Modern methods for treatment of deciduous teeth pulpitis: a literature review

Abstract

Relevance. Pulpitis is one of the most common diseases. Currently, the development of pediatric dentistry does not allow achieving complete success in the treatment of deciduous tooth pulpitis. The relevance of pulpitis treatment method exploration is obvious. Materials and methods. The study analyzed 75 sources of literature describing four main methods for pulpitis treatment in deciduous teeth: indirect pulp capping, direct pulp capping, pulpotomy (amputation) and pulpectomy (extirpation).Results. The effectiveness of primary tooth pulpitis treatment is questionable and ranges from 40% to 100%, depending on the method and duration of observation. Mineral trioxide aggregate (MTA), calcium hydroxide, zinc oxide-eugenol paste, formocresol, ferric sulphate are the most studied materials for the endodontic treatment of the deciduous teeth. Studies on the new biocompatible materials, such as tricalcium silicate (Biodentine), CEM (calciumenriched mixture), enamel matrix proteins (Emdogain), etc., confirm their effectiveness, but the evidence is still inconclusive. In indirect pulp capping, non-resorbable biocompatible cements showed better results provided a tight seal of the restoration was achieved. Glass ionomer cements may be an option. Direct pulp capping is a controversial technique for the treatment of deciduous tooth pulpitis. MTA is the most effective material for pulpotomy. No hard evidence is provided for the comparative evaluation of a certain material effectiveness in pulpectomy; both ZOE and calcium hydroxide with iodoform can be used for root canal filling. Conclusions. Biologically based methods for the treatment of pulpitis, which preserve the viability of the pulp as much as possible, are currently considered preferable. Further research is needed to assess the effectiveness of the new biocompatible materials with regenerative properties.