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Clinical and Radiographic Evaluation of Two Newly Pulp Medicaments Used in Primary Molars Pulpotomy

El-Morsy Badran MM1*, Awad SM2 and Shalan HM1

1Faculty of Dentistry, Pediatric Dentistry and Dental Public Health Department, Mansoura University, Egypt

2Chairman of Pediatric Dentistry and Public Health Department, Mansoura University, Egypt

*Corresponding Author:
Badran El-Morsy MM
Faculty of Dentistry
Pediatric Dentistry and Dental Public Health Department
Mansoura University, Egypt
Tel: 002-01228066974
E-mail: mahmoudbadran2010@mans.edu.eg

Received Date: February 10, 2017; Accepted Date: March 15, 2017; Published Date: March 25, 2017

Citation: El-Morsy Badran MM, Awad SM, Shalan HM (2017) Clinical and Radiographic Evaluation of Two Newly Pulp Medicaments Used in Primary Molars Pulpotomy. Pediatr Dent Care 2:135.

Copyright: © 2017 El-Morsy Badran MM, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

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Abstract

Primary molars pulpotomy is a very common therapy for primary molars with extensive caries. Many agents including formaldehydebased materials, electro surgery, lasers, glutaraldehyde, haemostatic medicaments, zinc oxide eugenol, bone morphogenic protein (BMP), collagen and calcium involving, Dentin Bridge inducing materials have been developed. However, the ideal pulpotomy treatment still needs to be improved, so this research was done.

Introduction

Primary molars pulpotomy is a very common therapy for primary molars with extensive caries. Many agents including formaldehydebased materials, electro surgery, lasers, glutaraldehyde, haemostatic medicaments, zinc oxide eugenol, bone morphogenic protein (BMP), collagen and calcium involving, Dentin Bridge inducing materials have been developed. However, the ideal pulpotomy treatment still needs to be improved, so this research was done.

Aim

To evaluate clinically and radiographically the effect of (Biodentine and Mineral Trioxide Aggregate) as pulpotomy medicament agents vs. Formocresol in primary molars.

Design

The design groups are divided according to Split Mouth design so, the number of control group was 30 primary molar and the two experimental groups (Bio dentine, MTA) was 15 primary molar for each. The 3 groups were divided randomly without any bias and written content was taken from their parents for participating acceptance. All teeth were examined both clinically and radio graphically according to Coll and Sadrian Criteria for 3,6,9 months expect 2 cases did not come the last follow up.

Criteria of Coll and Sadrian

Clinical criteria

No pain on percussion on recall checkup.

No gingival swelling or sinous tract 6 months postoperatively.

No purulent exudate expressed from the gingival margin.

No abnormal mobility of tooth.

Radiographic criteria

No pathologic root resorption

A furcation radiolucency resolved 6-12 months postoperatively

No periapical radiolucency formation postoperatively

Sixty carious primary molars, followed pulpotomy indications, for 17 child were used in this study. The teeth were divided into 3 groups

• Group I (Control group ) 30 molar treated by Formocresol

• Group II (Experimental group) 15 molar treated by Biodentine

• Group III (Experimental group)15 molar treated by MTA

Patients preparation, profound local anesthesia, isolation by rubber dam was done then the whole caries was removed, all of undermined enamel was removed, the whole coronal pulp was amputated by sharp spoon excavator, initial stabilized clot was established [1-3], then the various pulp medicaments were applied over the pulp stump, so the pulp was treated by group I (formocresol), group II (Bio dentine), group III (MTA). Final restoration was performed with composite [4-6]. Then, both clinical and radiographic evaluation was done for all teeth at 3,6,9 months according to Coll and Sadrian Criteria. The data were analyzed to obtain Descriptive statistics and Analytical statistics to test the significance of difference between groups (Figure 1 and Table 1).

pediatric-dental-care-sex-distribution-studied-cases

Figure 1: Sex distribution of studied cases.

  n=17 %
Age (years)    
Mean ± SD 5.53 ± 1.07
Sex    
Male 8 47.1
Female 9 52.9

Table 1: Demographic characters of studied groups.

Results

The results of this study showed that no significant difference in between Biodentine and MTA in the three periods of follow up (P>0.05) on the other hand there was a statistically significant difference between biodentine and its control group (P<0.05) and between MTA group and its control group( P<0.05).

Statistical results: These two tables show the comparison between the 3 groups both clinically and radiographically at 3,6,9 months follow up (Tables 2 and 3).

Period of follow up Clinical assessment Groups Chi-square test
Biodentine group Control MTA
n (%) group group
  n (%) n (%)
3 months pain 0 (0.0) 1 (3.3) 0 (0.0) p=0.6
Gingival Swelling 0 (0.0) 1 (3.3) 0 (0.0) p=0.6
Purulent exudates 0 (0.0) 1 (3.3) 0 (0.0) p=0.6
Abnormal mobility 0 (0.0) 1 (3.3) 0 (0.0) p=0.6
6 pain 0 (0.0) 5 (16.7) 2 (13.3) p=0.25
months Gingival Swelling 0 (0.0) 3 (10.0) 1 (6.7) p=0.45
  Purulent exudates 0 (0.0) 3 (10.0) 1 (6.7) p=0.45
  Abnormal mobility 0 (0.0) 2 (6.7) 0 (0.0) p=0.36
9 pain 2 (14.3) 6 (21.4) 2 (14.3) p=0.78
 months Gingival Swelling 0 (0.0) 3 (10.7) 1 (7.1) p=0.56
  Purulent exudates 1 (7.1) 4 (14.3) 1 (7.1) p=0.75
  Abnormal mobility 0 (0.0) 2 (7.1) 0 (0.0) p=0.36

Table 2: Three groups at 3,6,9 months follow up clinical assessment.

Period of follow up Radiographic evaluation Groups Chi-square test
Biodentine group Control MTA
n (%) group n (%) group n (%)
3 months Pathological Root Resorption 0 (0.0) 1 (3.3) 0 (0.0) p=0.6
χ2=1.02
Furcation radiolucency resolved6-12 months postoperatively 0 (0.0) 1 (3.3) 0 (0.0) p=0.6
χ2=1.02
Periapical radiolucency formation 0 (0.0) 1 (3.3) 0 (0.0) p=0.6
χ2=1.02
6 months Pathological Root Resorption 0 (0.0) 3 (10.0) 1 (6.7) χ2=1.02
p=0.4
Furcation radiolucency resolved6-12 months postoperatively 1 (6.7) 4 (13.3) 1 (6.7) p=0.69
χ2=0.7
Periapical radiolucency formation 0 (0.0) 2 (6.7) 0 (0.0) p=0.35
χ2=0.7
9 months Pathological Root Resorption 2 (14.3) 5 (17.9) 2 (14.3) p=0.94
χ2=0.13
Furcation radiolucency resolved6-12 months postoperatively 0 (0.0) 3 (10.7) 1 (7.1) p=0.45
χ2=1.6
Periapical radiolucency formation 0 (0.0) 3 (10.7) 0 (0.0) p=0.2
χ2=3.17

Table 3: Three groups at 3,6,9 months follow up Radiographic evaluation.

Conclusion

Both MTA and Biodentine can be considered as a great substitute to Formocresol as pulp medicaments after pulpotomy.

Future Aspects

The clue for future about primary molars treatment after surgery. I really recommend the use of MTA and Biodentine as a great substitute to Formocresol as many researches proved that it is mutagenic and carcinogenic.

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