No abstract

No abstract

Aim To evaluate the effect of collagen membrane on the healing of through‐and‐through periapical lesions using 2‐dimensional (2D) and 3‐dimensional (3D) imaging techniques. Methodology Thirty‐two patients with periapical radiolucencies measuring at least 10 mm and with confirmed loss of buccal and lingual cortical plates were randomly divided into GTR and control groups. Periapical surgery was performed in both groups, using a resorbable collagen membrane in the GTR group only. 2D healing was evaluated according to Molven's criteria, while 3D healing was assessed using modified PENN 3D criteria, RAC indices and the B index, 12 months after surgery. Data were analysed using Chi‐square, Mann–Whitney and Wilcoxon signed rank tests. Results Thirty patients were analysed at the 12 months follow‐up. Both groups had a significant reduction in the size of lesions [92 ± 12% (control) and 86 ± 14% (GTR) in 2D and 85 ± 19% (Control) and 82 ± 13% (GTR) in 3D], with no significant difference between the groups (P > 0.05). A total of 29(14 control, 15 GTR) teeth and 26(13 control, 13 GTR) teeth were classified as success according to Molven's (2D) and modified PENN 3D criteria, respectively, with no significant difference in success between 2D and 3D assessments. RAC indices of 3D images revealed the greatest percentage of complete healing in R scores (55% for Control, 41% for GTR), whereas cortical plate had the lowest percentage of healing (30% for Control, 27% for GTR) (P > 0.05). Only 2 (13%) patients in each group had complete healing using the B index. Conclusion Periapical surgery with or without GTR was a predictable and viable solution for through‐and‐through lesions. There was no benefit in using a collagen membrane with regard to the outcome of periapical surgery in through‐and‐through lesions. Both cone beam computed tomography (CBCT) and periapical radiographs (PA) allowed similar assessment of healing after periapical surgery.

Aim The study aimed to compare the outcome of complete pulpotomy (CP) and partial pulpotomy (PP) techniques when utilised for the management of mature permanent teeth with carious pulpal exposure and symptomatic irreversible pulpitis (SIP). Methodology The study protocol was registered with ClinicalTrials.gov (NCT04397315). One hundred and six permanent mandibular molars with carious pulpal exposure and clinical diagnosis of SIP with periapical index ≤2, from patients aged between 18 and 40 years were randomly allocated in equal proportion to either CP or PP group. Allocated procedures were performed using standardised protocols. The allocated procedure was abandoned in cases where pulpal bleeding could not be controlled within 6 min using cotton pellets soaked in 3% sodium hypochlorite. MTA was used as a pulpotomy agent and teeth were restored using a base of glass ionomer followed by composite restoration. The pain was recorded by the patient preoperatively before administration of local anaesthesia and postoperatively every 24 h for 1 week using visual analogue scale. Success was analysed at 12 months based on clinical and radiographic examination. Mann–Whitney U test was used to compare age, pain scores and mean analgesic consumption between the groups. Categorical data were analysed using chi‐square test. Fisher's exact test was used to assess the clinical and radiographic success and incidence of pain. Kaplan–Meier analysis was used to assess the survival of teeth. A p‐value <.05 was considered as statistically significant. Results One hundred and one patients were analysed at follow up. Higher success was observed in CP (89.8%) in comparison to PP group (80.8%), but the difference was non‐significant statistically (p = .202). Although no significant difference was observed in pain incidence between the groups at 24 h (p = .496), a significant difference in pain intensities was observed between groups at all the tested time intervals, with lower values reported in CP group (p < .05). Conclusions Both CP and PP resulted in favourable outcomes in the management of cariously exposed permanent teeth with signs indicative of SIP. Given the more conservative nature of PP, it may be attempted first before proceeding to CP in such cases.

No abstract