Dental Pulp Capping ; Humans ; Pulpotomy

Internal root resorption is a pathologic phenomenon with a characterization of the intraradicular dentin destruction due to the abnormal activities of odontoclasts. With its insidious pathology, internal root resorption can progress to a great extent before its clinical detection. The etiology and natural history of internal root resorption are uncertain and the associated key molecular pathogenesis have not been understood completely. The resorption is usually initiated by a stimulus with the loss of the protective predentin and progressed by the continuous stimuli of pulp infection. Various factors including trauma, chronic inflammation of the pulp, pulpotomy and tooth transplantation have been proposed for the occurrence of internal root resorption. The present paper reviews the etiology and pathogenesis of internal root resorption and provides guidance for the early intervention in the clinical practice.
Humans ; Pulpotomy ; Root Resorption/etiology*

Paraformaldehyde has been used in the past as a pulpotomy agent. However, it has a severe cytotoxic effect and may cause alveolar bone necrosis. Depulpin, a devitalizing agent containing 49% paraformaldehyde, is no longer used frequently due to its severe side effects. In the two cases described in the present study, Depulpin was used as a devitalizing agent during root canal treatment. It caused a gradual loss of sensibility in adjacent teeth, gingival necrosis, and osteomyelitis. This case report demonstrates the serious side effects of using a paraformaldehyde-containing paste as a devitalizing agent for pulp, particularly mandibular bone necrosis.
Dental Pulp Cavity ; Necrosis* ; Osteomyelitis ; Pulpotomy ; Tooth

Traumatic injuries to an immature permanent tooth may result in cessation of dentin deposition and root maturation. Endodontic treatment is often complicated in premature tooth with an uncertain prognosis. This article describes successful treatment of two traumatized maxillary central incisors with complicated crown fracture three months after trauma. The radiographic examination showed immature roots in maxillary central incisors of a 9-year-old boy with a radiolucent lesion adjacent to the right central incisor. Apexogenesis was performed for the left central incisor and revascularization treatment was considered for the right one. In 18-month clinical and radiographic follow-up both teeth were asymptomatic, roots continued to develop, and periapical radiolucency of the right central incisor healed. Considering the root development of these contralateral teeth it can be concluded that revascularization is an appropriate treatment method in immature necrotic teeth.
Apexification ; Crowns ; Dentin ; Follow-Up Studies ; Incisor ; Prognosis ; Pulpotomy ; Tooth

The ultimate goal of a regenerative pulp treatment strategy is to reconstitute normal tissue continuum at the pulp-dentin border, regulating tissue-specific processes of reparative dentinogenesis. However, little is known about the molecular mechanism of reparative dentinogenesis. The purpose of this study was to investigate the pulpal response after direct pulp capping and pulpotomy with mineral trioxide aggregate (MTA) by histological and immunohistochemical studies. There was continuous reparative dentin bridge formation at 2 weeks after treatment with MTA in both the pulp capping and the pulpotomy groups. The cells in the pulp capping group showed typical odontoblast characteristics, while the cells of reparative dentin in pulpotomy group were round in shape, lost their polarity, organized as a sheet of cells, and trapped in osteodentin-like mineralized tissue. In pulp capping group, upper layer of the reparative dentin showed cell lacunae indicating osteoblastic characteristics, whereas lower layer of the reparative dentin contained predentin and dentinal tubule-like structures as normal dentin. However, there was osteodentin formation in pulpotomy group. DSP protein was expressed at 4 weeks in odontoblasts of pulp capping group, while BSP was expressed at 4 weeks after pulpotomy. These results suggest that two different types of reparative dentin formation, dentin-like and bone-like dentin, may depend on the type and extent of the injury and the effect of the associated defense reaction on the structural and functional integrity at the dentin-pulp border.
Dental Pulp Capping* ; Dentin* ; Dentinogenesis ; Odontoblasts ; Osteoblasts ; Pulpotomy* ; Pemetrexed

In recent years, great progress has been made in research on the treatment of pulpitis, mainly due to the rapid development of basic and clinical researches in this field, and some achievement from basic research has been applied in clinical practice. Advances in the diagnostic methods for pulpitis can help the clinicians to recognize the true state of pulpitis more accurately and to adopt the corresponding treatment methods including indirect/direct pulp capping, pulpotomy, pulp regeneration and root canal therapy. The new theory of pulpitis diagnosis and the studies on immune defense, repair function of dental pulp and new pulp capping materials have significantly improved the success rate of vital pulp therapy. For diffuse coronary pulpitis or radicular pulpitis, which is difficult to achieve vital pulp therapy successfully, methods of pulp revascularization, cell homing and pulp stem cells-mediated pulp regeneration can also be used as treatment options in addition to root canal therapy. The present article focuses on the research progress on pulpitis treatments and related clinical transformation practices, in order to provide reference on vital pulp therapy and pulp regeneration for clinicians.
Dental Pulp ; Dental Pulp Capping ; Humans ; Pulpitis/therapy* ; Pulpotomy ; Regeneration

The purpose of this study was to investigate whether rhBMP-2 (BMP2) could induce synergistic effect with Pro-Root(R) MTA (MTA) in pulpotomized teeth in the rats. Healthy upper first molars from thirty-two, 10 weeks old, Sprague-Dawley rats were used for this investigation. The molars were exposed with round bur, and light pressure was applied with sterilized cotton to control hemorrhage. 1.2 grams of MTA cement was placed in right first molars as a control group. In left first molars, 1 microg of BMP2 was additionally placed on exposed pulps with MTA. All cavities were back-filled with light-cured glass-ionomer cements. The rats were sacrificed after 2 weeks and 7 weeks, respectively. Then histologic sections were made and assessed by light microscopy. Data were statistically analyzed via student t-test with SPSSWIN 12.0 program (p < 0.05). Inflammation observed in 2 weeks groups were severe compared to the 7 weeks groups. But the differences were not statistically significant. BMP2-addition groups had less inflammation than MTA groups in both periods, though these differences were also not statistically significant. In conclusion, the combination of BMP2 and MTA showed no differences with MTA only for pulpotomy of rat teeth.
Animals ; Hemorrhage ; Humans ; Inflammation ; Microscopy ; Molar ; Pulpotomy ; Rats* ; Rats, Sprague-Dawley ; Tooth* ; Pemetrexed

OBJECTIVETo investigate the stimulation of Cinnamaldehyde to the pulp tissue and the periapical tissue of rats' teeth, to provide evidence for developing Cinnamaldehyde as a pulp-cap of pulpotomy in primary teeth.

METHODSUsing Cinnamaldehyde as pulp-cap in pulpotomy of rats' teeth, set up Cinnamaldehyde group, formaldehyde cresol formocresol group and blank group. After different treatment according to the empirical procedure, rats were killed in the 4th week and on the 12th week. Then the experiment teeth and the periodontal tissue were made into HE slides and observed using light microscope.

RESULTSThe 4" week, internal absorption, external absorption, and calcification were of no significance among all the groups. Inflammation in blank group was far more severe than that in other two groups (P<0.05), while the latter two were of no significance. The 12th week, internal absorption, external absorption, and inflammation between the former two groups were of no differences, but the indexes were significantly different from them of the blank group (P<0.005). Calcify was not obvious in all the slides.

CONCLUSIONAs a pulp-cap, Cinnamaldehyde stimulates the pulp tissue and the periapical tissue at a very low level. The research provides histopathology rationale for Cinnamaldehyde as pulp-cap of pulpotomy in primary teeth.

Acrolein ; analogs & derivatives ; Animals ; Dental Pulp ; Formocresols ; Pulpotomy ; Rats ; Tooth, Deciduous

OBJECTIVETo observe the histological and immunohistochemical characteristics of the pulp of teeth after pulpotomy.

METHODSTwenty-nine permanent anterior teeth with completely formed roots after pulpotomy due to dental trauma were selected. Thirty permanent premolars with completely formed roots served as control, which were extracted for orthodontic treatment. HE stain and immunohistochemical study of collagen I and collagen III were performed on the root pulp of these two groups.

RESULTSThere were degenerative changes in root pulp of the teeth after pulpotomy, such as vacuolization and homogenization of the odontoblasts, cell reduction, fibrosis, hyaline degeneration and calcification. In healthy root pulp, collagen I had a dispersed distribution, calcification substance was stained positive, but collagen III weakly stained in the extreme at peripheric pulp, and calcification substance stained negative. While in pulp of teeth after pulpotomy, both types of collagens had increased expression, fibers aggregated forming thick fiber bundles. In the wall of blood vessels collagen I had increased expression, but collagen III decreased.

CONCLUSIONSThe root pulp below dentin bridge after pulpotomy was different from the healthy pulp, and there were some histological degenerative changes in the pulp of the immature anterior teeth after pulpotomy. It is suggested that root canal treatment should eventually be performed on these teeth.

Child ; Collagen ; metabolism ; Dental Pulp ; metabolism ; pathology ; Female ; Humans ; Immunohistochemistry ; Male ; Pulpotomy ; Staining and Labeling

OBJECTIVES: The purpose of this study was to evaluate the efficacy of mineral trioxide aggregate (MTA), Biodentine and Propolis as pulpotomy medicaments in primary dentition, both clinically and radiographically. MATERIALS AND METHODS: A total of 75 healthy 3 to 10 yr old children each having at least one carious primary molar tooth were selected. Random assignment of the pulpotomy medicaments was done as follows: Group I, MTA; Group II, Biodentine; Group III, Propolis. All the pulpotomized teeth were evaluated at 3, 6, and 9 mon clinically and radiographically, based on the scoring criteria system. RESULTS: The clinical success rates were found to be similar among the three groups at 3 and 6 mon where as a significant decrease in success rate was observed in Group III (84%) compared to both Group I (100%) and Group II (100%) at 9 mon. Radiographic success rates over a period of 9 mon in Groups I, II, and III were 92, 80, and 72%, respectively. CONCLUSIONS: Teeth treated with MTA and Biodentine showed more favorable clinical and radiographic success as compared to Propolis at 9 mon follow-up.
Child ; Follow-Up Studies ; Humans ; Molar ; Propolis* ; Pulpotomy* ; Tooth ; Tooth, Deciduous* ; Pemetrexed