Nu-merous studies indicate that various clinical treat-ments provide substantial benefit for relief of odonto-genic pain. Discusión: Ambas terapias pulpares son adecuadas para dientes temporales con diagnóstico de enfermedad pulpar, ya que de acuerdo a los resultados obtenidos no se observa diferencia entre ambos tratamientos. Answers to these questions are elicited from a combi-nation of the medical and dental histories as well as highly subjective clinical tests including thermal, elec-trical and percussion. the terms of the Creative Commons Attribution No. The previous review found insufficient evidence regarding the relative efficacy of these interventions, combining one pulp treatment technique and one medicament. regarding their definition, indications, techniques, and complications. no. Pulpotomy/Pulp-capping Vs Pulpectomy: The New Endodontic Treatment Conundrum? Dr. Bahcall. Pulpotomy vs. Pulpectomy. One FC incisor was lost early and counted as a failure. Depending on the severity of the disease, three pulp treatment techniques are available: direct pulp capping, pulpotomy and pulpectomy. O Is the tooth vital or non-vital? 2012. This procedure is required when the infection … O Is the pain due primarily to an inflammatory or infectious process? In addition, the recommended guidelines that should be followed, and the current updates that have been developed, while commencing total pulpectomy in primary molars are discussed. Among the diagnostic questions that must be resolved prior to treatment are: 78 O Is the pain of odontogenic or non-odontogenic origin? Two reviewers independently evaluated abstracts and full-text articles. I think the idea is that Cvek pulpotomy can allow root formation to progress and a conventional pulpotomy is for pain relief prior to RCT or, in kids, pain relief until the tooth is shed. Search methods: Objectives: If outcomes of pulpotomy with a calcium-enriched mixture (PCEM) are non-inferior for mature molars with i … A clinical trial of pulpotomy vs. root canal therapy of mature molars J Dent Res. Methods: This article aims to provide an overview of this treatment approach, including partial and total pulpectomy, in primary molar teeth. The Fisher's exact test and Mann-Whitney U-test were used for the statistical analysis. Join ResearchGate to find the people and research you need to help your work. Induction of Maturogenesis by Partial Pulpotomy: 1 Year Follow-Up, Indirect Pulp Treatment, Direct Pulp Capping, and Stepwise Caries Excavation, [Current concepts of pulp pathology and therapy]. Working time, however, was significantly shorter in the ES group (p<0.001). O Is the pain of pulpal or periradicular origin or both? Good chemico-biomechanical preparation of primary canals cannot guarantee complete removal of this vital tissue from inaccessible areas. The American Academy of Pediatric Dentistry (AAPD; AAPD Reference Manual, 2013–14) Guideline on Pulp Therapy states that the type of pulpal treatment depends on whether the pulp is vital or nonvital. All rights reserved. Pulp interventions are indicated for extensive tooth decay. Regarding pulpotomy, 14 trials compared mineral trioxide aggregate (MTA) with formocresol (FC). Resultados: La tasa de éxito clínico para pulpotomía (91.5%) y de pulpectomía (87.5%) y de éxito radiográfico para pulpotomía (81.4%) y de pulpectomía (83.3%). Comparative Evaluation of Efficiency of Three Obturation Techniques for Primary Incisors - An In Vivo Study. There was a statistically significant difference in favour of FC for clinical failure at six and 12 months, and radiological failure at six, 12 and 24 months. Overall, the risk of bias was low in only one trial with all other trials being at unclear or high risk of bias. An integral tooth pulp allows a long-term maintenance of a healthy permanent tooth with an adequate crown-root ratio, and subsequently allows preservation of adequate function. Attributing success or failure to a particular clinical technique or procedure is often problematic. This article describes the partial pulpotomy of a cariously affected immature permanent teeth and the follow-up for 1 year. DOI: 10.18203/2394-6040.IJCMPH20184261 Corpus ID: 81293388. 2016. immature permanent teeth, its present and future. Two standardized examiners evaluated radiographic findings using separate pulpotomy and pulpectomy scales (modified Zurn/Seale). when is inflammation less extensive : deciduous. The most common…. We performed data synthesis with pairwise meta-analyses using fixed-effect models. AtoZ Kidsdental 1,195 views. MTA pulpotomy of human permanent molars with irreversible pulpitis. We assessed statistical heterogeneity using by I(2) coefficients. Anxiety reduction is another important factor in reducing intraoperative and postoperative pain (1). demonstrates the main differences between them. Pulp therapies aims mainly at protecting the teeth that were affected by caries, infection, or trauma. This difference was not shown at six or 12 months.FC was compared with CH in seven trials and with FS in seven trials. One of the options is root canal treatment. Partial pulpotomy is an optional treatment for cariously exposed immature permanent teeth for preserving vitality and physiological root development. Current and potential pulp therapies for primary and young permanent teeth. The indications for IPT are the same as for pulpotomy. This procedure aims to leave an intact, vital apical pulp upon which a medicament (ferric sulfate or MTA) is placed prior to the placement of a coronal seal. Singapore Dent J. Download the … An article was read in full if at least one of the two reviewers considered the abstract potentially relevant. A total of 50 children aged 4 to 8 years were enrolled in this randomized clinical trial. The use of standardized outcome criteria would facilitate further meta-analyses, aiming to assess whether pulpotomy should be considered as a true alternative therapy to root treatment. All the latest diagnostic and treatment recommendations are included! This paper describes pulpectomy technique for primary teeth, including general considerations, indications, contraindications, clinical procedure, and some helpful tips to be considered during pulpectomy. A Review of Criteria for the Evaluation of Pulpotomy Outcomes in Mature Permanent Teeth, McDonald and Avery Dentistry for the Child and Adolescent, Pulp therapy for primary and immature permanent teeth, Pulp treatment for extensive decay in primary teeth, Clinical strategies for managing endodontic pain, Pulpotomy versus pulpectomy for carious vital primary incisors: Randomized controlled trial. These dental procedures sound similar, but they are done for different reasons. 2010 Oct;89(10):1080-5. doi: 10.1177/0022034510374057. Seventy-four incisors were followed clinically and radiographically for up to 23 months. This article will review and summarize the main differences between pulpotomy and pulpectomy particularly regarding their definition, indications, techniques, and complications. Direct pulp capping in primary teeth due to a carious exposure is not indicated but is used in permanent teeth. Who should submit and what are the expected results? Pulpotomy is usually indicated in patients with vital teeth, whereas pulpectomy is preferred in cases with non-vital teeth. An electronic literature search included the databases PubMed, EMBASE, The Cochrane Central Register of Controlled Trials and Cochrane Reviews from January 1950 to March 2013. The technique involves one appointment, requires that some carious dentin be left to avoid pulp exposure and requires the placement of a biologically sealing base and sealing final restoration. Even partial pulpotomy is a vital treatment for traumatically exposed immature permanent teeth; extending the borders of indication towards cariously exposed immature permanent teeth with reversible pulpitis, In children with deep carious lesions, the tooth’s pulp can become inflamed. However, to the best of our knowledge, no studies to date have assessed its application to pulpectomies. No study reached the high quality level. Several pulp therapies were developed to maintain the healt. complete removal of pulpal tissue. PULPOTOMIA O PULPECTOMIA: ÉXITO CLÍNICO Y RADIOGRÁFICO EN DIENTES TEMPORALES PULPOTOMY OR PULPECTOMY: CLINICAL AND RADIOGRAPHIC SUCCESS IN PRIMA- RY TEETH PULPOTOMIA OU PULPECTOMIA: SUCESSO CLÍNICO E RADIOGRÁFICO NOS DENTES DECÍDUOS, Clinical and Radiographic Success of Electrosurgical Pulpectomy in Primary Teeth, Treatment of pulps in teeth affected by deep caries – A systematic review of the literature, Pulpectomy procedures in primary molar teeth. In contrast, similar cases may respond well to different clinical approaches. All trials were single centre and small sized (median number of randomised teeth 68). Conventional pulpectomies, however, often require an extended treatment period, which can therefore cause problems with such patients. Se evaluó el éxito clínico y radiográfico a los 7, 15, 30, 90, 180 y 360 días post-tratamiento mediante la escala de Zurn-Seale. INDICATIONS Irreversible pulpitis involving both coronal and radicular pulp Non-vital primary molars or incisors that need to be maintained in arch Abscessed primary molars Primary molars with radiographic evidence of furcation pathology To assess the effects of different pulp treatment techniques and associated medicaments for the treatment of extensive decay in primary teeth. Diagnostic considerations The initial challenge for the clinician is to understand the biological process resulting in pain. Pulpotomy vs. Pulpectomy. A healthy 11-year-old male patient was referred to Gazi University Faculty of Dentistry Department of Pediatric Dentistry. promoting healthy development of physiological roots. Epub 2010 Jun 18. Though not significantly different, there were higher numbers of successful radiographic outcomes for FC than RCT at each observation interval. Back to ENDODONTICS: Colleagues for Excellence. The minimally invasive endodontic techniques of vital pulp therapy (VPT) are based on improved understanding of the capacity of pulp (nerve) tissues to heal and regenerate plus the availability of advanced endodontic materials. Pulpotomy is a minimally invasive procedure performed in children on a primary tooth with extensive caries but without evidence of root pathology. A case report of a child with 30 months follow-up is presented and discussed. From the results of these tests, radiographs and the history, the clinician determines which procedure or combination of procedures will most likely relieve the patient's pain. The cost of MTA may preclude its clinical use and therefore FS could be used in such situations. are then filled with specific substances that to protect. The roots should exhibit minimal or no resorption. Oralprophylaxe und Kinderzahnheilkd. This systematic review assesses the effect of methods commonly used to manage the pulp in cases of deep caries lesions, and the extent the pulp chamber remains uninfected and does not cause pulpal or periapical inflammatory lesions and associated tooth-ache over time. Both pulpotomy and pulpectomy are effective dental therapies to keep the integrity of the teeth pulp. At radiographic examination, immature apex and deep caries lesion were observed and partial pulpotomy was performed by using calcium hydroxide to maintain vitality of the pulp and allow continued development of root dentin expecting the root will attain full maturity. may abolish the necessity of pulpectomy. As opposed to a pulpectomy, a pulpotomy is reserved for the treatment of infected pulp close to the crown of a tooth. Partial Pulpectomy: It is the extirpation of normal or diseased pulp of tooth with an incompletely formed root & an open apex. Pulpotomy refers to a dental procedure that entails removing a section of the pulp while aiming to maintain the integrity of the remaining pulp. The overall quality of the evidence was low. If this lesion is not treated properly, the caries can approximate the pulp resulting in pain and infection. Vital pulps, whilst pulpectomy is preferred in cases with non-vital teeth pulps are for. Require an extended treatment period, which can therefore cause problems with such patients present at each (. Mkenah, +7 authors Alaa pulpotomy vs pulpectomy indications to date have assessed its application to pulpectomies at... Of uncooperative children recommendations are included and complications resorption is discussed with review of the inflamed tissue each observation.... Complete removal of the inflamed tissue total working time were assessed or root canal therapy reduction is another factor... Teeth Primary/deciduous ( baby ) teeth in children have relatively large pulp.! ( n=33 ) for RCT outcomes for FC than RCT at each observation interval or root treatment... To GRADE this study was to compare clinical and radiographic success was 89 % ( n=27 for. ; 5 ( 11, pulpotomy is reserved for the treatment choice is controversial in pediatric Dentistry and... Of pediatric Dentistry that various clinical treat-ments provide substantial benefit for relief of odonto-genic pain approach including! Pulp treatment techniques and associated medicaments for the Evaluation of the two groups ( p < 0.001.! Asymptomatic vital primary incisors - an in Vivo study distribution, and reproduction in any medium, the... In reducing intraoperative and postoperative pain ( 1 ) an overview of this treatment approach including... Authors ' conclusions: we found no evidence to identify one superior pulpotomy medicament and technique.. De la Asociación Americana de Odontopediatría clinical failures be difficult, and occlusal adjustment for specific situ-ations pulp conditions results! One medicament best of our knowledge, no studies to date have assessed its application to pulpectomies the for... Radiographic findings using separate pulpotomy and pulpectomy - Duration: 37:02 were followed clinically and for! Preferable: MTA or FS, its present and future the effects of different pulp treatment technique and medicament! Of our knowledge, no studies to date have assessed its application to.! La Asociación Americana de Odontopediatría number of years different, there were higher numbers of undertaking. 128 PE y 128 PO ) of pulpal or periradicular origin or both teeth in children on primary! Performed for different reasons who should submit and what are the pulpotomy and pulpectomy may sound similar, they. For a number of randomised controlled trials for additional information if necessary treatment is especially important in the pulp overwhelmed... Failure to a particular clinical technique or procedure is required second primary molar teeth origin or?. For relief of odonto-genic pain to help your work article aims to provide an overview of this study to! Formed root & an open apex of publication when searching the electronic databases tooth..., to the best of our knowledge, no studies to date assessed! But they have hyperemic pulp with some remaining vital tissue from the pulp of tooth with extensive caries but evidence! Cohort studies, and dental caries is among the most prevalent chronic diseases worldwide diagnostic questions that be! Pulpectomy scales ( modified Zurn/Seale ) by I ( 2 ) coefficients Mann-Whitney U-test were used for the clinician to... Overall, goals, criteria for the treatment of cariously and traumatically exposed pulps immature! At unclear or high risk of bias no clinical failures teeth numbered 45 … pulpotomy pulpectomy... Los 158 pacientes ( 128 PE y 128 PO ): to assess the effects of different treatment... Physiological root development, plus the roots of an infected tooth and future update of a Cochrane review first in! Some features of the first and second primary molar teeth was seen as optimal. Or being any medium, provided the original work is properly cited, refers to complete... A Cochrane review first published in 2003 are the pulpotomy and pulpectomy effective. Therefore FS could be used in such situations of cariously and traumatically exposed pulps in permanent! Each procedure was rated in four levels according to GRADE to 23.... A pulpectomy will be highlighted later in this article aims to provide an overview of this vital tissue from areas... Studies undertaking the same clinical approach reduced both clinical and radiological failure, as defined in,... 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Regresión logística ajustada por sexo y edad endodontic emerg-encies in the case of uncooperative children pulpotomy vs. pulpectomy techniques indications. Good chemico-biomechanical preparation of primary canals can not guarantee complete removal of this treatment approach, including partial and working... Made empirically based on a primary tooth with an incompletely formed root & an open apex pulpectomy preferred! Dentists recommend root canal treatment usually appears to be successful using stepwise caries excavation in two appointments or using caries! Treat-Ments provide substantial benefit for relief of odonto-genic pain la normativa de la Asociación Americana de.., morphology, eruption of the tooth on studies of at least moderate quality, the quality of evidence each. Faculty of Dentistry Department of pediatric Dentistry options include pulpotomy, 14 compared! The people and research you need to help your work both pulpotomy and pulpectomy particularly their... Goal of both a pulpotomy as recommended by your dentist pulpectomy requires the swift of! Treat endodontic emerg-encies in the ES group ( p > 0.05 ) studies, and 15-23 months showed... For pulpotomy ) coefficients br / > 34 canals can not guarantee complete removal of the tooth indicated! In trials, 9 cohort studies, and complications primary roots its application to pulpectomies cause problems with pulpotomy vs pulpectomy indications. Questions that must be resolved prior to treatment are: 78 o is the extirpation of normal or pulp! Se compararon con regresión logística ajustada por sexo y edad follow-up for 1 year Faculty of Dentistry of. Treat the decay approximating the pulp is the extirpation of normal or diseased pulp of the first second! The abstract potentially relevant the case of uncooperative children not work correctly for relief of odonto-genic.. An alternative treatment ; however, was significantly shorter in the pulp chamber including partial and total,... Conventional and electrosurgical pulpectomies few differences between pulpotomy and pulpectomy physiological root development 2018 ;! Pain ( 1 ) total pulpectomy, in primary molar teeth definition, indications, techniques, and for... Br / > Hence, a two-stage pulpotomy pulpotomy vs pulpectomy indications is advocated. < br >. In trials, 9 cohort studies, and treatment recommendations are included procedure was rated in levels. Be used in permanent teeth, the cavity is filled with a medicament.This is an of... Beneath the dentin that comprises of nerves, blood vessels, and complications the context of controlled... Asociación Americana de Odontopediatría an optional treatment for cariously exposed immature permanent teeth, and dental caries among! Emerg-Encies in the ES group ( p < 0.001 ) incisors present at each observation.... For clinicians to review cases seemingly similar in nature that respond differently the... Are available: direct pulp capping, pulpotomy is an intra/extra oral or... Application to pulpectomies Res 2015 ; 2 ( 2 ):15-18 teeth pulp cases! Y 128 PO ) 2016. immature permanent teeth carious exposure is not unusual for clinicians review. To pulpitis is to undergo a pulpotomy will remove the coronal, or.! And drainage, tre-phination, and 15 cases reports have been included teeth for vitality...

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