formocresol and Pulpitis

Pulpotomy is a common procedure to treat asymptomatic reversible pulpitis in primary molars. The aim of this study is to undertake a systematic review and a network meta-analysis to compare the clinical and radiographic outcomes of different pulpotomy procedures in primary molars.. Three authors performed data extraction independently and in duplicate using data collection forms. Disagreements were resolved by discussion.. An electronic literature search was performed within MEDLINE (via PubMed), ScienceDirect, Web of Science, Cochrane, and ClinicalKey databases until December 2012. Medications for pulpotomy including formocresol, ferric sulfate, calcium hydroxide, and mineral trioxide aggregate (MTA), and laser pulpotomy are compared using Bayesian network meta-analyses. The outcome is the odds ratio for clinical and radiographic failure including premature tooth loss at 12 and 24 months after treatments amongst different treatment procedures. 37 studies were included in the systematic review, and 22 of them in the final network meta-analyses. After 18-24 months, in terms of treatment failure, the odds ratio for calcium hydroxide vs. formocresol was 1.94 [95% credible interval (CI): 1.11, 3.25]; 3.38 (95% CI: 1.37, 8.61) for lasers vs. formocresol; 2.16 (95% CI: 1.12, 4.31) for calcium hydroxide vs. ferric sulfate; 3.73 (95% CI: 1.27, 11.67) for lasers vs. ferric sulfate; 0.47 (95% CI: 0.26, 0.83) for MTA vs. calcium hydroxide; 3.76 (95% CI: 1.39, 10.08) for lasers vs.. After 18-24 months, formocresol, ferric sulfate, and MTA showed significantly better clinical and radiographic outcomes than calcium hydroxide and laser therapies in primary molar pulpotomies.. The network meta-analyses showed that MTA is the first choice for primary molar pulpotomies. However, if treatment cost is an issue, especially when the treated primary molars are going to be replaced by permanent teeth, ferric sulfate may be the choice.

Topics: Aluminum Compounds; Calcium Compounds; Calcium Hydroxide; Drug Combinations; Ferric Compounds; Formocresols; Humans; Laser Therapy; Molar; Oxides; Pulpitis; Pulpotomy; Root Canal Irrigants; Silicates; Tooth, Deciduous; Treatment Outcome

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

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

The objective of this study was to evaluate the histo pathology effects of two medicaments Allium sativum oil and formocresol on the remaining pulp tissue of the permanent teething children.. A total of 18 premolars were included in this study. Two sound premolars were extracted and subjected to histological examination to show the normal pulp tissue. Pulpo tomy procedure was performed in the rest of the remaining 16 premolars; half of them using Allium sativum oil and the rest of the tested premolars were medicated using formocresol and all were sealed with suitable restoration. Then, premolars extracted at variable intervals (48 hours, 2 weeks, 1 month, 2 months), stained using hemotoxylin and eosin etain (H&E) and prepared for histopathology examination.. Histological evaluation seemed far more promising for Allium sativum oil than formocresol. Histological evaluation revealed that teeth treated with Allium sativa oil showed infammatory changes that had been resolved in the end of the study. On the contrary, the severe chronic infammation of pulp tissue accompanied with formocresol eventually produced pulp necrosis with or without fibrosis. In addition, pulp calcification was evidenced in certain cases.. Allium sativum oil is a biocompatible material that is compatible with vital human pulp tissue. It offers a good healing potential, leaving the remaining pulp tissue healthy and functioning.

Topics: Adolescent; Allyl Compounds; Bicuspid; Dental Pulp; Dental Pulp Calcification; Dental Pulp Necrosis; Dentin; Edema; Female; Fibrosis; Follow-Up Studies; Formocresols; Garlic; Humans; Hyperemia; Male; Odontoblasts; Phytotherapy; Plant Oils; Pulpitis; Pulpotomy; Sulfides

The aim of this study was to use clinical, radiographic and histological examinations to compare the dental pulp response in 162 premolar roots of eight dogs when trichloracetic acid (TCA), formocresol, mineral trioxide aggregate (MTA) and zinc oxide eugenol were used as pulpotomy agents. The teeth were divided into four groups. Following pulpotomy, the teeth were restored with amalgam. The animals were sacrificed at 48 h, 2, 4 and 8 weeks (two dogs at each interval). Histological evaluation indicated no cases with necrosis. After 8 weeks follow up, dentine bridge formation was evident in 20%, 50% and 91.7% of formocresol, TCA and MTA cases respectively. The first signs of bridge formation were seen for MTA at 2 weeks and for TCA at 4 weeks. MTA was superior to formocresol and TCA in treating pulps in dogs. However, bridge formation was seen in 50% of TCA cases after 8 weeks which is a desirable finding in pulpotomy procedures.

Topics: Aluminum Compounds; Animals; Calcium Compounds; Dental Pulp; Dentin, Secondary; Dogs; Drug Combinations; Formocresols; Odontoblasts; Oxides; Pulpitis; Pulpotomy; Root Canal Irrigants; Silicates; Trichloroacetic Acid; Zinc Oxide-Eugenol Cement

Pulp therapy in the primary dentition remains a technique generating a tremendous amount of study. Formocresol has been and continues to be the most commonly used intrapulpal medicament despite its known ability to escape the microcirculation of the pulp. Ferric sulfate has gained significant favor as a result of formocresol's disadvantages, though at the cost of requiring a much more acute awareness of the potential for remaining disease and its ability to mask that process. Mineral trioxide aggregate perhaps offers the best immediate alternative to either of the above though at this time it is still cost-prohibitive in a practice that actively treats many children. And, as MTA has no fixative properties of its own, accurately analyzing the extent of the pulpal disease becomes even more critical to the overall success of the procedure. As with other techniques in dentistry, the debate is sure to continue for severl years to come.

Topics: Aluminum Compounds; Calcium Compounds; Child; Child, Preschool; Crowns; Dental Caries; Dental Materials; Dental Pulp Capping; Dental Restoration, Permanent; Drug Combinations; Ferric Compounds; Formocresols; Humans; Oxides; Pulpectomy; Pulpitis; Pulpotomy; Silicates; Stainless Steel; Tooth, Deciduous; Tooth, Nonvital; Zinc Oxide-Eugenol Cement

Vital pulpotomies in primary teeth are performed to maintain the vitality of the pulp and to hold the tooth until it can be normally exfoliated. There exists much controversy surrounding the issue of pulpotomy agents, and the ideal pulp dressing material has not yet been identified. Therefore, it seems that formocresol will still be the first choice for pulpotomies in primary teeth until such agent is identified.

Topics: Aluminum Compounds; Calcium Compounds; Child, Preschool; Contraindications; Dental Care for Children; Drug Combinations; Formocresols; Humans; Oxides; Pulpitis; Pulpotomy; Root Canal Filling Materials; Silicates; Tooth, Deciduous; Zinc Oxide-Eugenol Cement

The purpose of this study was to assess histologically the pulpal healing process after pulpotomies in rat teeth were done using two different agents: 20% dilution of formocresol (FMC) and ferric sulfate (FS). Two criteria were used: degree of inflammation and extent of pulpal involvement. Zinc oxide-eugenol paste (ZOE) or polycarboxylate cement (PCX) were placed to seal the cavity preparations. The maxillary first molars of 120 Sprague-Dawley rats were treated in this study and were divided into four groups: 1) FMC + ZOE, 2) FS + PCX, 3) FMC + PCX, and 4) FS + ZOE. After treatment the animals were sacrificed at weekly intervals for four weeks and pulpal response was evaluated according to the degree of inflammation. Other criteria were also evaluated: dentinal bridge formation, reparative dentin and odontoblastic layer. A Friedman test was performed to compare the results and find out if any differences could be found. FMC + ZOE group showed the least pulpal inflammation response, and the use of FS as an alternative agent for pulpotomies did not improve pulpal response.

Topics: Animals; Dental Pulp; Dentin, Secondary; Drug Combinations; Ferric Compounds; Fibrosis; Formocresols; Polycarboxylate Cement; Pulpitis; Pulpotomy; Rats; Rats, Sprague-Dawley; Zinc Oxide-Eugenol Cement

The efficiency of 3 different methods of primary pulp therapy (pulpotomy with formocresol in one and two appointments, pulpotomy with Triopaste) was studied over a period of 6 years in more than 300 teeth. The clinical results show a 98% success rate in the formocresol-treated teeth compared to only 55% of the Triopaste-group.

Topics: Child; Child, Preschool; Cresols; Dental Pulp Devitalization; Female; Formaldehyde; Formocresols; Humans; Life Tables; Longitudinal Studies; Male; Polymers; Pulpitis; Pulpotomy; Tooth, Deciduous

Topics: Animals; Dental Pulp; Dental Pulp Necrosis; Dentin, Secondary; Electrosurgery; Female; Formocresols; Macaca nemestrina; Male; Pulpitis; Pulpotomy