Permanent molar pulpotomy with a new endodontic cement: A case series

Iranian Center for Endodontic Research, Dental Research Center, Dental School, Tehran, Iran.
Journal of Conservative Dentistry 04/2009; 12(1):31-6. DOI: 10.4103/0972-0707.53340
Source: PubMed


The aim of this case series was to determine the clinical and radiographic success rate of pulpotomy, with new endodontic cement (NEC), in human mature permanent molar teeth. Twelve molars with established irreversible pulpitis were selected from patients 14 - 62 years old. The selection criteria included carious pulp exposure with a positive history of lingering pain. After isolation, caries removal, and pulp exposure, pulpotomy with NEC was performed and a permanent restoration was immediately placed. At the first recall (+1 day) no patients reported postoperative pain. One wisdom tooth had been extracted after two months because of failure in coronal restoration. Eleven patients were available for the second recall, with a mean time of 15.8 months. Clinical and radiographic examination revealed that all teeth were functional and free of signs and symptoms. Histological examination of the extracted teeth revealed complete dentin bridge formation and a normal pulp. Although the results favored the use of NEC, more studies with larger samples and a longer recall period were suggested, to justify the use of this novel material for treatment of irreversible pulpitis in human permanent molar teeth.

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Available from: Saeed Asgary, Apr 04, 2014
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    • "It appears that CEM cement can be used as a pulpotomy material in permanent teeth with open apices [27] and also in mature and primary teeth [28] [29]. This cement can be used for management of internal root resorption and repair of furcal perforation [30] [31]. As this material is used for endodontic treatment, the effect of CEM cement on the mechanical properties of teeth substrates during its application could help clinicians improve their clinical procedure. "
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    ABSTRACT: Introduction: Many of highly-alkaline dental materials have some adverse effects on physical properties of dentin. As basic substances, mineral trioxide aggregate (MTA), calcium hydroxide (CH) and the new endodontic material, calcium-enriched mixture (CEM) cement, may adversely affect dentin. The purpose of this in vitro study was to evaluate the effect of long-term application of CEM cement, MTA and CH on flexural strength of bovine dentin. Materials and methods: Three hundred and twenty bovine dentin samples were divided into 4 groups, which were either exposed to CEM cement, CH, MTA or normal saline (control group). Samples of each group were divided into 4 subgroups which were tested by means of Instron Universal Testing Machine for periods of 7, 30, 180 and 365 days after exposure to the test materials. The required force for sample breakage was recorded. The data were analyzed by the two-way ANOVA and Tukey tests. Results: The mean value of forces to break the samples in CEM cement and CH groups was significantly lower than the control group after 1 month (P<0.05). After 180 days, the samples of CEM cement group retrieved their strength but in MTA and CH groups the time interval weakened the samples. After one year of exposure to CH and MTA, flexural strength of the dentin reduced to 72% and 38.7%, respectively (P<0.05). Yet the flexural strength of samples in CEM cement group did not change significantly compared to control group. Conclusion: Following 365 days of application of experimental materials to bovine dentin, the CEM cement showed an interesting result and the samples in this group reached their initial strength during the first week of the study but the other materials caused a reduction in dentin strength at the end of the study.
    Iranian Endodontic Journal 07/2014; 9(3):185-9.
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    • "In a case series study of 12 permanent mature molars with irreversible pulpitis, CEM was used for pulpotomy, and resulted in complete success at a 16-month follow-up. It was also shown that to enable improved regeneration, the pulp-dentin complex had isolated itself by forming a calcified bridge [73]. In a multicenter randomized clinical trial in 23 dental centers linked to five medical universities in Iran, pulpotomy treatment of mature permanent molars diagnosed with irreversible pulpitis was performed using CEM and MTA. "
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    ABSTRACT: Vitality of dental pulp is essential for long-term tooth survival. The aim of vital pulp therapy is to maintain healthy pulp tissue by eliminating bacteria from the dentin-pulp complex. There are several different treatment options for vital pulp therapy in extensively decayed or traumatized teeth. Pulp capping or pulpotomy procedures rely upon an accurate assessment of the pulp status, and careful management of the remaining pulp tissue. The purpose of this review is to provide an overview of new approaches in vital pulp therapy in permanent teeth.
    Iranian Endodontic Journal 01/2014; 9(1):15-22.
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    • "It is thought that subsequent to periradicular surgery, mesenchymal cells initiate the healing process by differentiating into mature cells such as osteoblasts, fibroblasts, or cementoblasts thus inducing osseous regeneration and apical attachment healing [16, 17]. The favorable treatment outcomes for CEM cement in this study can be due to its good sealing ability [15], antibacterial activity, high alkalinity [16], hydroxyapatite formation [28], low cytotoxicity [29], biocompatibility [30], and induction of hard tissue formation [31, 32]. Biomaterials may help to make IR a more standard form of therapy, in the right hands. "
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    ABSTRACT: This case series aims to comprehensively introduce intentional replantation with a focus on its indications and case selection in endodontics. In all represented cases, calcium enriched mixture (CEM) cement is used for root-end filling. This case series demonstrates twenty cases of IR and extraoral root-end resection and filling with CEM cement. All the selected teeth had a failed endodontic treatment and required surgical/nonsurgical endodontic (re)treatment or extraction. Subsequent to gentle tooth extraction, an appropriate root-end cavity was prepared and filled with CEM cement. Then the tooth was replanted; maximun procedure time was 15 min. A total of 18 cases (90%) were successful over a mean follow-up period of 15.5 months. It can be concluded that intentional replantation with careful case selection can have a high success rate over 2 years. Intentional replantation may be a suitable treatment option for both trained general practitioners and specialists provided that the extraction is simple and straightforward.
    Iranian Endodontic Journal 01/2014; 9(1):71-8.
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