Pulpotomies with portland cement in human primary molars

Two clinical cases in which Portland cement (PC) was applied as a medicament after pulpotomy of mandibular primary molars in children are presented. Pulpotomy using PC was carried out in two mandibular first molars and one mandibular second molar, which were further followed-up. At the 3, 6 and 12-month follow-up appointments, clinical and radiographic examinations of the pulpotomized teeth and their periradicular area revealed that the treatments were successful in maintaining the teeth asymptomatic and preserving pulpal vitality. Additionally, the formation of a dentin bridge immediately below the PC could be observed in the three molars treated. PC may be considered as an effective alternative for primary molar pulpotomies, at least in a short-term period. Randomized clinical trials with human teeth are required in order to determine the suitability of PC before unlimited clinical use can be recommended

Pulp therapy in deciduous teeth: therapeutic possibilities based on evidences

Introduction: Pulpotomy of primary teeth has been the treatment of choice in cases of inflammation of the coronal pulp caused by caries or trauma with no involvement of the radicular pulp, thus avoiding the premature loss of the teeth. Not only is the diagnosis of the inflamed dental pulp required for this therapy to succeed, but also the selection of an effective and biocompatible medicament. However, none of the drugs available and recommended for pulpotomy therapy present all the requirements of an ideal pulp capping agent. Objective: Through a systematic literature review, between the years of 2000 and 2011, focusing in randomized clinical trials, systematic reviews and meta-analysis, aiming to analyze and discuss based on alternatives for the treatment of pulpotomy in human deciduous teeth. Conclusion: Scientific evidences showed that the medicaments and techniques influence were few. Thus, further and well-designed studies are suggested for clarification. The information generated in such experiments may contribute to a better understanding of the mechanisms of pulp therapy to new therapeutic approaches aimed at improving pulp therapy in deciduous teeth.Introdução: A pulpotomia em dentes decíduos é uma técnica conservadora de terapia pulpar amplamente utilizada \ud em Odontopediatria, sendo de fundamental importância para evitar a perda prematura desses dentes, quer seja \ud por alterações provocadas pela cárie dentária ou traumatismo dentário. Apesar de ser uma técnica estudada há \ud muitos anos, causa muitas controvérsias e discussões, principalmente em termos de biocompatibilidade dos \ud medicamentos empregados e pelas dificuldades e falhas no diagnóstico da condição pulpar. Objetivo: Por meio \ud de uma revisão sistemática da literatura, no período compreendido entre 2000 e 2011, e com enfoque em estudos \ud clínicos randomizados, revisões sistemáticas e meta-análises, este trabalho teve como objetivo discutir, com base em \ud evidências científicas, alternativas para o tratamento de pulpotomia em dentes decíduos humanos. Conclusão: As \ud evidências científicas fidedignas com o uso de materiais capeadores pulpares e as técnicas de Eletrocirurgia e Laser \ud de Baixa Potência foram escassas. Desta forma, sugere-se a realização de estudos complementares bem delineados \ud estatisticamente para maiores esclarecimentos. As informações geradas em tais experimentos poderão contribuir \ud para um melhor entendimento dos mecanismos da terapia pulpar, podendo gerar o desenvolvimento de protocolos \ud com novas formas terapêuticas, que visam a melhorar a terapia pulpar em dentes decíduo

Mineral trioxide aggregate as an alternative treatment for intruded permanent teeth with root resorption and incomplete apex formation

A case of extensive crown fracture associated with intrusion of the permanent maxillary central incisors in an 8-year-old boy is reported. The treatment of both injured teeth included attempts of apexification and arrest of root resorption with calcium hydroxide. After 8 months of the trauma, there was no calcified barrier formation in the apex. Mineral trioxide aggregate (MTA) was then used as a filling material. At 15-month follow up, the teeth were asymptomatic and correctly sealed, the external inflammatory root resorption had stopped, and the radiolucent image had disappeared, which meant the initial healing of the periapical lesion. MTA may be considered as an alternative option for the treatment of traumatized and immature permanent teeth

Replantation of an avulsed maxillary primary central incisor and management of dilaceration as a sequel on the permanent successor

This case report outlines the sequel and possible management of a permanent tooth traumatized through the predecessor, a maxillary right primary central incisor that was avulsed and replanted by a dentist 1 h after the trauma in a 3-year-old girl. Three years later, discoloration and fistula were present, so the primary tooth was extracted. The patient did not come to the scheduled follow-ups to perform a clinical and radiographic control of the succeeding permanent incisor, and only returned when she was 10 years old. At that moment, the impaction and dilaceration of the maxillary right permanent central incisor were observed through radiographic examination. The dilacerated permanent tooth was then surgically removed, and an esthetic fixed appliance was constructed with the crown of the extracted tooth. Positive psychological influence of the treatment on this patient was also observed

Pulpotomies with portland cement in human primary molars

Two clinical cases in which Portland cement (PC) was applied as a medicament after pulpotomy of mandibular primary molars in children are presented. Pulpotomy using PC was carried out in two mandibular first molars and one mandibular second molar, which were further followed-up. At the 3, 6 and 12-month follow-up appointments, clinical and radiographic examinations of the pulpotomized teeth and their periradicular area revealed that the treatments were successful in maintaining the teeth asymptomatic and preserving pulpal vitality. Additionally, the formation of a dentin bridge immediately below the PC could be observed in the three molars treated. PC may be considered as an effective alternative for primary molar pulpotomies, at least in a short-term period. Randomized clinical trials with human teeth are required in order to determine the suitability of PC before unlimited clinical use can be recommended

Terapia pulpar em dentes decíduos: possibilidades terapêuticas baseadas em evidências

INTRODUÇÃO: A pulpotomia em dentes decíduos é uma técnica conservadora de terapia pulpar amplamente utilizada em Odontopediatria, sendo de fundamental importância para evitar a perda prematura desses dentes, quer seja por alterações provocadas pela cárie dentária ou traumatismo dentário. Apesar de ser uma técnica estudada há muitos anos, causa muitas controvérsias e discussões, principalmente em termos de biocompatibilidade dos medicamentos empregados e pelas dificuldades e falhas no diagnóstico da condição pulpar. OBJETIVO: Por meio de uma revisão sistemática da literatura, no período compreendido entre 2000 e 2011, e com enfoque em estudos clínicos randomizados, revisões sistemáticas e meta-análises, este trabalho teve como objetivo discutir, com base em evidências científicas, alternativas para o tratamento de pulpotomia em dentes decíduos humanos. CONCLUSÃO: As evidências científicas fidedignas com o uso de materiais capeadores pulpares e as técnicas de Eletrocirurgia e Laser de Baixa Potência foram escassas. Desta forma, sugere-se a realização de estudos complementares bem delineados estatisticamente para maiores esclarecimentos. As informações geradas em tais experimentos poderão contribuir para um melhor entendimento dos mecanismos da terapia pulpar, podendo gerar o desenvolvimento de protocolos com novas formas terapêuticas, que visam a melhorar a terapia pulpar em dentes decíduos

Evaluation of superficial microhardness in dental enamel with different eruptive ages

This study evaluated the superficial microhardness of enamel in teeth at different posteruptive ages (before eruption in the oral cavity, 2-3 years after eruption, 4-10 years after eruption and more than 10 years after eruption). The study sample was composed of 134 specimens of human enamel. One fragment of each tooth was obtained from the flattest central portion of the crown to produce specimens with 3 x 3 mm. The enamel blocks were minimally flattened out and polished in order to obtain a flat surface parallel to the base, which is fundamental for microhardness testing. Microhardness was measured with a microhardness tester and a Knoop diamond indenter, under a static load of 25 g applied for 5 seconds. Comparison between the superficial microhardness obtained for the different groups was performed by analysis of Student's t test. The results demonstrated that superficial microhardness values have a tendency to increase over the years, with statistically significant difference only between unerupted enamel and that with more than 10 years after eruption. According to the present conditions and methodology, it was concluded that there were differences between the superficial micro-hardness of specimens at different eruptive ages, revealing an increasing mineralization. However, this difference was significant only between unerupted specimens and those with more than 10 years after eruption