OBJECTIVE: To evaluate the clinical characteristics and effectiveness of pulpotomy in mature permanent teeth with bioceramic putty repairmen iRoot and mineral trioxide aggregate (MTA). METHODS: Pulpotomy was performed on mature permanent premolars and molars with carious exposures at the Department of General Dentistry of Peking University School and Hospital of Stomatology, from November 2017 to September 2019. The patients were randomly divided into 2 groups, Group iRoot (n=22) and Group MTA (n=21). In Group iRoot, bioceramic putty repairmen iRoot was used as pulp capping agent, while in Group MTA, mineral trioxide aggregate was used as pulp capping agent. All the patients had signed informed consent forms. The clinical efficacy was evaluated by clinical examinations (temperature and electrical activity test) and imaging examinations 3, 6, and 12 months after surgery. Blinding was used for the patients and evaluators, but due to the obvious differences in the properties of the two pulp capping agents, the blinding method was not used for the treatment provider (the attending physician). RESULTS: There was no significant difference in gender, average age, dentition and tooth position distribution between the two groups (P>0.05). In the study, 7 cases were lost to follow-up 12 months after operation (4 cases in Group iRoot, and 3 cases in Group MTA). One case in each of the two groups had transient sensitivity at the end of the 3-month follow-up, and the pulp vitality was normal at the end of the 6-month follow-up. One case in Group iRoot showed sensitivity at the end of the 12-month follow-up. The success rates of the two groups at the end of 12-month follow-up were 100%, and the cure rates were 94.4% (Group iRoot) and 100% (Group MTA), respectively, and the difference was not statistically significant (P>0.05). No cases in Group iRoot had obvious crown discoloration, while 3 cases in Group MTA had. CONCLUSION The clinical characteristics and effectiveness of pulpotomy in mature permanent teeth with bioceramic putty repairmen iRoot were similar with MTA. Bioceramic putty repairmen iRoot is an acceptable material when used in pulpotomy of mature permanent teeth. Because it is not easy to cause tooth discoloration after treatment and is convenient to operate, bioceramic putty repairmen iRoot has a better clinical application prospect.
Aluminum Compounds/therapeutic use* ; Calcium Compounds/therapeutic use* ; Drug Combinations ; Humans ; Oxides/therapeutic use* ; Pulpotomy ; Silicates/therapeutic use* ; Treatment Outcome

OBJECTIVE: To evaluate the two-year outcomes of primary molars pulpotomy using mineral trioxided aggregate (MTA) and to find out the potential influence factor, with the help of electronic medical record database. METHODS: Children who received primary molars pulpotomy in the Department of Pediatric Dentistry in Peking University School and Hospital of Stomatology from May, 2014 to November, 2015 were searched in the Electronic Medical Record Database of Peking University School and Hospital of Stomatology, via the database for scientific research provided by the corporation of Kaientai. The children who were healthy, no more than 8 years old and followed up over 1.5 years were selected as the subjects of this study. At the same time, those children who didn't have complete medical records and X-rays before and after treatment were removed. Basic information, the relevant medical records and radiographic records of those children were collected. All molars were examined clinically and radiographically, and classified into 1 of 5 outcomes: N, H, P0, PX, PY. Molars classified into P0, PX and PY were regarded as failed. Survival analysis was applied. The survival rate and survival time of the deciduous teeth were calculated.Multivariate analysis was performed by using Cox proportional hazard model. RESULTS: One hundred and fifteen children were finally included,aged from 2.6 to 8.2 years, with the mean age of (4.5±1.1) years. 211 primary molars were included, and the average follow up time was (880±154) days. A good level of agreement between the raters was found for molars with five outcomes(κ=0.913). Intrarater reliability was good for molars with five outcomes (κ=0.916). Forty-nine molars failed by September, 2017. Forty-three molars had abnormal radiographic manifestation. Six molars suffered premature loss. Only fourteen molars had an associated gingival swelling or parulis, or pathologic mobility upon clinical examination. The cumulative survival probability of half a year, one year, one year and a half, two years, two year and a half for the pulpotomy was 100%, 98.5%, 92.9%, 90.5%,73.8% through the Kaplan-Meier method, respectively. Through the analysis of Cox proportional hazard model, the survival probability was significantly higher when the age was younger. When sodium hypochlorite and the saline were used as the irrigation at the same time, the survival probability was not improved for those teeth with more bleeding in the operation compared with that used saline only. The teeth with preformed metal crown (PMC) gained longer median survival time than those restored with resin composite and others, but the difference was not significant, either. What's more, gender, the restoration time of PMC, the restoration of the opposite teeth were not found to be associated with the success of the treatment. CONCLUSION The cumulative survival probability of two years after the primary pulpotomy was 90.5%, complying the current instructions in our department. The survival probability of the molars after the treatment was significantly affected by the age.
Aluminum Compounds/therapeutic use* ; Calcium Compounds/therapeutic use* ; Child ; Drug Combinations ; Humans ; Molar ; Oxides/therapeutic use* ; Pulpotomy/methods* ; Reproducibility of Results ; Retrospective Studies ; Silicates/therapeutic use* ; Tooth, Deciduous

OBJECTIVE: To evaluate the efficacy of iRoot BP Plus, a novel bioceramic material, and mineral trioxide aggregate (MTA) by comparing the clinical and radiographic results of pulpotomy in human primary molars, and to find out the influence factor. METHODS: Children who had at least one primary molar diagnosed as pulpitis, and received pulpotomy in the Department of Pediatric Dentistry, Peking University School and Hospital of Stomatology from January, 2017 to December, 2018 were searched by the selection criteria in the Electronic Medical Record Database of Peking University School and Hospital of Stomatology. The molars with the pulp capping agents were iRoot BP Plus or MTA were included, and the molars with other pulp capping agents were excluded. Molars using iRoot BP Plus were selected into the experimental group (iRoot BP Plus group). Molars using MTA were selected into the control group (MTA group) using propensity score matching model (1 ∶ 1), considering the gender, age, tooth position, the title of clinician, pulp status, restoration and length of follow-up as the potential influence factor. Basic information, the relevant medical records including symptoms, clinical and radiographic examination before and after operation, intraoperative information and follow up examination records were collected. The success rates were compared and the influence factors were analyzed respectively. RESULTS: The study included 132 children, 178 molars (89 molars from each group) and the mean follow-up time was (462±99) days by December, 2019. In the iRoot BP Plus group, 9 molars failed whilst 6 molars failed in MTA group. The success rate was 89.9% and 93.3%, respectively, showing no significant difference between the two groups. Through Cox proportional risk model analysis, the success rate of iRoot BP Plus was significantly lower when the pulp status was poor, while other factors including age, tooth position, title of clinician and restoration were not found to be associated with the clinical outcome. CONCLUSION Pulpotomy of human primary molars with iRoot BP Plus has the same effectiveness with MTA. The pulp status is the main factor that influences the outcome of iRoot BP Plus. Further studies with larger sample sizes and longer follow-up terms are needed.
Child ; Humans ; Pulpotomy/methods* ; Pulp Capping and Pulpectomy Agents ; Pemetrexed ; Silicates/therapeutic use* ; Aluminum Compounds/therapeutic use* ; Calcium Compounds ; Oxides ; Molar/surgery* ; Drug Combinations ; Treatment Outcome ; Tooth, Deciduous

OBJECTIVE: To compare the clinical effects of pulpotomy with two kinds of calcium silicate materials, and to evaluate the formation of dentin bridge and pulp calcification after pulpotomy of adult permanent teeth. METHODS: Patients who visited the General Department of Peking University School and Hospital of Stomatology from November 2017 to September 2019 and planned for pulpotomy on permanent premolars and molars with carious exposed pulp were selected. They were randomly divided into two groups. Bioceramic putty material iRoot BP (iRoot group, n=22) and mineral trioxide aggregate MTA (MTA group, n=21) were used as pulp capping agents, respectively. The patients were recalled after one year and two years. The clinical efficacy, dentin bridge index (DBI) and pulp calcification index (PCI) were recorded. Blinding method was used for the patients and evaluators. RESULTS: There was no significant difference in gender, mean age, dentition and tooth position between the two groups (P>0.05). Seven cases were lost during the first year (4 cases in iRoot group and 3 cases in MTA group). In the iRoot group, 1 case had transient sensitivity at the time of 1-year follow-up. The cure rate of the two groups was 100% at the time of 2-year follow-up. The proportion of dentin bridge formation was 38.9% one year after operation, 55.6% two years after operation. The proportion of partial or even complete disappearance of root canal image was 5.6% before operation, 38.9% and 55.6% one and two years after operation, respectively. The difference was statistically significant by rank sum test (P < 0.05). There was no significant difference in dentin bridge formation and pulp calcification between the two groups (P < 0.05). DBI and PCI after operation was as the same as those before operation (44.4% cases of DBI and 25% cases of PCI) or gradually increased (55.6% cases of DBI and 75% cases of PCI). Spearman's nonparametric correlation analysis showed that age was positively correlated with preoperative pulp calcification index (PCI0, P < 0.05), but not with the dentin bridge index (DBI1, DBI2), pulp calcification index (PCI1, PCI2) and the degree of change (DBI2 vs. DBI1, PCI1 vs. PCI0, PCI2 vs. PCI0) 1-year and 2-year after operation (P>0.05). CONCLUSION According to this study, good clinical effects were obtained within 2-year after pulpotomy of adult permanent teeth with MTA and iRoot. In some cases, the root canal system had a tendency of calcification aggravation, and there was no statistical difference in the development of this trend between the two groups.
Humans ; Adult ; Pulpotomy/methods* ; X-Rays ; Calcium Compounds/therapeutic use* ; Dentition, Permanent ; Molar/surgery* ; Treatment Outcome ; Silicates/therapeutic use* ; Aluminum Compounds/therapeutic use* ; Oxides ; Drug Combinations ; Dental Pulp Capping

The time domain entombment of bacteria by intratubular mineralization following orthograde canal obturation with mineral trioxide aggregate (MTA) was studied by scanning electron microscopy (SEM). Single-rooted human premolars (n=60) were instrumented to an apical size #50/0.06 using ProFile and treated as follows: Group 1 (n=10) was filled with phosphate buffered saline (PBS); Group 2 (n=10) was incubated with Enterococcus faecalis for 3 weeks, and then filled with PBS; Group 3 (n=20) was obturated orthograde with a paste of OrthoMTA (BioMTA, Seoul, Korea) and PBS; and Group 4 (n=20) was incubated with E. faecalis for 3 weeks and then obturated with OrthoMTA-PBS paste. Following their treatments, the coronal openings were sealed with PBS-soaked cotton and intermediate restorative material (IRM), and the roots were then stored in PBS for 1, 2, 4, 8 or 16 weeks. After each incubation period, the roots were split and their dentin/MTA interfaces examined in both longitudinal and horizontal directions by SEM. There appeared to be an increase in intratubular mineralization over time in the OrthoMTA-filled roots (Groups 3 and 4). Furthermore, there was a gradual entombment of bacteria within the dentinal tubules in the E. faecalis inoculated MTA-filled roots (Group 4). Therefore, the orthograde obturation of root canals with OrthoMTA mixed with PBS may create a favorable environment for bacterial entombment by intratubular mineralization.
Aluminum Compounds ; therapeutic use ; Calcification, Physiologic ; physiology ; Calcium Compounds ; therapeutic use ; Crystallization ; Dental Pulp Cavity ; microbiology ; Dentin ; microbiology ; Drug Combinations ; Enterococcus faecalis ; ultrastructure ; Humans ; Methylmethacrylates ; therapeutic use ; Microscopy, Electron, Scanning ; Oxides ; therapeutic use ; Root Canal Filling Materials ; therapeutic use ; Root Canal Obturation ; methods ; Root Canal Preparation ; instrumentation ; Silicates ; therapeutic use ; Time Factors ; Zinc Oxide-Eugenol Cement ; therapeutic use

OBJECTIVETo assess the efficacy of calcium-magnesium (Ca/Mg) infusion and glutathione (GSH) for preventing the neurotoxicity induced by oxaliplatin.

METHODSThis is a randomized, double blind, placebo controlled clinical trail. The patients receiving FOLFOX4 chemotherapy for their solid tumor were randomized to receive Ca/Mg, GSH or normal saline with chemotherapy simultaneously. The incidence and severity of oxaliplatin-induced neurotoxicity were observed. The ECOG performance status was recorded and compared among the 3 groups.

RESULTSNinety-three patients admitted in our department from Mar 2006 to Dec 2007 were entered into this study, including 29 patients in the Ca/Mg group, 33 in the GSH group and 31 in the chemotherapy alone group. The incidences of acute neurotoxicity were 82.8%, 90.9% and 93.5%, respectively. At the third cycle, the incidences of grade 1-2 chronic neurotoxicity were 37.9%, 48.5% and 42.0%, respectively. No grade 3 neuropathy was observed. After 6 cycles, the incidence of grade 1-2 neuropathy was increased to 68.2%, 88.9% and 85.2%, respectively. A lower percentage was observed in Ca/Mg arm without a statistically significant difference, and grade 3 neuropathy occurred in 5 patients. After 9 cycles, the incidence of grade 1-2 neuropathy was increased to 81.3%, 90.0% and 92.9%, respectively. Grade 3 neuropathy occurred in another 2 patients. No statistically significant difference was observed among the 3 arms. Changes of patient's ECOG score after chemotherapy were similar.

CONCLUSIONThis study didn't provide evidence that Ca/Mg infusion and GSH can prevent the oxaliplatin-induced neurotoxicity.

Adolescent ; Adult ; Aged ; Anticonvulsants ; administration & dosage ; Antineoplastic Combined Chemotherapy Protocols ; adverse effects ; therapeutic use ; Calcium Gluconate ; administration & dosage ; Colorectal Neoplasms ; drug therapy ; Double-Blind Method ; Drug Therapy, Combination ; Female ; Fluorouracil ; adverse effects ; therapeutic use ; Glutathione ; therapeutic use ; Humans ; Infusions, Intravenous ; Leucovorin ; adverse effects ; therapeutic use ; Magnesium Sulfate ; administration & dosage ; Male ; Middle Aged ; Neurotoxicity Syndromes ; etiology ; prevention & control ; Organoplatinum Compounds ; adverse effects ; therapeutic use ; Stomach Neoplasms ; drug therapy ; Young Adult

Mineral trioxide aggregate (MTA) is considered at the present time as the gold standard for root-end filling in endodontic surgery. However, this biocompatible material presents several drawbacks such as a long setting time and handling difficulties. The aim of this article is to present a new commercialized calcium silicate-based material named Biodentine with physical improved properties compared to MTA in a clinical application. Two endodontic microsurgeries were performed by using specific armamentarium (microsurgical instrumentation, ultrasonic tips) under high-power magnification with an operatory microscope. Biodentine was used as a root-end filling in order to seal the root canal system. The two cases were considered completely healed at 1 year and were followed for one more year. The 2-year follow-up consolidated the previous observation with absence of clinical symptoms and radiographic evidence of regeneration of the periapical tissues.
Calcium Compounds ; therapeutic use ; Female ; Follow-Up Studies ; Humans ; Microsurgery ; instrumentation ; Middle Aged ; Periapical Diseases ; therapy ; Periapical Tissue ; diagnostic imaging ; physiology ; Radiography, Bitewing ; Regeneration ; physiology ; Retrograde Obturation ; methods ; Root Canal Filling Materials ; therapeutic use ; Root Canal Preparation ; instrumentation ; Silicates ; therapeutic use ; Ultrasonic Surgical Procedures ; instrumentation ; Wound Healing ; physiology

One-step apexification using mineral trioxide aggregate (MTA) has been reported as an alternative treatment modality with more benefits than the use of long-term calcium hydroxide for teeth with open apex. However, orthograde placement of MTA is a challenging procedure in terms of length control. This case series describes the sequence of events following apical extrusion of MTA into the periapical area during a one-step apexification procedure for maxillary central incisor with an infected immature apex. Detailed long-term observation revealed complete resolution of the periapical radiolucent lesion around the extruded MTA. These cases revealed that direct contact with MTA had no negative effects on healing of the periapical tissues. However, intentional MTA overfilling into the periapical lesion is not to be recommended.
Adolescent ; Adult ; Aluminum Compounds ; adverse effects ; Apexification ; methods ; Calcium Compounds ; adverse effects ; Dental Fistula ; therapy ; Dental Pulp Necrosis ; therapy ; Drug Combinations ; Female ; Follow-Up Studies ; Foreign Bodies ; etiology ; Gutta-Percha ; therapeutic use ; Humans ; Incisor ; pathology ; Longitudinal Studies ; Male ; Oxides ; adverse effects ; Periapical Abscess ; therapy ; Root Canal Filling Materials ; adverse effects ; Root Canal Obturation ; adverse effects ; Root Canal Preparation ; methods ; Silicates ; adverse effects ; Tooth Apex ; pathology ; Treatment Outcome ; Wound Healing ; physiology