sodium-hypochlorite and Furcation-Defects

The aim of this study was to evaluate the effectiveness of a Pulpotec modified endodontic approach on primary molars presenting necrotic pulp and furcation bone loss in a cohort of healthy children.. Forty primary necrotic molars in healthy children, aged between 4 and 6 years underwent clinical and radiological assessment. A chemomechanical removal of pulpal necrotic debris was performed with 1% sodium hypochlorite irrigation. The canals were dried and Pulpotec was inserted in the pulp chamber, and the teeth were then restored. Clinical evaluation, vertical and horizontal measurements of the bone radiolucency were performed for up to one year after the Pulpotec procedure.. Wilcoxon signed-rank test was applied for comparison of groups.. In this study 67.7% of patients showed healing of bone loss, and a significant difference in height and width of the lesion was observed (respectively 80.6%, 71%; p<0.05; p<0.025).. This technique can be used as an alternative to conventional endodontic treatment for primary necrotic teeth. This procedure may allow paedodontists the ability to postpone extraction of necrotic teeth in particular situations or until eruption of the first permanent molar. Necrotic primary molars presenting furcation bone lesion due to infection may be treated with this modified Pulpotec procedure. With certain caveats, this procedure will preserve the molar on the dental arch for a certain period of time. In our study this technique yielded significant clinical improvements, but the radiological improvement is considered moderate. Future investigations are warranted in order to determine the possible effects of Pulpotec on the succedaneous teeth as well as their path of eruption.

Topics: Anti-Bacterial Agents; Child; Child, Preschool; Cohort Studies; Compomers; Crowns; Dental Pulp Cavity; Dental Pulp Necrosis; Dental Restoration, Permanent; Female; Follow-Up Studies; Furcation Defects; Humans; Male; Methylmethacrylates; Molar; Pulp Capping and Pulpectomy Agents; Pulpotomy; Radiography, Bitewing; Root Canal Irrigants; Sodium Hypochlorite; Tooth, Deciduous; Treatment Outcome; Wound Healing; Zinc Oxide-Eugenol Cement

An in vitro dye leakage study was performed to determine the incidence of patent furcal accessory canals following exposure of the pulp chamber to 5.25% sodium hypochlorite. One hundred extracted molars were labeled, endodontically opened, and irrigated for 1 h at 5-min intervals. The external furcations were exposed to 0.5% basic fuchsin for 24 h. Patency was determined by dye presence on the chamber floor. Statistical analysis revealed that first and second molars, regardless of arch position or location, demonstrated a patent accessory canal at a rate of 57% +/- 19.6% in the furcal area. It was concluded that accessory canal exposure to 5.25% sodium hypochlorite in the furcal area of molars produced patency which was demonstrable via passive methods--no vacuum or injection pressures were utilized.

Topics: Chi-Square Distribution; Coloring Agents; Dental Leakage; Dental Pulp Cavity; Extravasation of Diagnostic and Therapeutic Materials; Female; Furcation Defects; Humans; Male; Molar; Sodium Hypochlorite; Tooth Root