UNLABELLEDOBJECTIVE To investigate the in vitro antimicrobial activity of nano-hydroxyapatite/polyamide 66 composites (nHA-PA66) as a pulp capping agent.

METHODSThe micro-organisims used in this study included Streptococcous mutans (S. mutans), Lactobacillus casei (L. casei) and Actinomyces viscosus (A. viscosus), three standard bacterial strains predominant in deep carious lesions. Agar diffusion test was used to determine the diameter of bacterial inhibition zones of nHA-PA66 compared with hydroxyapatite paste, calcium hydroxide paste and nHA-PA66 mixed with iodoform paste.

RESULTSIt showed that the polymerized films and fresh paste of nHA-PA66 had no antimicrobial activity to S. mutans and very little to L. casei and A. viscosus. The antimicrobial activity of nHA-PA66 mixed with iodoform paste obviously increased, but no significant difference compared with calcium hydroxide paste. There, was no antimicrobial activity of hydroxyapatite paste to the three test bacterial strains.

CONCLUSIONThese findings suggest nHA-PA66 used as pulp capping agent alone almost has no antimicrobial effect to the three test bacteria, but the antimicrobial activity can be increased by combining with iodoform.

Anti-Infective Agents ; Durapatite ; Humans ; In Vitro Techniques ; Nylons ; Pulp Capping and Pulpectomy Agents

The purpose of this study is to analyze the changes in patient distribution and practice pattern resulted from changes of socioeconomic circumstances. From January 2008 to December 2017, information about patient distribution and practice pattern was collected and reviewed.Both the number of new patients and revisiting patients increased. The average age of new patients showed a declining trend. Children aged between 0 and 6 had the majority. In case of restorative treatment, the use of composite resin decreased, whereas resin modified glass ionomer increased. As to pulp treatment of primary tooth, the proportion of pulpectomy increased significantly, but decreased in pulpotomy. The results showed an increase in the treatments under sedation and general anesthesia and with the use of midazolam and nitric oxide increased after 2014.
Anesthesia, General ; Child ; Glass ; Humans ; Midazolam ; Nitric Oxide ; Pediatric Dentistry ; Pulpectomy ; Pulpotomy ; Tooth, Deciduous

OBJECTIVETo compare the painless effect of four anesthetic methods during opening pulp cavity and undergoing pulpectomy for acute or chronic pulpitis.

METHODS80 teeth of 80 patients were randomly allocated into four groups. Each group had 20 teeth. Anesthetic methods applied four different groups included block anesthesia of nerve, supraperiosteal infiltration, periodontal membrane injection and intrapulpal injection. Anesthesia doses were recorded and the pierced points, the zones of pain, the time of anesthesia action, the time of anesthesia persistence and the degrees of anesthesia were evaluated with four levels synthetic evaluation standard of anesthesia.

RESULTSCompared with periodontal membrane injection and intrapulpal injection, block anesthesia of nerve and supraperiosteal infiltration had the later time of anesthesia action and the longer time of anesthesia persistence (P<0.05). In four anesthetic methods, block anesthesia of nerve had the best painless effect (P<0.05).

CONCLUSIONFour anesthetic methods have their own superiorities, and we should select proper anesthetic methods in clinical work.

Adult ; Anesthesia, Dental ; Anesthetics ; Anesthetics, Local ; Bicuspid ; Female ; Humans ; Injections ; Lidocaine ; Male ; Mandibular Nerve ; Nerve Block ; Periodontal Ligament ; Pulpectomy ; Pulpitis

This study evaluated the microleakage of three restorative materials and three tricalcium silicate-based pulp capping agents. The restorative materials were composite resin (CR), resin-reinforced glass ionomer cement (RMGI), and traditional glass ionomer cement (GIC) and the pulp capping agents were TheraCal LC® (TLC), Biodentine® (BD), and ProRoot® white MTA (WMTA). Additionally, shear bond strengths between the pulp-capping agents and dentine were compared.Class V cavities were made in bovine incisors and classified into nine groups according to the type of pulp-capping agent and final restoration. After immersion in 0.5% fuchsin solution, each specimen was observed with a stereoscopic microscope to score microleakage level. The crowns of the bovine incisors were implanted into acrylic resin, cut horizontally, and divided into three groups. TLC, BD and WMTA blocks were applied on dentine, and the shear bond strengths were measured using a universal testing machine.The microleakage was lowest in TLC + GIC, TLC + RMGI, TLC + CR, and BD + GIC groups and highest in WMTA + RMGI and WMTA + CR groups. The shear bond strength of BD group was the highest and that of WMTA group was significantly lower than the others.
Crowns ; Dental Pulp Capping ; Dentin ; Glass Ionomer Cements ; Immersion ; Incisor ; Pemetrexed ; Pulp Capping and Pulpectomy Agents ; Rosaniline Dyes

Endodontic treatment of primary molars is a great challenge to the dentists because of their complex morphology. However, there have been limited controlled in vivo studies about filling materials for primary teeth. Hence, the aim of this study is to evaluate and compare histologic responses of different calcium hydroxide canal filling materials that are used in daily clinical practice.Pulpectomies were performed in 132 teeth of the dogs. The root canals were randomly filled with either Vitapex® (n = 44), Metapex® (n = 44), or Metapaste® (n = 44). After 4 or 13 weeks, respectively after operation, the dogs were sacrificed, and teeth were processed for histologic examinations. Inflammatory reaction was evaluated and scored in a blind manner. The Fisher's exact test and Kruskal-Wallis test were used to compare the tested groups.In 4-week-group, all inflammatory responses were in normal range except for fibrosis. In 13-week-group, increased response to various inflammation reaction was shown compared to the 4-week-group. However, there were no statically significant differences between the tested groups in all inflammatory reaction.Overall, there were no significant differences among three materials in responses of apical tissues and all of them showed favorable tissue responses.
Animals ; Calcium Hydroxide ; Dental Pulp Cavity ; Dentists ; Dogs ; Fibrosis ; Humans ; Inflammation ; Molar ; Pulpectomy ; Reference Values ; Tooth ; Tooth, Deciduous

PURPOSE: Tooth injuries are common complaints presenting at emergency departments, so emergency physicians (EP) should play an important role in the initial care of dental trauma. However, there has been little interest in and research on this subject. Examining the various clinical factors helpful for the emergency physician's care of tooth injuries, we attempted to acquire basic data for establishing treatment guideline. METHODS: A retrospective analysis was done by reviewing the dental charts of 214 patients who presented to the emergency departments of one secondary hospital and one tertiary hospital following tooth injuries during a 1-year period (Oct. 2000-Sept. 2001). The following variables were extracted and examined: age, mechanism of injury, number and location of injured teeth, radiograph performance, diagnosis, type of treatment. RESULTS: With the 1992-WHO classification, 9 types of tooth injuries were found (multiple response): in adults, concussion (23.5% of cases), subluxation (16.7%), pulp-exposed crown fracture (16.7%), avulsion (10.8%), and non-pulpexposed crown fracture(15.7%); in children, subluxation (20.2%), luxation (17.2%), avulsion (17.2%), and concussion (11.1%), Seven types of treatment were performed based on single most difficult treatment recorded per patient: 91 conservative cares (42.5% of cases), 9 pulp cappings (4.2%), 49 splints (22.9%), 7 replantations (3.3%), 17 pulpectomies (7.9%), 30 extractions (14.0%), and 10 others. CONCLUSION: Considering that the most prevalent treatments were splints and conservative cares, we think emergency medicine could play a wide role in the initial management of tooth injuries and suggest a further co-study with a dentist.
Adult ; Child ; Classification ; Crowns ; Dental Pulp Capping ; Dentists ; Diagnosis ; Emergencies* ; Emergency Medicine ; Emergency Service, Hospital* ; Humans ; Pulpectomy ; Replantation ; Retrospective Studies ; Splints ; Tertiary Care Centers ; Tooth Injuries* ; Tooth*

The long-term effect of direct pulp capping and pulpotomy is closely related to the type of pulp capping materials. Various kinds of direct pulp capping materials are available, such as calcium hydroxide and mineral trioxide aggregates. Diverse new pulp capping materials have been reported recently. The excellent performance of calcium silicates has attracted much attention in previous studies. Moreover, enamel matrix derivative (Emdogain), which is capable of regeneration and remineralization, and other materials with similar capabilities have shown potential for use in pulp capping.
Aluminum Compounds ; Calcium Compounds ; Calcium Hydroxide ; Dental Pulp ; Dental Pulp Capping ; Drug Combinations ; Oxides ; Pulp Capping and Pulpectomy Agents ; Pulpotomy ; Root Canal Therapy ; Silicates

The purpose of this study was to investigate the distribution of neuropeptide Y (NPY) in the cat spinal trigeminal subnucleus caudalis following pulpectomy of mandibular premolars and molar by means of an immunohistochemical and immunoelectron microscopic study. The animals were divided into normal and experimental group which were sacrificed at 14 days after pulpectomy. The results were as follows; 1. On the light microscopic observation of the spinal trigeminal subnucleus caudalis in normal group, NPY-immunoreactivity (IR) was weak within lamina I and lamina II outer. In pulpectomy group, NPY-IR was strong and appeared to extend into lamina I and lamina II inner at 14 days. 2. On the immunoelectron microscopic observation of the spinal trigeminal subnucleus caudalis in normal group, NPY-IR was revealed in axon terminals, dendrites, myelinated axons and unmyelinated axons. NPY-IR was associated with membrane structures within microtubules, synaptic vesicles, outer membrane of mitochondria and inner surface of the axolemma. In NPY-immunoreactive structure, there was a small amount of DAB precipita-tions. 3. On the immunoelectron microscopic observation of the spinal trigeminal subnucleus caudalis at 14 days in pulpectomy group, the number of NPY-immunoreactive axon terminals, dendrites, myelinated axons and unmyelinated axons was increased than normal group. DAB precipitations in NPY-immunoreactive structure was increased than normal group. Some NPY-immunoreactive axon terminal formed synaptic glomerulus and axoaxonic synapse. 4. The results indicate that NPY-IR was increased in the spinal trigeminal subnucleus caudalis after pulpectomy, and it is speculated that the increased NPY by injury of peripheral nerve may participate in the processing of nociception.
Animals ; Axons ; Bicuspid ; Cats* ; Dendrites ; Immunohistochemistry ; Membranes ; Microtubules ; Mitochondria ; Molar ; Myelin Sheath ; Neuropeptide Y* ; Neuropeptides* ; Nociception ; Peripheral Nerves ; Presynaptic Terminals ; Pulpectomy* ; Synapses ; Synaptic Vesicles

BACKGROUND: This study evaluated the efficacy of virtual reality (VR) distraction and counter-stimulation (CS) on dental anxiety and pain perception to local anesthesia in children. METHODS: A prospective, randomized, single-blinded interventional clinical trial with a parallel design was used. Seventy children 7–11 years old who required local anesthesia (LA) for pulp therapy or tooth extraction were recruited and allocated to two groups with equal distribution based on the intervention. Group CS (n = 35) received CS and Group VR (n = 35) received VR distraction with ANTVR glasses. Anxiety levels (using pulse rate) were evaluated before, during, and after administration of local anesthesia, while pain perception was assessed immediately after the injection. Wong-Baker faces pain-rating scale (WBFPS), visual analog scale (VAS), and Venham's clinical anxiety rating scale (VCARS) were used for pain evaluation. Student's t-test was used to test the mean difference between groups, and repeated measures ANOVA was used to test the mean difference of pulse rates. RESULTS: Significant differences in mean pulse rates were observed in both groups, while children in the VR group had a higher reduction (P < 0.05), and the mean VCARS scores were significant in the VR group (P < 0.05). Mean WBFPS scores showed less pain perception to LA needle prick in the CS group while the same change was observed in the VR group with VAS scores. CONCLUSIONS: VR distraction is better than CS for reducing anxiety to injection in children undergoing extraction and pulpectomy.
Anesthesia, Local ; Anxiety ; Child ; Dental Anxiety ; Eyeglasses ; Glass ; Heart Rate ; Humans ; Needles ; Pain Perception ; Prospective Studies ; Pulpectomy ; Tooth Extraction ; Visual Analog Scale

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