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 Table of Contents  
REVIEW ARTICLE
Year : 2021  |  Volume : 6  |  Issue : 1  |  Page : 22-23

Recent advances in pulpotomy medicament


1 Senior Lecturer, Department of Pedodontics and Preventive Dentistry, Maitri College of Dentistry and Research Center, Bhilai, Chhattisgarh, India
2 Consultant Pediatric Dentist, Pune, Maharashtra, India
3 Senior Lecturer, Department of Pedodontics and Preventive Dentistry, Rungta College of Dental Sciences and Research, Bhilai, Chhattisgarh, India
4 Consultant Pediatric Dentist, Gadag, Karnataka, India
5 Consultant Pediatric Dentist, Bhilai, Chhattisgarh, India
6 RK Dental Clinic, Raniganj, West Bengal, India

Date of Submission15-Nov-2020
Date of Acceptance11-Dec-2020
Date of Web Publication17-Feb-2021

Correspondence Address:
Dr. Pratik Surana
Department of Pedodontics and Preventive Dentistry, Maitri College of Dentistry and Research Center, GE Road, Anjora, Durg - 491 001, Chhattisgarh
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijmo.ijmo_11_20

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  Abstract 


Pulpotomy is the most commonly used treatment modality used in cariously involved primary vital primary teeth. Formocresol shows a good clinical success rate over the period of years but concerns raised due to its toxicity, mutagenicity, and carcinogenicity. The current review of literature provides an overview of recent advances in pulpotomy medicament that can be used as an alternative to formocresol.

Keywords: Biodentine, formocresol, mineral trioxide aggregate, pulpotomy


How to cite this article:
Surana P, Khandelwal A, Gopal R, Koppalkar RR, Aafreen S, Gupta S. Recent advances in pulpotomy medicament. Int J Med Oral Res 2021;6:22-3

How to cite this URL:
Surana P, Khandelwal A, Gopal R, Koppalkar RR, Aafreen S, Gupta S. Recent advances in pulpotomy medicament. Int J Med Oral Res [serial online] 2021 [cited 2021 Oct 20];6:22-3. Available from: http://www.ijmorweb.com/text.asp?2021/6/1/22/309660




  Introduction Top


The major objective of pediatric endodontics is to maintain the primary teeth in their position in healthy and functional status until their successor teeth erupt. The primary tooth is as important as permanent tooth as it plays a vital role in mastication, digestion, and integration to the maintenance of arch integrity, stimulation of growth of the jaw, development of speech, and esthetic functions.[1] Pulpotomy is the most commonly used treatment modality for reversibly inflamed primary teeth. It involves complete removal of the coronal portion of the pulp application of a medication or dressing to preserve the vitality of radicular pulp tissue.[2] Formocresol pulpotomy was first described by Sweet, and it has been used over the year with immense success rate; however, there are some concerns that have been raised over the formocresol, mainly as a result of its toxicity and potential carcinogenicity.[3] The current review of literature provides an overview of recent advances in pulpotomy medicament that can be used as an alternative to formocresol.


  Ideal Requirement of Pulpotomy Agent Top


Ideal pulpotomy medicament should leave the remaining radicular pulp in a healthy and vital condition in an odontoblast-lined dentin chamber.[2]


  Recent Advancement in Pulpotomy Medicament Top


A variety of studies have been carried out to find out ideal pulpotomy agent [Table 1]. Few materials such as mineral trioxide aggregate (MTA), Biodentine, lyophilized freeze-dried platelet, enamel matrix protein, Aloe vera, and honey have shown effective results. These materials can broadly be classified as herbal and nonherbal medicaments.
Table 1: History of pulpotomy

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Nonherbal medicament

Lyophilized freeze-dried platelet

In 2004, Kalaskar and Damle compared the efficacy of lyophilized freeze-dried platelet-derived preparation with calcium hydroxide in primary molars and found lyophilized freeze-dried platelet to better than calcium hydroxide in 6-month follow-up.[9]

Bioactive glass

Bioactive glasses (BAGs) are a biocompatible material which is considered to have osteoconductive property. Salako et al. in 2004 conducted an animal study and found that BAG induced an inflammatory response at 2 weeks with resolution of inflammation at 4 weeks.[10]

Mineral trioxide

MTA, a bioactive material developed from Portland cement, was first introduced by Dr. Mahmoud Torabinejad at Loma Linda University in 1993 and its first reported use was by Lee et al. in 1993. Eidelman et al. (2001) evaluated the effectiveness of MTA as a pulpotomy agent in primary molars and reported a 100% success rate in 17-month follow-up.[11]

Biodentine

Biodentine is a bioactive and biocompatible dentine substitute introduced by Septodont group; it is mainly used as a dentine substitute both for restorative and endodontic purposes. Nasrallah et al. clinically and radiographically evaluated the efficacy of Biodentine™ as pulpotomy medicament on deciduous molars and found it very satisfactory.[12]

Herbal medicament

Honey

It has an excellent antimicrobial and wound healing property. Honey is used to treat various oral lesions such as lichen planus, candidiasis, and stomatitis. Kumari et al. evaluated the efficacy of honey as a pulpotomy agent and found very promising results both clinically and radiographically.[13]

Turmeric powder

Turmeric is a natural anti-inflammatory and antioxidant which is widely used as an ayurvedic medicine. Purohit et al. in their study found a good clinical and radiographic success with turmeric powder in 6-month follow-up.[14]

Aloe vera

It has got various properties such as immunomodulatory, antiviral and anti-inflammatory, antibacterial, antifungal as well as protective nature against a broad range of microorganisms. Gupta et al. evaluated the effect of freshly extracted A. vera gel from its leaves as a pulpotomy agent in primary molar teeth and found a good clinical and radiographic success.[15]


  Conclusion Top


The acceptable outcome of pulpotomy in primary teeth depends on case selection, proper clinical and radiographic evaluation, and most importantly, on aseptic clinical procedure and material used for pulpotomy. Formocresol shows a good clinical success rate over the period of years but concerns raised due to its toxicity, mutagenicity, and carcinogenicity. Other materials such as MTA and Biodentine can be used as an alternative to formocresol.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Guideline on Pulp Therapy for Primary and Immature Permanent Teeth. Am Acad Pediat Dent 2012-13;34:222-9.  Back to cited text no. 1
    
2.
Ranly DM. Pulpotomy therapy in primary teeth: new modalities for old rationales. Pediatr Dent 1994;16:403-9.  Back to cited text no. 2
    
3.
Fuks AB. Vital pulp therapy with new materials for primary teeth: New directions and treatment perspectives. Pediatric Dentistry 2008;30:211-9.  Back to cited text no. 3
    
4.
Stewart RE, Editor. Pediatric Dentistry: Scientific Foundation and Clinical Practice. Missouri: Mosby Publications; 1982.  Back to cited text no. 4
    
5.
Doyle WA, McDonald RE, Mitchell DF. Formocresol versus calcium hydroxide in pulpotomy. ASDC J Dent Children 1962;29:86-97.  Back to cited text no. 5
    
6.
Spedding RH, Mitchell DF, McDonald RE. Formocresol and calcium hydroxide therapy. J Dent Res 1965;44:1023-34.  Back to cited text no. 6
    
7.
Redig DF. A comparison and evaluation of two formocresol pulpotomy techniques utilizing “Buckley's” formocresol. ASDC J Dent Children 1968;35:22-30.  Back to cited text no. 7
    
8.
Hafez AA, Cox CF, Tarim B, Otsuki M, Akimoto N. An in vivo evaluation of hemorrhage control using sodium hypochlorite and direct capping with a one- or two-component adhesive system in exposed nonhuman primate pulps. Quintessence Int 2002;33:261-72.  Back to cited text no. 8
    
9.
Kalaskar RR, Damle SG. Comparative evaluation of lyophilized freeze dried platelet derived preparation with calcium hydroxide as pulpotomy agents in primary molars. J Indian Soc Pedod Prev Dent 2004;22:24-9.  Back to cited text no. 9
[PUBMED]  [Full text]  
10.
Salako N, Joseph B, Ritwik P, Salonen J, John P, Junaid TA. Comparison of bioactive glass, mineral trioxide aggregate, ferric sulfate, and formocresol as pulpotomy agents in rat molar. Dent Traumatol 2003;19:314-20.  Back to cited text no. 10
    
11.
Eidelman E, Holan G, Fuks AB. Mineral trioxide aggregate vs. formocresol in pulpotomized primary molars: a preliminary report. Pediatr Dent 2001;23:15-8.  Back to cited text no. 11
    
12.
Nasrallah H, El Noueiri B, Pilipili C, Ayoub F. Clinical and radiographic evaluations of Biodentine™ pulpotomies in mature primary molars (stage 2). Int J Clin Pediatr Dent 2018;11:496-504.  Back to cited text no. 12
    
13.
Kumari KK, Sridevi E, Sai Sankar AJ, Gopal AS, Pranitha K, Manoj Kumar MG. In vivo evaluation of honey as a new medicament for vital pulp therapy in primary teeth. SRM J Res Dent Sci 2017;8:58-63.  Back to cited text no. 13
  [Full text]  
14.
Purohit RN, Bhatt M, Purohit K, Acharya J, Kumar R, Garg R. Clinical and radiological evaluation of turmeric powder as a pulpotomy medicament in primary teeth: An in vivo study. Int J Clin Pediatr Dent 2017;10:37-40.  Back to cited text no. 14
    
15.
Gupta N, Bhat M, Devi P, Girish. Aloe-vera: A nature's gift to children. Int J Clin Pediatr Dent 2010;3:87-92.  Back to cited text no. 15
    



 
 
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