Pulpal response of primary and permanent teeth to various pulpotomy agents - A Systematic Review
Main Article Content
Keywords
pulpal response, pulpotomy, diseases, quality of life
Abstract
Context: Vital pulp therapy is the treatment of choice for treating reversible pulpal injuries in both primary and permanent teeth for maintaining pulp vitality and function. Rationale of this treatment is based on the healing ability of the healthy pulp. Pulpotomy is vital pulp therapy in which a portion of vital coronal pulp tissue is removed surgically and the remaining radicular dental pulp is covered with a suitable material that protects the pulp from further injury and promotes healing.
Aim: To histologically evaluate the pulpal response of teeth treated with pulpotomy..
Methods and Material: The search identified 20 publications out of which 14 were excluded. Out of the 14 studies excluded, 3 were animal studies, 5 studies were on pulp capping and in 6 studies histological analysis was not done. The number of articles included were eight. The outcomes evaluated were dentin bridge formation, soft tissue changes, inflammatory changes. A detailed search was done in five databases namely Pubmed, Scopus, Cochrane, Lilacs and Science Direct.
Results: Within the limitations of the study, it may be concluded that biodentine had a similar effect of dentin bridge formation like MTA and both showed less pulpal response and inflammation. Formocresol, Theracal and ferric sulfate on the other hand, caused more pulpal inflammation with almost negligible dentin bridge formation.
Conclusion: MTA and Biodentine had similar results. The average follow up of various studies were 8 weeks to 6 months. In order to get more accurate results, longer follow up periods and more number of clinical trials are to be conducted.
References
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Pulpotomies in Primary Teeth.” International Endodontic Journal 41 (7): 547–55.
19. Nandakumar, Mahalakshmi, and Iffat Nasim. 2020. “Effect of Intracanal Cryotreated Sodium Hypochlorite on Postoperative Pain after Root Canal Treatment - A Randomized Controlled Clinical Trial.” Journal of Conservative Dentistry: JCD 23 (2): 131–36.
20. Nematollahi, Hossein, Homa Noorollahian, Ali Bagherian, Mahsa Yarbakht, and Samane Nematollahi. 2018. “Mineral Trioxide Aggregate Partial Pulpotomy Versus Formocresol Pulpotomy: A Randomized, Split-Mouth, Controlled Clinical Trial with 24 Months Follow-Up.” Pediatric Dentistry 40 (3): 184–89.
21. Nguyen, Trang D., Peter L. Judd, Edward J. Barrett, Nicole Sidhu, and Michael J. Casas. 2017. “Comparison of Ferric Sulfate Combined Mineral Trioxide Aggregate Pulpotomy and Zinc Oxide Eugenol Pulpectomy of Primary Maxillary Incisors: An 18-Month Randomized, Controlled Trial.” Pediatric Dentistry 39 (1): 34–38.
22. Nishanthine, Cruz, Revathi Miglani, Indira R, Saravanan Poorni, Manali Ramakrishnan Srinivasan, Ali Robaian, Nassreen Hassan Mohammad Albar, et al. 2022. “Evaluation of Fluoride Release in Chitosan-Modified Glass Ionomer Cements.” International Dental Journal 72 (6): 785–91.
23. Nowicka, Alicja, Mariusz Lipski, Mirosław Parafiniuk, Katarzyna Sporniak-Tutak, Damian Lichota, Anita Kosierkiewicz, Wojciech Kaczmarek, and Jadwiga Buczkowska-Radlińska. 2013. “Response of Human Dental Pulp Capped with Biodentine and Mineral Trioxide Aggregate.” Journal of Endodontia 39 (6): 743–47.
24. Olatosi, O. O., E. O. Sote, and O. O. Orenuga. 2015. “Effect of Mineral Trioxide Aggregate and Formocresol Pulpotomy on Vital Primary Teeth: A Clinical and Radiographic Study.” Nigerian Journal of Clinical Practice 18 (2): 292–96.
25. Pandiyan, Indumathy, Sakthi D. Sri, Meignana Arumugham Indiran, Pradeep Kumar Rathinavelu, Jayashri Prabakar, and S. Rajeshkumar. 2022. “Antioxidant, Anti-Inflammatory Activity of Thymus Vulgaris-Mediated Selenium Nanoparticles: An in Vitro Study.” Journal of Conservative Dentistry: JCD 25 (3): 241–45.
26. Petrou, Marina Agathi, Fadi Alhaddad Alhamoui, Alexander Welk, Mohammed Basel Altarabulsi, Mohammed Alkilzy, and ChristianH Splieth. 2014. “A Randomized Clinical Trial on the Use of Medical Portland Cement, MTA and Calcium Hydroxide in Indirect Pulp Treatment.” Clinical Oral Investigations 18 (5): 1383–89.
27. Prabakar, Jayashri, Meignana A. Indiran, Pradeep Kumar, Srisakthi Dooraikannan, and Ganesh Jeevanandan. 2020. “Microleakage Assessment of Two Different Pit and Fissure Sealants: A Comparative Confocal Laser Scanning Microscopy Study.” International Journal of Clinical Pediatric Dentistry 13 (Suppl 1): S29–33.
28. Ravikumar, Dhanalakshmi, Mahesh R, Sharna Ningthoujam, Waikhom Robindro, Gayathri R, and Vishnu Priya V. 2018. “Genotypic Characterization of Streptococcus Mutans in Child-Mother Pair-A PCR Based Study.” Journal of Oral Biology and Craniofacial Research 8 (3): 225–30.
29. Sakai, Vivien Thiemy, A. B. S. Moretti, T. M. Oliveira, A. P. C. Fornetti, C. F. Santos, M. A. A. M. Machado, and R. C. C. Abdo. 2009. “Pulpotomy of Human Primary Molars with MTA and Portland Cement: A Randomised Controlled Trial.” British Dental Journal 207 (3): E5; discussion 128–29.
30. Shayegan, Amir, Michel Petein, and Astrid Vanden Abbeele. 2008. “Beta-Tricalcium Phosphate, White Mineral Trioxide Aggregate, White Portland Cement, Ferric Sulfate, and Formocresol Used as Pulpotomy Agents in Primary Pig Teeth.” Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontics 105 (4): 536–42.
31. Silva, Lidiane Lucas Costa E., Leopoldo Cosme-Silva, Vivien Thiemy Sakai, Camila Soares Lopes, Ana Paula Pereira da Silveira, Rafael
Tobias Moretti Neto, João Eduardo Gomes-Filho, Thais Marchini Oliveira, and Ana Beatriz da Silveira Moretti. 2019. “Comparison between Calcium Hydroxide Mixtures and Mineral Trioxide Aggregate in Primary Teeth Pulpotomy: A Randomized Controlled Trial.” Journal of Applied Oral Science: Revista FOB 27 (May): e20180030.
32. Srinivasan, Daya, and M. Jayanthi. 2011. “Comparative Evaluation of Formocresol and Mineral Trioxide Aggregate as Pulpotomy Agents in Deciduous Teeth.” Indian Journal of Dental Research: Official Publication of Indian Society for Dental Research 22 (3): 385–90.
33. Subramanyam, Divya, and Sujatha Somasundaram. 2020. “Clinical and Radiographic Evaluation of Aloe Vera vs Formocresol as a Pulpotomy Medicament in Primary Molars: A Double Blinded Randomized Controlled Trial.” International Journal of Clinical Pediatric Dentistry 13 (2): 138–43.
34. Torabinejad, M., M. Parirokh, and P. M. H. Dummer. 2018. “Mineral Trioxide Aggregate and Other Bioactive Endodontic Cements: An Updated Overview - Part II: Other Clinical Applications and Complications.” International Endodontic Journal 51 (3): 284–317.
35. W, Meslmani, W. Meslmani, MSc Department of Pediatric Dentistry, faculty of dentistry, Damascus University, Al-Mazzeh St. Damascus, and Syria. 2020. “Evaluation of Modified Portland Cement versus Mineral Trioxide Aggregate as a Pulpotomy Agent in Primary Molars: Histological Study.” International Journal of Dentistry and Oral Science. https://doi.org/10.19070/2377-8075-20000145.
2. Asgary, Saeed, Raheleh Hassanizadeh, Hassan Torabzadeh, and Mohammad Jafar Eghbal. 2018. “Treatment Outcomes of 4 Vital Pulp Therapies in Mature Molars.” Journal of Endodontia 44 (4): 529–35.
3. Awawdeh, Lama, Aladdin Al-Qudah, Hanan Hamouri, and Rosalie Jean Chakra. 2018. “Outcomes of Vital Pulp Therapy Using Mineral Trioxide Aggregate or Biodentine: A Prospective Randomized Clinical Trial.” Journal of Endodontia 44 (11): 1603–9.
4. Bakhtiar, Hengameh, Pouyan Aminishakib, Mohammad Reza Ellini, Fereshteh Mosavi, Fatemeh Abedi, Samar Esmailian, Ehsan Esnaashari, et al. 2018. “Dental Pulp Response to RetroMTA after Partial Pulpotomy in Permanent Human Teeth.” Journal of Endodontia 44 (11): 1692–96.
5. Bakhtiar, Hengameh, Mohammad Hossein Nekoofar, Pouyan Aminishakib, Fatemeh Abedi, Fereshteh Naghi Moosavi, Ehsan Esnaashari, Arash Azizi, et al. 2017. “Human Pulp Responses to Partial Pulpotomy Treatment with TheraCal as Compared with Biodentine and ProRoot MTA: A Clinical Trial.” Journal of Endodontia 43 (11): 1786–91.
6. Bhagat, Dipti, Ravi Kadur Sunder, Shashikiran Nandihalli Devendrappa, Amit Vanka, and Nidhi Choudaha. 2016. “A Comparative Evaluation of ProRoot Mineral Trioxide Aggregate and Portland Cement as a Pulpotomy Medicament.” Journal of the Indian Society of Pedodontics and Preventive Dentistry 34 (2): 172–76.
7. Brizuela, Claudia, Andrea Ormeño, Carolina Cabrera, Roxana Cabezas, Carolina Inostroza Silva, Valeria Ramírez, and Montse Mercade. 2017. “Direct Pulp Capping with Calcium Hydroxide, Mineral Trioxide Aggregate, and Biodentine in Permanent Young Teeth with Caries: A Randomized Clinical Trial.” Journal of Endodontia 43 (11): 1776–80.
8. Carti, O., and F. Oznurhan. 2017. “Evaluation and Comparison of Mineral Trioxide Aggregate and Biodentine in Primary Tooth Pulpotomy: Clinical and Radiographic Study.” Nigerian Journal of Clinical Practice 20 (12): 1604–9.
9. Çelik, Burcu Nihan, Merve Safa Mutluay, Volkan Arıkan, and Şaziye Sarı. 2019. “The Evaluation of MTA and Biodentine as a Pulpotomy Materials for Carious Exposures in Primary Teeth.” Clinical Oral Investigations 23 (2): 661–66.
10. Cuadros-Fernández, C., A. I. Lorente Rodríguez, S. Sáez-Martínez, J. García-Binimelis, I. About, and M. Mercadé. 2016. “Short-Term Treatment Outcome of Pulpotomies in Primary Molars Using Mineral Trioxide Aggregate and Biodentine: ARandomized Clinical Trial.” Clinical Oral Investigations 20 (7): 1639–45.
11. De Rossi, Andiara, Lea Assed Bezerra Silva, Patrícia Gatón-Hernández, Manoel Damião Sousa-Neto, Paulo Nelson-Filho, Raquel Assed Bezerra Silva, and Alexandra Mussolino de Queiroz. 2014. “Comparison of Pulpal Responses to Pulpotomy and Pulp Capping with Biodentine and Mineral Trioxide Aggregate in Dogs.” Journal of Endodontia 40 (9): 1362–69.
12. Divya, S., Ganesh Jeevanandan, S. Sujatha, E. M. G. Subramanian, and Vignesh Ravindran. 2019. “Comparison of Quality of Obturation and Post-Operative Pain Using Manual vs Rotary Files in Primary Teeth - A Randomised Clinical Trial.” Indian Journal of Dental Research: Official Publication of Indian Society for Dental Research 30 (6): 904–8.
13. Erfanparast, L., P. Iranparvar, and A. Vafaei. 2018. “Direct Pulp Capping in Primary Molars Using a Resin-Modified Portland Cement-Based Material (TheraCal) Compared to MTA with 12-Month Follow-up: A Randomised Clinical Trial.” European Archives of Paediatric Dentistry: Official Journal of the European Academy of Paediatric Dentistry 19 (3): 197–203.
14. Hegde, Swaroop, B. Sowmya, Sylvia Mathew, Shilpa H. Bhandi, Shruthi Nagaraja, and K. Dinesh. 2017. “Clinical Evaluation of Mineral Trioxide Aggregate and Biodentine as Direct Pulp Capping Agents in Carious Teeth.” Journal of Conservative Dentistry: JCD 20 (2): 91–95.
15. Janani, Krishnamachari, Kavalipurapu Venkata Teja, and P. Ajitha. 2021. “Cytotoxicity of Oregano Essential Oil and Calcium Hydroxide on L929 Fibroblast Cell: A Molecular Level Study.” Journal of Conservative Dentistry: JCD 24 (5): 457–63.
16. Kang, C-M, S-H Kim, Y. Shin, H-S Lee, J-H Lee, G. T. Kim, and J. S. Song. 2015. “A Randomized Controlled Trial of ProRoot MTA, OrthoMTA and RetroMTA for Pulpotomy in Primary Molars.” Oral Diseases 21 (6): 785–91.
17. Li, Yuanyuan, Bingdong Sui, Christian Dahl, Brian Bergeron, Peter Shipman, Lina Niu, Jihua Chen, and Franklin R. Tay. 2019. “Pulpotomy for Carious Pulp Exposures in Permanent Teeth: A Systematic Review and Meta-Analysis.” Journal of Dentistry 84 (May): 1–8.
18. Moretti, A. B. S., V. T. Sakai, T. M. Oliveira, A. P. C. Fornetti, C. F. Santos, M. A. A. M. Machado, and R. C. C. Abdo. 2008. “The Effectiveness of Mineral Trioxide Aggregate, Calcium Hydroxide and Formocresol for
Pulpotomies in Primary Teeth.” International Endodontic Journal 41 (7): 547–55.
19. Nandakumar, Mahalakshmi, and Iffat Nasim. 2020. “Effect of Intracanal Cryotreated Sodium Hypochlorite on Postoperative Pain after Root Canal Treatment - A Randomized Controlled Clinical Trial.” Journal of Conservative Dentistry: JCD 23 (2): 131–36.
20. Nematollahi, Hossein, Homa Noorollahian, Ali Bagherian, Mahsa Yarbakht, and Samane Nematollahi. 2018. “Mineral Trioxide Aggregate Partial Pulpotomy Versus Formocresol Pulpotomy: A Randomized, Split-Mouth, Controlled Clinical Trial with 24 Months Follow-Up.” Pediatric Dentistry 40 (3): 184–89.
21. Nguyen, Trang D., Peter L. Judd, Edward J. Barrett, Nicole Sidhu, and Michael J. Casas. 2017. “Comparison of Ferric Sulfate Combined Mineral Trioxide Aggregate Pulpotomy and Zinc Oxide Eugenol Pulpectomy of Primary Maxillary Incisors: An 18-Month Randomized, Controlled Trial.” Pediatric Dentistry 39 (1): 34–38.
22. Nishanthine, Cruz, Revathi Miglani, Indira R, Saravanan Poorni, Manali Ramakrishnan Srinivasan, Ali Robaian, Nassreen Hassan Mohammad Albar, et al. 2022. “Evaluation of Fluoride Release in Chitosan-Modified Glass Ionomer Cements.” International Dental Journal 72 (6): 785–91.
23. Nowicka, Alicja, Mariusz Lipski, Mirosław Parafiniuk, Katarzyna Sporniak-Tutak, Damian Lichota, Anita Kosierkiewicz, Wojciech Kaczmarek, and Jadwiga Buczkowska-Radlińska. 2013. “Response of Human Dental Pulp Capped with Biodentine and Mineral Trioxide Aggregate.” Journal of Endodontia 39 (6): 743–47.
24. Olatosi, O. O., E. O. Sote, and O. O. Orenuga. 2015. “Effect of Mineral Trioxide Aggregate and Formocresol Pulpotomy on Vital Primary Teeth: A Clinical and Radiographic Study.” Nigerian Journal of Clinical Practice 18 (2): 292–96.
25. Pandiyan, Indumathy, Sakthi D. Sri, Meignana Arumugham Indiran, Pradeep Kumar Rathinavelu, Jayashri Prabakar, and S. Rajeshkumar. 2022. “Antioxidant, Anti-Inflammatory Activity of Thymus Vulgaris-Mediated Selenium Nanoparticles: An in Vitro Study.” Journal of Conservative Dentistry: JCD 25 (3): 241–45.
26. Petrou, Marina Agathi, Fadi Alhaddad Alhamoui, Alexander Welk, Mohammed Basel Altarabulsi, Mohammed Alkilzy, and ChristianH Splieth. 2014. “A Randomized Clinical Trial on the Use of Medical Portland Cement, MTA and Calcium Hydroxide in Indirect Pulp Treatment.” Clinical Oral Investigations 18 (5): 1383–89.
27. Prabakar, Jayashri, Meignana A. Indiran, Pradeep Kumar, Srisakthi Dooraikannan, and Ganesh Jeevanandan. 2020. “Microleakage Assessment of Two Different Pit and Fissure Sealants: A Comparative Confocal Laser Scanning Microscopy Study.” International Journal of Clinical Pediatric Dentistry 13 (Suppl 1): S29–33.
28. Ravikumar, Dhanalakshmi, Mahesh R, Sharna Ningthoujam, Waikhom Robindro, Gayathri R, and Vishnu Priya V. 2018. “Genotypic Characterization of Streptococcus Mutans in Child-Mother Pair-A PCR Based Study.” Journal of Oral Biology and Craniofacial Research 8 (3): 225–30.
29. Sakai, Vivien Thiemy, A. B. S. Moretti, T. M. Oliveira, A. P. C. Fornetti, C. F. Santos, M. A. A. M. Machado, and R. C. C. Abdo. 2009. “Pulpotomy of Human Primary Molars with MTA and Portland Cement: A Randomised Controlled Trial.” British Dental Journal 207 (3): E5; discussion 128–29.
30. Shayegan, Amir, Michel Petein, and Astrid Vanden Abbeele. 2008. “Beta-Tricalcium Phosphate, White Mineral Trioxide Aggregate, White Portland Cement, Ferric Sulfate, and Formocresol Used as Pulpotomy Agents in Primary Pig Teeth.” Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontics 105 (4): 536–42.
31. Silva, Lidiane Lucas Costa E., Leopoldo Cosme-Silva, Vivien Thiemy Sakai, Camila Soares Lopes, Ana Paula Pereira da Silveira, Rafael
Tobias Moretti Neto, João Eduardo Gomes-Filho, Thais Marchini Oliveira, and Ana Beatriz da Silveira Moretti. 2019. “Comparison between Calcium Hydroxide Mixtures and Mineral Trioxide Aggregate in Primary Teeth Pulpotomy: A Randomized Controlled Trial.” Journal of Applied Oral Science: Revista FOB 27 (May): e20180030.
32. Srinivasan, Daya, and M. Jayanthi. 2011. “Comparative Evaluation of Formocresol and Mineral Trioxide Aggregate as Pulpotomy Agents in Deciduous Teeth.” Indian Journal of Dental Research: Official Publication of Indian Society for Dental Research 22 (3): 385–90.
33. Subramanyam, Divya, and Sujatha Somasundaram. 2020. “Clinical and Radiographic Evaluation of Aloe Vera vs Formocresol as a Pulpotomy Medicament in Primary Molars: A Double Blinded Randomized Controlled Trial.” International Journal of Clinical Pediatric Dentistry 13 (2): 138–43.
34. Torabinejad, M., M. Parirokh, and P. M. H. Dummer. 2018. “Mineral Trioxide Aggregate and Other Bioactive Endodontic Cements: An Updated Overview - Part II: Other Clinical Applications and Complications.” International Endodontic Journal 51 (3): 284–317.
35. W, Meslmani, W. Meslmani, MSc Department of Pediatric Dentistry, faculty of dentistry, Damascus University, Al-Mazzeh St. Damascus, and Syria. 2020. “Evaluation of Modified Portland Cement versus Mineral Trioxide Aggregate as a Pulpotomy Agent in Primary Molars: Histological Study.” International Journal of Dentistry and Oral Science. https://doi.org/10.19070/2377-8075-20000145.
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Published
May 13, 2023
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How to Cite
S B Divya, & M.S. Nivedhitha. (2023). Pulpal response of primary and permanent teeth to various pulpotomy agents - A Systematic Review. Journal of Population Therapeutics and Clinical Pharmacology, 30(10), 442–460. https://doi.org/10.47750/jptcp.2023.30.10.049
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