pulpal status, bleeding control and the specific technique are highly important for long-term success of pulpotomies in primary molars. According to the presented long-term data, pulpotomies using ferric sulphate revealed the best treatment outcome among the used techniques, while calcium hydroxide resulted in the lowest success rates after 3 years. Therefore, we can recommend ferric sulphate for easy and successful treatment of primary molars with caries-exposed pulps.

Topics: Anesthesia, Dental; Calcium Hydroxide; Child; Child, Preschool; Composite Resins; Crowns; Dental Caries; Dental Cavity Lining; Dental Materials; Dental Pulp Exposure; Dental Restoration Failure; Dental Restoration, Permanent; Ferric Compounds; Follow-Up Studies; Formocresols; Glass Ionomer Cements; Humans; Laser Therapy; Lasers, Solid-State; Longitudinal Studies; Methylmethacrylates; Molar; Pulp Capping and Pulpectomy Agents; Pulpotomy; Single-Blind Method; Tooth, Deciduous; Treatment Outcome; Zinc Oxide-Eugenol Cement

To compare the clinical and radiographic success rates of two vital pulpotomy agents: formocresol (FC) and Ankaferd Blood Stopper(®) (ABS), in primary molars during a 12-month follow-up period.. A randomised, single-blind study design was used in a sample of 30 healthy 6-9 year old children with 60 carious primary molars without clinical or radiographic evidence of pulp degeneration.. The pulpotomy agents were assigned as follows: Group 1 was 1:5 diluted Buckley's formocresol (FC) and Group 2 was ABS. Clinical and radiographic follow-up at 3, 6, and 12 months used the following criteria: pain, swelling, sinus tract, mobility, internal root resorption, and furcation and/or periapical bone destruction.. The data were analysed using Chi-square tests.. The clinical and radiographic evaluation at 3 months revealed total success rates of 100% in the FC and ABS groups. Success rates in FC and ABS groups at 6 months were 96.7% and 93.3% respectively. At the 12-month follow-ups, the total success rates in the FC, and ABS groups were 89.3% and 85.7%, respectively. When the groups were compared according to the time intervals, no significant differences were observed between the 3, 6, and 12 month values. The success rates of the materials decreased over time.. FC and ABS were found successful as pulp dressings in primary molars. ABS appears to be an alternative pulpotomy agent but periodical follow-ups must be considered to evaluate long term success rates.

Topics: Child; Dental Amalgam; Dental Caries; Dental Pulp Exposure; Dental Restoration, Permanent; Female; Follow-Up Studies; Formocresols; Hemostatics; Humans; Male; Molar; Periapical Diseases; Phytotherapy; Plant Extracts; Postoperative Complications; Pulp Capping and Pulpectomy Agents; Pulpotomy; Radiography; Root Resorption; Single-Blind Method; Tooth, Deciduous; Treatment Outcome; Zinc Oxide-Eugenol Cement

Clinical and radiographic evaluation of the premedicated direct pulp capping using formocresol (PDC) versus conventional direct pulp capping using calcium hydroxide (CDC) in human carious primary molars.. A total of 120 vital primary molars with pinpoint exposure during caries removal in 84 patients aged 4-5 years were selected. In the PDC group (n = 60), 20% Buckley's formocresol solution, and in the CDC group (n = 60), calcium hydroxide powder were applied to the exposure sites followed by placement of zinc oxide-eugenol base. Teeth were restored with preformed stainless steel crowns. Clinical and radiographic evaluations of the treatment outcomes were performed at regular intervals of 6 and 12 months, respectively, for two years post-operatively.. The prevalence of spontaneous pain, sensitivity on percussion, and fistula were significantly higher in the CDC group compared to the PDC group (P < 0.05). The number of teeth exhibiting periapical/furcal radiolucency or external/internal root resorption was also higher in the CDC group (P < 0.05). The clinical success rate of the PDC was 90% compared to the 61.7% of the CDC (P < 0.05). The radiographic success rates of the PDC and CDC groups were 85% and 53.3%, respectively (P < 0.05).. It seems formocresol premedicated direct pulp capping could safely be used as a substitute for conventional direct pulp capping.

Topics: Calcium Hydroxide; Child, Preschool; Crowns; Dental Alloys; Dental Caries; Dental Cavity Lining; Dental Materials; Dental Pulp Capping; Dental Pulp Exposure; Follow-Up Studies; Formocresols; Humans; Molar; Oral Fistula; Percussion; Periapical Diseases; Radiography; Root Resorption; Stainless Steel; Tooth, Deciduous; Toothache; Treatment Outcome; Zinc Oxide-Eugenol Cement

Pulpotomy of primary incisors is a serious challenge due to the lack of a distinct boundary between the coronal and the radicular pulp and the inaccuracy of the clinical indication criteria. The aim of the present study is the clinical and radiographic evaluation of pulpotomy versus root canal therapy (RCT) of vital primary incisors.. A total of 100 incisors in 50 patients (female: 27, male: 23) aged 3-4 years were allocated to formocresol pulpotomy (45 teeth) and RCT (46 teeth) using zinc oxide-eugenol. The radiographic and clinical evaluation of treatment outcomes was performed at 12 and 24 months post-operatively. A history of spontaneous pain, missing restorations, recurrent caries, mobility and percussion sensitivity, parulis or fistula, erythema, and swelling were recorded. Data analysis was performed based on two sample proportional test.. The clinical success rate was 86.9% for pulpotomy and 95.6% for RCT (P > 0.05). The radiographic assessment exhibited no pathologic signs in 76.08% of pulpotomy group and 91.3% of RCT group and the difference was statistically significant (P < 0.05). The most common pathologic finding was periodontal widening followed by external/internal root resorption. Periapical radiolucency and fistula in pulpotomized teeth was significantly higher than in RCT-treated teeth (P < 0.05). It may be concluded that the root canal therapy of vital primary incisors may be efficiently substituted for the pulpotomy of these teeth.

Topics: Child, Preschool; Dental Fistula; Dental Pulp Exposure; Double-Blind Method; Female; Formocresols; Humans; Incisor; Male; Periapical Periodontitis; Pulpotomy; Root Canal Filling Materials; Root Canal Therapy; Root Resorption; Tooth, Deciduous; Zinc Oxide-Eugenol Cement

The purpose of this study was to compare the clinical and radiographic success rates of two different pulpotomy agents: one novel agent, the biologically active odontogenic protein enamel matrix derivative (EMD) versus formocresol (FC). A randomized, single-blind, split-mouth study was used with a sample of 15 children aged 4 to 7 years (mean age, 5 +/- 0.73 years). A total of 15 pairs of teeth, 1 pair per child, were selected for treatment. One tooth from each pair was randomly assigned to either the EMD pulpotomy group or the FC pulpotomy group. All teeth were followed up clinically and radiographically at 2, 4, and 6 months. After 6 months, the clinical success rates for the FC and EMD groups were 67% and 93%, respectively. Although most likely clinically relevant, the clinical success rate difference after 6 months was not statistically significant. After 6 months, the radiographic success rates for the FC and EMD groups were 13% and 60 %, respectively. There was a statistically significant difference at p < or = 0.05. The clinical and radiographic assessment of EMD pulpotomized teeth in this study offers preliminary evidence that EMD is a promising material which may be as successful, or more so, than other pulpotomy agents.

Topics: Child; Child, Preschool; Dental Enamel Proteins; Dental Pulp Exposure; Female; Formocresols; Humans; Male; Molar; Pulpotomy; Radiography; Single-Blind Method; Tooth, Deciduous

The aim of this study was to compare the effect of white mineral trioxide aggregate (MTA) to that of formocresol (FC) as pulp dressing agents in pulpotomised primary molars.. In this clinical trial study, 60 lower second primary molars of 46 children were treated by a conventional pulpotomy technique. The teeth were randomly assigned to the MTA (experimental) and FC (control) groups by random numbered table. Following removal of the coronal pulp and haemostasis, the pulp stumps were covered with an MTA paste in the experimental group. In the control group, FC was placed with a cotton pellet over the pulp stumps. The teeth of both groups were restored with stainless steel crowns. Children arrived for clinical and radiographic follow-up evaluation after 6, 12 and 24 months.. The treated teeth in FC group (n = 18) were clinically and radiographically successful after 24 months. The radiographic follow-up evaluation revealed one failure (furcation involvement) in 18 molars treated with MTA after 24 months. The treated teeth in MTA group were clinically successful 24 months postoperatively. Pulp canal obliteration was observed in one of the teeth treated with MTA and four of the teeth treated with FC.. MTA could be used as a safe medicament for pulpotomy in cariously exposed primary molars and could be a substitute for FC.

Topics: Aluminum Compounds; Calcium Compounds; Child; Child, Preschool; Dental Caries; Dental Pulp Capping; Dental Pulp Exposure; Drug Combinations; Female; Follow-Up Studies; Formocresols; Humans; Male; Mandible; Molar; Oxides; Pulpotomy; Radiography; Root Canal Filling Materials; Root Canal Irrigants; Silicates; Tooth, Deciduous; Treatment Outcome

Pulpotomy is the accepted therapy for the management of cariously exposed pulps in symptom-free primary molars; however, evidence is lacking about the most appropriate technique. The aim of this study was to compare the relative effectiveness of the Er:YAG laser, calcium hydroxide, and ferric sulfate techniques with that of dilute formocresol in retaining such molars symptom-free. Two hundred primary molars in 107 healthy children were included and randomly allocated to one of the techniques. The treated teeth were blindly re-evaluated after 6, 12, 18, and 24 months. Descriptive data analysis and logistic regression analysis, accounting for each patient's effect by a generalized estimating equation (GEE), were used. After 24 months, the following total and clinical success rates were determined (%): formocresol 85 (96), laser 78 (93), calcium hydroxide 53 (87), and ferric sulfate 86 (100). Only calcium hydroxide performed significantly worse than formocresol (p = 0.001, odds ratio = 5.6, 95% confidence interval 2.0-15.5). In conclusion, calcium hydroxide is less appropriate for pulpotomies than is formocresol.

Topics: Calcium Hydroxide; Child; Child, Preschool; Crowns; Dental Pulp Capping; Dental Pulp Exposure; Dental Restoration, Permanent; Female; Ferric Compounds; Follow-Up Studies; Formocresols; Glass Ionomer Cements; Hemostatics; Humans; Laser Therapy; Male; Pulpotomy; Single-Blind Method; Tooth, Deciduous; Treatment Outcome; Zinc Oxide-Eugenol Cement

Prostaglandin E2 (PGE2) has been suggested as an indicator of irreversible pulpitis in permanent teeth [1]. There is scant information on the role of chemical mediators in primary molar pulp inflammation. The aim of this preliminary study was to investigate the levels of PGE2 in blood harvested from root pulp stumps following coronal pulp amputation in vital primary molar teeth with carious exposures.. Seventy-nine cariously exposed primary molars underwent treatment by one of two vital pulp therapy techniques. Blood was harvested from 38 teeth and volume and concentration of PGE2 ([PGE2]) determined [2]. Treatment outcome was assessed from both clinical and radiographic evidence.. PGE2 was detected in all samples, with a wide concentration range (1-2641 ng/mL). The distribution was skewed, requiring log transformation. The difference in the mean (log) [PGE2] for radiological success (3.12, SD 1.60 and failure (4.62, SD 1.80) was significant, t = 2.05, P = 0.047. The difference in the mean (log) [PGE2] for clinical success (3.24, SD 1.65) and failure (5.44, SD 1.43 was near-significant, t = 1.84, P = 0.074.. [PGE2] correlated positively with radiological outcome following vital pulp therapy.

Topics: Calcium Hydroxide; Child; Child, Preschool; Dental Cements; Dental Pulp; Dental Pulp Exposure; Dinoprostone; Female; Formocresols; Humans; Immunoenzyme Techniques; Logistic Models; Male; Molar; Outcome Assessment, Health Care; Prognosis; Prospective Studies; Pulpitis; Pulpotomy; Single-Blind Method; Tooth, Deciduous

Qualitative comparison of the clinical, radiographic and histological outcomes in a small sample of cariously exposed primary molars, extracted after unsuccessful pulp treatment by two vital pulpotomy methods.. The primary molars were extracted, because of treatment failure, during a longitudinal clinical investigation of the relative efficacy of 20% Buckley's Formocresol versus calcium hydroxide powder as pulp dressings in vital pulp therapy (in press). Fifty-two child patients were sequentially enrolled in the longitudinal clinical investigation, 26 boys and 26 girls. Primary molar teeth requiring vital pulp therapy were randomly allocated to either the formocresol group (F) or the calcium hydroxide group (C). Coronal pulp amputation was prescribed only in teeth with vital, cariously-exposed pulp tissue. All cases were reviewed using predefined clinical and radiological criteria. Seventy-nine cariously-exposed primary molars required vital pulp therapy. Forty-four teeth were included in group F and 35 in group C. Five per cent (n = 2) of teeth in group F and 11 per cent of teeth (n = 4) in group C were terminated from the trial due to clinical and/or radiographic failure. Of the six teeth extracted, five were sufficiently intact to be retained for histological evaluation.. Post-extraction radiographs taken before specimen preparation showed reactionary dentine barrier (bridge) formation in teeth treated with calcium hydroxide. However, the narrowing of root canals, indicative of appositional reactionary dentine deposition, was seen in both groups (F and C). Histological examination confirmed these findings and revealed that pus cells were evident in all specimens examined. There was also histological evidence of resorption of reactionary dentine within the root canal and that forming the calcified barrier (dentine bridge).. The clinical and radiographic outcomes for the five teeth correlate well with the reported findings from decalcified histological section. Although numbers are small, the histological findings may indicate possible reasons for treatment failure. There are few reports of this sort in the literature of this under-researched treatment modality.

Topics: Calcium Hydroxide; Child; Child, Preschool; Dental Caries; Dental Pulp Calcification; Dental Pulp Capping; Dental Pulp Exposure; Dentin, Secondary; Female; Formocresols; Humans; Longitudinal Studies; Male; Molar; Pulpotomy; Radiography; Root Canal Irrigants; Suppuration; Tooth, Deciduous; Treatment Failure; Zinc Oxide-Eugenol Cement

Seventy primary molar teeth, carious exposed, symptom free, without any sign of root resorption in children aged from 3 to 6 years (main age 4.3 yr) were treated with conventional pulpotomy procedures. Ferric sulfate 15.5% solution (applied for 15 second for 35 teeth) and formocresol solution (five minute procedure of Buckley's formula for next 35 teeth) have been used as pulpotomy agents. In both groups, pulp stumps were covered with zinc-oxide eugenol paste. Permanent restorations were stainless steel crowns. Clinical check up was every three-months and radiographic follow-up time was six and twenty months after treatment. Our results within this period revealed 100% clinical success rate in both groups. Radiographic success rate was in both groups 97.2%, while in 2.8% cases has shown internal root resorption. On the basis of these results, we can recommend ferric sulfate as a pulpotomy agent in primary teeth in substitution for formocresol at the moment.

Topics: Child; Child, Preschool; Dental Pulp Exposure; Female; Ferric Compounds; Follow-Up Studies; Formocresols; Humans; Male; Pulpotomy; Treatment Outcome

The aim of this study was to evaluate and to compare clinical and radiographic outcomes of 4 materials (formocresol, mineral trioxide aggregate (MTA), Portland cement and enamel matrix derivative) using in primary teeth pulpotomies.. Sixty-five patients aged 5-9 years (32 female, 33 male) were included in this study. A total of 140 primary first and second molars with deep caries were treated with pulpotomy. All teeth were then restored with stainless steel crowns. The treated teeth were evaluated clinically and radiographically at 3, 6, 12, 18 and 24 months.. At 24 months, the clinical success rates of formocresol, MTA, Portland cement, and enamel matrix derivative were 96.9%, 100%, 93.9%, and 93.3%, respectively. The corresponding radiographic success rates were 84.4%, 93.9%, 86.7% and 78.1%, respectively.. Although there were no statistically significant differences in clinical and radiographic success rates among the 4 groups, MTA appears to be superior to formocresol, Portland cement, and enamel matrix derivative as a pulpotomy agent in primary teeth.

Topics: Aluminum Compounds; Calcium Compounds; Child; Child, Preschool; Crowns; Dental Caries; Dental Enamel Proteins; Dental Pulp Exposure; Drug Combinations; Female; Follow-Up Studies; Formocresols; Glass Ionomer Cements; Humans; Male; Molar; Oxides; Periapical Tissue; Pulp Capping and Pulpectomy Agents; Pulpotomy; Radiography; Silicates; Stainless Steel; Tooth, Deciduous; Treatment Outcome; Zinc Oxide-Eugenol Cement

The purpose of this study was to compare the effectiveness of an antibacterial and hemostatic agent to diode laser irradiation in the healing of mechanically exposed porcine pulps.. The experiment required three adult swine (Sus scrofa domestica, Yorkshire) with 36 teeth prepared with occlusal penetrations into the pulpal tissues. The preparations were performed under general anesthesia and the pulps were exposed using high speed instrumentation with rubber dam isolation and a disinfected field. Following instrumentation the coronal pulpal tissue was amputated and immediately treated with ferric sulfate and chlorhexidine semi-gel (12), diluted Buckley' formocresol solution (12) for 5 minutes or laser irradiation with a diode laser (12). After treatment, hemostasis was obtained and a ZOE base applied to the treated pulps (36). The pulpal bases were all covered with a RMGI (Fuji II LC). The tissue samples were collected at 4 weeks (28 days). Following fixation, the samples were de-mineralized, sectioned, stained and histologically graded with a scale of 0-4.. The treatment groups were statistically different with the Laser Treated Group demonstrating the least inflammation.. Pulpotomy treatment with the KaVo Gentle Ray Diode Laser demonstrated significantly less inflammation than the other two pulpal therapy modalities. The ferric sulfate and chlorhexidine mixture demonstrated the greatest inflammation as histologically graded. Also, the histological sections of pulpotomized swine teeth treated with the ferric sulfate and chlorhexidine mixture presented with black pigmented areas in the pulp and surrounding tissue. The formocresol group (clinical standard) and the diode laser group did not present with the black precipitate.

Topics: Animals; Anti-Infective Agents; Biocompatible Materials; Chlorhexidine; Dental Pulp; Dental Pulp Capping; Dental Pulp Exposure; Drug Combinations; Ferric Compounds; Formocresols; Glass Ionomer Cements; Hemostasis; Hemostatics; Laser Therapy; Lasers, Semiconductor; Pigmentation; Pulpotomy; Root Canal Filling Materials; Swine; Zinc Oxide-Eugenol Cement

The purpose of this study was to compare the effectiveness of antibacterial agents and mineral trioxide aggregate in the healing of bacterial contaminated primate pulps.. The experiment required four adult male primates (Cebus opella) with 48 teeth prepared with buccal penetrations into the pulpal tissues. The preparations were performed under general anesthesia and the exposed pulps were exposed to cotton pellets soaked in a bacterial mixture consisting of microorganisms normally found in human pulpal abscesses obtained from the Endodontic Clinic of UNESP. Following bacterial inoculation (30 minute exposure), the pulpal tissue was immediately treated with either sterile saline, Cipro HC Otic solution (12), diluted Buckley' formecresol solution (12) or Otosporin otic solution (12) for 5 minutes. After removal of the pellet, hemostasis was obtained and a ZOE base applied to the DFC treated pulps and the non-treated controls (12). After hemostasis, the other exposed pulps were covered with mineral trioxide aggregate (ProRoot). The pulpal bases were all covered with a RMGI (Fuji II LC). The tissue samples were collected at one day, two days, one week and over four weeks (34 days).. Following perfusion fixation, the samples were demineralized, sectioned, stained and histologically graded. After histologic analysis, presence of neutrophilic infiltrate and areas of hemorrhage with hyperemia were observed. The depth of the neutrophilic infiltrate depended on the agent or material used. The pulpal tissue treated with Otic suspensions demonstrated significantly less inflammation (Kruskal Wallis non parametric analysis, H = 9.595 with 1 degree of freedom; P = 0.0223) than the formocresol and control groups. The hard tissue bridges formed over the exposure sites were more organized in the MTA treatment groups than in the control and ZOE groups (Kruskal Wallis non parametric analysis, H = 18.291 with 1 degree of freedom; P = 0.0004).. Otic suspensions and MTA are effective in treating bacterial infected pulps and stimulate the production of a hard tissue bridge over the site of the exposure.

Topics: Aluminum Compounds; Animals; Anti-Bacterial Agents; Bicuspid; Calcium Compounds; Cebus; Ciprofloxacin; Dental Cements; Dental Pulp; Dental Pulp Capping; Dental Pulp Exposure; Dental Pulp Necrosis; Drug Combinations; Formocresols; Glass Ionomer Cements; Hydrocortisone; Male; Mandible; Maxilla; Neomycin; Oxides; Polymyxin B; Pulpotomy; Resins, Synthetic; Silicates

The purpose of this study was to compare clinical, radiographic, and histopathologic effects of Nd:YAG laser pulpotomy to formocresol pulpotomy on human primary teeth. Patients with at least two vital primary molar teeth that required pulpotomy, because of pulpal exposure to caries, were selected for this study. After hemorrhage control, complete hemostasis into the canal orifice was achieved by exposure to Nd:YAG laser (1064 nm) and an He-Ne laser (the aiming beam of the Nd:YAG laser) in noncontact mode at 2 W, 20 Hz, 100 mJ, or was achieved by applying 1:5 dilution of formocresol. Forty-two teeth in two groups were to be followed up clinically and radiographic at 1, 3, 6, 9, and 12 months. Eighteen teeth planned for serial extractions were selected for histopathologic study. The teeth were extracted at 7 and 60 days. The teeth in the laser group had a clinical success rate of 85.71% and a radiographic success rate 71.42% at 12 months. The teeth in the formocresol group had a clinical and radiographic success rate of 90.47% at 12 months. There were no statistically significant differences between laser and formocresol group with regard to both clinical and radiographic success rates. There was a statistically significant difference between 7- and 60-day laser groups with regard to inflammatory cell response criteria. Dentin bridge was absent in all samples. No stained bacteria were observed in any of these samples. In conclusion, Nd:YAG laser may be considered as an alternative to formocresol for pulpotomies in primary teeth.

Topics: Aluminum Silicates; Bacteria; Child; Dental Caries; Dental Pulp Exposure; Dentin, Secondary; Female; Follow-Up Studies; Formocresols; Hemostatic Techniques; Humans; Laser Therapy; Male; Molar; Neodymium; Periapical Diseases; Pulpotomy; Radiography; Root Resorption; Tooth, Deciduous; Treatment Outcome; Yttrium

The objective of this study was to compare the effects of ferric sulphate (FS) to that of the full strength of formocresol (Buckley's formula) (FC) as pulpotomy agents in primary human molar teeth 42-48 months after treatment. This was to assess the succeeding premolar teeth for decalcification, abnormal morphology or any other defect.. Seventy children, ranging in age from 3 to 6 years, mean 4.3 years, were treated for pulpotomy of primary molars. Ferric sulphate 15.5% solution (applied for 15 seconds for 84 teeth) and formocresol solution (5 minutes procedure for next the 80 teeth) were used as pulpotomy agents. In both groups, pulp stumps were covered with zinc oxide eugenol paste. Permanent restorations were, in most cases, stainless steel crowns and in some of them amalgams. Follow-up clinical assessments were every 3 months and the radiographic follow-up time was 6, 20 and 42-48 months after treatment.. The differences were statistically analyzed using the Chi square test.. These revealed 96.4% clinical success rate in the FS and 97.5% in the FC groups. Radiographic success rate in the FS group was 92.0%, while 94.6% in the FC group. No statistical significant differences were found between the radiographic assessment of the two pulpotomy agents.. Ferric sulphate showed similar clinical and radiographic success rate as a pulpotomy agent for primary molar teeth after long term evaluation period, compared with formocresol. Ferric sulphate, because of its lower toxicity, may become a replacement for formocresol in primary molar teeth.

Topics: Child; Child, Preschool; Dental Care for Children; Dental Pulp Devitalization; Dental Pulp Exposure; Female; Ferric Compounds; Follow-Up Studies; Formocresols; Humans; Male; Molar; Pulpotomy; Radiography; Retrospective Studies; Root Canal Irrigants; Tooth, Deciduous; Treatment Outcome

To investigate whether formocresol, in Buckley's original formulation, is mutagenic in vivo to lymphocyte cultures obtained from the peripheral blood of children aged from 5 to 10 years old. These children were recruited from those attending the dental clinics of Recife City Council and the University of Pernambuco School of Dentistry, Brazil.. The sample comprised 20 children who had primary teeth with cariously exposed vital pulps. Two venous blood samples were collected (6-8 ml) from each child, the first prior to vital pulpotomy (control group) and the second 24 h after pulpotomy (treated group). This research is a case-control study. The peripheral lymphocytes were grown in a complete culture medium consisting of 78% RPMI 1640 medium (a), supplemented with streptomycin (0.01 mg/ml), penicillin (0.005 ml(-1)), 20% fetal bovine serum (b) and 2% phytohemagglutinin (c). The lymphocytes were assessed for chromosomal aberrations via a previously published method which was modified. The cytogenetic analysis was performed in a blind test, where the slides were codified by an annotator and the scorers did not know which group they were analyzing. For each sample, this envolved the analysis of 200 metaphases. The level of significance adopted in the statistical test was 5.0% (p<0.05).. There was no statistically significant difference in clinical doses between the control and treated groups, using Wilcoxon's Signed Ranks test, for the chromosomal aberrations (P=0.251) and for the total chromosomal breaks (P=0.149). Although there were no statistically significant differences between the control and treated groups, Buckley's formocresol was mutagenic for one patient, raising doubt about the desirability of its use for pulpotomies in children.. The results revealed that, from a statistical standpoint, formocresol is not mutagenic. However, further investigations are required, preferably with a larger sample, in patients needing more than one pulpotomy in order to observe whether an increase in the quantity of the drug would increase the quantity of chromosome aberrations and also to verify individual susceptibility to chromosome alterations with the use of formocresol.

Topics: Case-Control Studies; Cell Culture Techniques; Child; Child, Preschool; Chromatids; Chromosome Aberrations; Cytogenetics; Dental Caries; Dental Pulp Exposure; Female; Formocresols; Humans; Lymphocytes; Male; Mutagens; Pulpotomy; Single-Blind Method; Statistics, Nonparametric; Tooth, Deciduous

Bioactive glass (BAG) is often used as a filler material for repair of dental bone defects. Although there is evidence of osteogenic potential of this material, it is not clear yet whether the material exhibits potential for dentinogenesis. Hence, the aim of the present study was to evaluate BAG as a pulpotomy agent and to compare it with three commercially available pulpotomy agents such as formocresol (FC), ferric sulfate (FS), and mineral trioxide aggregate (MTA). Pulpotomies were performed in 80 maxillary first molars of Sprague Dawley rats, and pulp stumps were covered with BAG, FC, FS, and MTA. Histologic analysis was performed at 2 weeks and then at 4 weeks after treatment. Experimental samples were compared with contra-lateral normal maxillary first molars. At 2 weeks, BAG showed inflammatory changes in the pulp. After 4 weeks, some samples showed normal pulp histology, with evidence of vasodilation. At 2 weeks, MTA samples showed some acute inflammatory cells around the material with evidence of macrophages in the radicular pulp. Dentine bridge formation with normal pulp histology was a consistent finding at 2 and 4 weeks with MTA. Ferric sulfate showed moderate inflammation of pulp with widespread necrosis in coronal pulp at 2 and 4 weeks. Formocresol showed zones of atrophy, inflammation, and fibrosis. Fibrosis was more extensive at 4 weeks with evidence of calcification in certain samples. Among the materials tested, MTA performed ideally as a pulpotomy agent causing dentine bridge formation while simultaneously maintaining normal pulpal histology. It appeared that BAG induced an inflammatory response at 2 weeks with resolution of inflammation at 4 weeks.

Topics: Aluminum Compounds; Animals; Calcium Compounds; Dental Pulp; Dental Pulp Capping; Dental Pulp Exposure; Dentinogenesis; Drug Combinations; Ferric Compounds; Formocresols; Glass; Male; Materials Testing; Maxilla; Molar; Oxides; Pulpotomy; Rats; Rats, Sprague-Dawley; Root Canal Filling Materials; Silicates

Topics: Child; Cresols; Dental Caries; Dental Pulp; Dental Pulp Exposure; Formaldehyde; Formocresols; Humans; Pathology; Pulpotomy; Radiography, Dental; Tooth, Deciduous