Is pulpotomy obsolete? A clinical study on the success rates of indirect pulp capping and pulpotomy in the treatment of deep dentinal caries in primary second molars

Background and Objectives: Traditionally, there are two treatment modalities for vital primary teeth with deep carious lesion, which include indirect pulp therapy (IPT) and pulpotomy. Enormous research and review in vital pulp therapy gave rise to a question, if primary tooth pulpotomy is obsolete, and should IPT replace pulpotomy? IPT has shown higher long-term success rates than any pulpotomy procedures other than mineral trioxide aggregate (MTA). Hence, the objectives of this study were to evaluate the success rates of IPT using calcium hydroxide and MTA pulpotomy clinically and radiographically. Materials and Methods: Eighty primary second molars were selected and randomly divided into two therapeutic groups of 40 each. Group 1 were treated with IPT using calcium hydroxide paste and Group 2 were treated with conventional pulpotomy using MTA paste followed by stainless steel crown. Follow-up evaluation was done at an interval of 6 weeks, 3 months, and 6 months. Results: The follow-up evaluation revealed 100% clinical success in teeth treated with MTA pulpotomy and one radiographic failure of internal resorption detected at 3 months. There was 100% clinical and radiographic success with teeth treated with IPT. Though there was one radiographic failure with MTA pulpotomy, it was not statistically significant (P > 0.05). Conclusion: Indications being the same for both the procedures why not opt for IPT which offers several advantages over pulpotomy like fewer potential side effects, non-invasive, decreased chair time, child cooperation, and cost-effectiveness

Retrieval of swallowed endodontic file with gastro-scope

Swallowing or aspiration of dental instruments and objects can occur in every field of dentistry. These instruments and objects vary in sizes, shapes and quality which make it difficult to locate their position. Gastro scope is a versatile instrument used in both diagnostic as well as interventional surgical procedures. This report emphasizes on the important of using rubber dam during root canal treatment and the use of gastroscope as an emergency procedure when the swallowed instrument has been located in stomach; to prevents further complications