title: Comparison of mineral trioxide aggregate and calcium hydroxide as pulpotomy agents in young permanent teeth (apexogenesis). A clinical and histological evaluation of conservative pulpal therapy in human teeth. Reparative hard tissue formation following calcium hydroxide application after partial pulpotomy in cariously exposed pulps of permanent teeth. CONTROVERSIES IN ENDODONTICS. A prospective clinical study of mineral trioxide aggregate for partial pulpotomy in cariously exposed permanent teeth Clinical assessment of mineral trioxide aggregate (MTA) as direct pulp capping in young permanent teeth. Calcium Hydroxide vs. Mineral Trioxide Aggregates for Partial Pulpotomy of Permanent Molars with Deep Caries A clinical study of direct pulp capping applied to carious-exposed pulps. Clinical and radiographic evaluation of pulpotomies performed under intrapulpal injection of anaesthetic solution. Stainless steel crown versus modified open-sandwich restorations for primary molars: a 2-year randomized clinical trial.
abstract: PURPOSE The purpose of this study was to compare mineral trioxide aggregate ( MTA ) with calcium hydroxide ( Ca(OH)2 ) clinical ly and radiographically as a pulpotomy agent in immature permanent teeth ( apexogenesis ) . METHODS Fifteen children , each with at least 2 immature permanent teeth requiring pulpotomy ( apexogenesis ) , were selected for this study . All selected teeth were evenly divided into 2 test groups . In group 1 , the conventional Ca(OH)2pulpotomy ( control ) was performed , whereas in group 2 , the MTA pulpotomy ( experimental ) was done . The children were recalled for clinical and radiographic evaluations after 3 , 6 , and 12 months . RESULTS The follow-up evaluations revealed failure due to pain and swelling detected at 6 and 12 months postoperative evaluations in only 2 teeth treated with Ca(OH)2 . The remaining 28 teeth appeared to be clinical ly and radiographically successful 12 months postoperatively . Calcific metamorphosis was a radiographic finding in 2 teeth treated with Ca(OH)2 and 4 teeth treated with MTA . CONCLUSIONS Mineral trioxide aggregate showed clinical and radiographic success as a pulpotomy agent in immature permanent teeth ( apexogenesis ) and seems to be a suitable alternative to calcium hydroxide Three intermediary base material s , a zinc oxide-eugenol ( Cavitec ) and two calcium hydroxide liners ( Life and Dycal ) , were selected at r and om for use as a base beneath  amalgam or composite restorations on humans following complete caries removal .  Life and Dycal , selected at r and om , were also used as direct and indirect pulp capping agents as clinical ly indicated . Clinical evaluations of signs and symptoms were made before treatment and at one-week , six-month , and one-year intervals following treatment . Histological evaluations were performed on three complete caries removal teeth and 18 direct pulp capping teeth six months following treatment . No significant differences in clinical symptomatology result ed between the material s in the complete caries removal group or the indirect and direct pulp capping groups In a prospect i ve study , partial pulpotomy was performed on six permanent molars with deep carious lesions and pulpal involvement . The bleeding pulp was irrigated with normal tap water until bleeding had stopped and the exposed pulp was covered with calcium hydroxide followed by zinc oxide eugenol , and finally covered with a semipermanent restoration . All teeth showed hard tissue barrier formation , both clinical ly and radiographically , within three months and were free from subjective and objective symptoms through the observation period ( average observation period was 26 months ) . The patients also experienced the therapy positively . These findings and those of others have helped gain more recognition for partial pulpotomy as a strong possible alternative therapy when pulps are exposed by deep carious lesions and a bleeding pulp is exposed during the excavation process . The rationale for this therapy is to remove the infected and /or inflamed pulpal areas beneath the carious lesion and disintegrated tissue . A rapid and simplified procedure would allow the general practitioner to perform this procedure when necessary at dental clinics , without specialist facilities under conditions that avoid unnecessary contamination of the pulp Diseases of the dental pulp often have an infectious origin , and treatments are aim ed to control infections of the root canal system . Endodontic treatment principles originally evolved on the basis of trial and error , and only in recent decades have scientific methods been adopted to support clinical strategies . Yet , relevant research on the disease processes , their diagnoses , and efficient treatment are rare in the endodontic literature . Hence , the advancement of biologically based knowledge significant to clinical endodontics has been slow . Therefore , many differences of opinion still prevail in this field of dentistry . This review highlights and analyzes the background of some of the more heavily debated issues in recent years . Specifically , it deals with disagreements regarding the clinical management of pulpal exposures by caries in the adult dentition , definitions of success and failure of endodontic therapy  , and causes of and measures to control infections of the root canal system . Clearly , a most apparent gap in the published endodontic literature is the lack of r and omized clinical trials that address the more significant controversial matters relating to the management of pulpal wounds , medication , and the number of appointments required for the treatment of infected root canals . However , trials in endodontics require extremely long follow-up periods if valid conclusions are to be generated . Therefore , it is not to be expected that there will be rapid solutions to these issues in the foreseeable future After 2 yrs ' follow-up , mineral trioxide aggregate ( MTA ) appeared suitable for this purpose UNLABELLED Carious pulp exposure in permanent molars of children is a common incident . Mineral trioxide aggregate is a new material that possesses numerous exciting possibilities for pulp therapy . AIM The purpose of this study was to evaluate the efficiency of MTA as a direct pulp capping agent in young permanent teeth . METHODS Thirty asymptomatic permanent molars with pulp exposures were treated by pulp capping using MTA . At each recall ( 6 12 , 18 and 24 months ) , the teeth were assessed clinical ly , through pulpal sensitivity tests , as well as radiographically to evaluate periapical healing . RESULTS None of the cases reported spontaneous pain at the six months follow up and the pulp showed signs of vitality and absence of periapical radiolucency . At 24 months , the clinical and radiographic success rate was 93 % with evidence of continued root growth . CONCLUSION Pulp capping with MTA is recommended for teeth with carious pulp exposures specially immature teeth with high potential for healing Aim : To prospect ively compare the clinical success rate of partial pulpotomy treatment in permanent molars using calcium hydroxide ( CH ) and mineral trioxide aggregates ( MTA ) as pulp dressing agents . Methods : Restorable permanent first molars ( 64 ) with carious pulp exposures were r and omly assigned to two groups ; CH and MTA . A st and ardized operative procedure was followed in both groups . Following isolation and caries removal , the exposed superficial pulp tissue layers were removed with a sterile flame shape diamond bur to a depth of 2–4 mm . Bleeding was controlled and pulp dressed with either a paste of non- setting Ca(OH)2 followed by a setting layer of Ca(OH)2 , or with grey MTA . The dressing material s in both groups were then covered with a layer of light cured glass ionomer cement . The teeth were either restored using amalgam , or where grossly carious with preformed metal crowns . Patients were scheduled for follow-up at 3 , 6 , 12 months and annually thereafter . Results : There were 34 patients ( 17 males and 17 females ) with 51 teeth available for evaluation . The age of patients at the time of restoration ranged between 6.8 to 13.3 years ( mean of 10.3 ±1.8 years ) . The follow-up period ranged from 25.4 to 45.6 months with an average of 34.8 ± 4.4 months . There was no statistically significant difference in the success rate of teeth treated with CH ( 91 % ) in comparison to teeth treated with MTA ( 93 % ) . Radiographically , a hard tissue barrier under CH was noticed in 12 ( 55 % ) teeth compared with 18 ( 64 % ) teeth under MTA ( p=0.4 ) . Conclusions : MTA has clinical success rate comparable to CH as a pulp dressing material for partial pulpotomy in permanent molars with carious Direct  pulp capping of carious-exposed pulp was performed on 44 teeth . We evaluated the success rates of these cases , and analyzed the relationships between the success rates and their clinical findings . Furthermore , we examined the length of time necessary for adequate postoperative follow-up . The success rate in this study was 81.8 % . Age of the patients , type of teeth , responses to thermal stimuli and percussion , and the diameter of pulpal exposure had no bearing on the success rate . However , the degree of bleeding on pulpal exposure was related to the success rate ( p = 0.042 ) . The success rates of cases in which postoperative follow-up periods were 3 to 18 months were similar ( 80 to 83 % ) , whereas those with follow-up for 21 months ( 91.7 % ) and 24 months ( 100 % ) showed higher success rates . These results showed that direct pulp capping was applicable to carious-exposed pulp , and the degree of bleeding is indicative of the prognosis of this treatment . The length of time necessary for adequate postoperative follow-up was suggested to be 21 months AIM The purpose of this study was to evaluate clinical ly and radiographically pulpotomies carried out under intrapulpal injection of anaesthetic solution . METHODOLOGY Forty-one permanent m and ibular molar teeth presenting with deep carious lesions and /or exposed pulps , with or without periapical changes on radiographic examination , were treated with pulpotomy and dressed with calcium hydroxide . The teeth were divided into three groups . Group A consisted of 15 teeth , where intrapulpal anaesthesia was administered by a slow injection of lidocaine hydrochloride 2 % . Group B , with 14 teeth , where intrapulpal anaesthesia was obtained with lidocaine hydrochloride 2 % with adrenaline 1:100,000 . Group C consisted of 12 teeth in which anaesthesia was performed with a m and ibular block using prilocaine hydrochloride 3 % with felypressin 1 : 100,000 .  Healing was evaluated using clinical and radiographic criteria : dentine barrier formation , absence of clinical symptoms and resolution of periapical involvement . RESULTS After an observation time of 6 - 8 weeks ( postoperative control ) and 24 - 32 weeks ( intermediate control ) , healing occurred in 13 teeth from group A ( 87 % ) , in 11 teeth from group B ( 79 % ) and in 10 teeth from group C ( 83 % ) . No statistical difference was demonstrated between the three groups ( Fisher 's exact test ) . CONCLUSIONS Based on the methodology adopted , intrapulpal injection of anaesthetic solution did not impair healing in pulpotomized teeth OBJECTIVE The aim of this study was to investigate the clinical performance and survival of stainless steel crown ( SSC ) restoration  and  modified open-s and wich technique using resin-modified glass ionomer cement . DESIGN R and omized clinical trial . SETTING General dental practice . MATERIAL S AND METHODS A total of 87 children aged 4 - 7 years at baseline with one or more primary molars that have undergone pulp therapy were r and omly assigned to receive either SSC or modified open-s and wich restoration . One hundred and sixty restorations were placed and evaluated after 6 , 12 , 18 , and 24 months using the Ryge criteria . RESULTS Comparable survival rates were observed for both SSC and modified open-s and wich restoration . With only four SSCs and six modified open-s and wich restorations failing over 24 months , the survival rates were high for both material s ( 2-year survival rate : 95.0 % for SSCs and 92.5 % for modified open-s and wich restorations ) . Significantly better gingival health ( P < 0.05 ) was observed for the modified open-s and wich restorations compared with SSCs , as only one modified open-s and wich restoration was rated Charlie compared to 13 SSCs . No significant differences were observed between the two material s for marginal integrity , proximal contact , occlusion , or recurrent caries . CONCLUSION The 2-year results indicated that the modified open-s and wich restoration is an appropriate alternative to SSC in extensive restorations , particularly where aesthetic considerations are important
target: Vital permanent teeth with cariously exposed pulp can be treated successfully with vital pulp therapy .
background: INTRODUCTION This systematic review aims to illustrate the outcome of vital pulp therapy , namely  direct pulp capping , partial pulpotomy , and full pulpotomy  , in vital permanent teeth with cariously exposed pulp .