ledermix 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

Vital pulp therapy for cariously exposed permanent teeth remains one of the most controversial areas in dentistry. Because a vital, functioning pulp is capable of initiating several defence mechanisms to protect the body from bacterial invasion, it is beneficial to preserve the vitality and health of an exposed pulp rather than replace it with a root filling material following pulp exposure. There is no consensus on the survival rate of formerly cariously exposed pulps. Observation time, judgement criteria, pulpotomy/pulp capping technique and, most importantly, pulpal status at the time of treatment, vary to a great extent amongst studies. In mature teeth, a pulp exposed by caries is usually removed and the root canals are cleaned, shaped and filled. Amongst the methods for preservation of a cariously exposed pulp, partial pulpotomy has yielded a markedly high success rate in young teeth. Major limitations in the success of vital pulp therapy in cariously exposed permanent teeth exist. The lack of predictability and long-term success greatly influence decision-making. The decision-making itself is unreliable primarily due to the difficulty of accurately diagnosing the ability of the pulp to repair. While there are indications for vital pulp therapy in young permanent molars, it must be remembered that ultimately, none of these procedures enjoy the long-term success of complete root canal therapy.

Topics: Age Factors; Aluminum Compounds; Animals; Anti-Bacterial Agents; Anti-Inflammatory Agents; Calcium Compounds; Calcium Hydroxide; Demeclocycline; Dental Caries; Dental Cements; Dental Pulp; Dental Pulp Capping; Dental Pulp Exposure; Dentin, Secondary; Dentition, Permanent; Drug Combinations; Humans; Oxides; Pulpotomy; Silicates; Triamcinolone Acetonide