Endodontic treatment in primary teeth can be challenging and time consuming, especially during canal preparation, which is considered one of the most important steps in root canal therapy. The conventional instrumentation technique for primary teeth remains the "gold-standard" over hand instrumentation, which makes procedures much more time consuming and adversely affects both clinicians and patients. Recently nickel-titanium (Ni-Ti) rotary files have been developed for use in pediatric endodontics. Using rotary instruments for primary tooth pulpectomies is cost effective and results in fills that are consistently uniform and predictable. This article reviews the use of nickel-titanium rotary files as root canal instrumentation in primary teeth. The pulpectomy technique is described here according to different authors and the advantages and disadvantages of using rotary files are discussed.
A deciduous tooth affected by dental caries involving the pulp tissue with subsequent periradicular pathosis at times makes the conventional endodontic procedures a dilemma for a variety of reasons. In this situation, lesion sterilization and tissue repair (LSTR) stands out as the only option by which dentists could increase the longevity of the deciduous teeth of a young child. This therapy aims to eliminate bacteria from the root canals by sterilizing the lesion and promoting tissue repair and regeneration by the host’s natural tissue responses. This article reviews the rationale, indications, contraindications and the procedure in detail.How to cite this article: Sain S, Reshmi J, Anandaraj S, George S, Issac JS, John SA. Lesion Sterilization and Tissue Repair-Current Concepts and Practices, Int J Clin Pediatr Dent. 2018;11(5):446-450.
Background
Indirect pulp capping therapy has gained increased popularity in paediatric dentistry since it is less invasive, and is of low cost. The aim of the present study was to evaluate and to compare the diffusion of calcium (Ca2+) and hydroxyl (OH–) ions through coronal dentin into pulp after indirect pulp capping in vitro using TheraCal LC, ProRoot MTA and Calcimol LC.
Materials and methods
Total of 60 human caries-free maxillary first premolars were selected for the study. Samples were divided into 4 groups with 15 in each group: Group 1 TheraCal LC; Group 2 ProRoot MTA; Group 3 Calcimol LC; Group 4 Control Group. Indirect pulpcapping on the coronal RDT (remaining dentine thickness) system was performed using pulp-capping materials, such as TheraCal LC, ProRoot MTA and Calcimol LC, on the respective samples. The control group was completely filled with composite. Ca2+ ions (ppm) and OH– ions (pH) were analysed in deionized water using a multimeter connected to a calcium probe (calcium ion electrode) and pH metre connected to a temperature-compensated pH probe after 3 h, 24 h, 7 days, 14 days, 28 days and 60 days.
Results
Calcium release was significantly higher (P < 0.05) in the TheraCal LC group than in the other groups. Slightly alkaline pH values were observed in all the groups except for the control.
Conclusion
TheraCal is a new light-curable pulp capping material that initially releases high Ca2+ ions and creates an environmental pH close to physiological pH after 60 days.
Trauma to the anterior teeth is relatively common in young children and teenagers. Traumatized anterior teeth require quick functional and aesthetic repair, and poses a challenge to the dental practitioner owing to the lack of co-operation ceded and the longer time invested. Reattachment of tooth fragment should be the first choice to restoring teeth when a usable fragment is available, since it gives a psychological and aesthetic advantage over the conventional technique. With the vast improvement in adhesive technology, reattachment is definitely a predictable treatment option for very young children. This paper describes the treatment of a 2½ year old female child who sustained crown-root fracture, extending subgingivally, in primary upper central incisor.
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