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Home Clinical and radiographic success of (partial) pulpotomy and pulpectomy in primary teeth:...

Clinical and radiographic success of (partial) pulpotomy and pulpectomy in primary teeth: A systematic review

Authors:

  • C. Boutsiouki
    Department of Paediatric Dentistry, Medical Center for Dentistry, University Medical Center Giessen and Marburg, Campus Giessen, Giessen, Germany
  • R. Frankenberger
    Department of Operative Dentistry, Endodontics, and Pediatric Dentistry, Medical Center for Dentistry, University Medical Center Giessen and Marburg, Campus Marburg, Marburg, Germany
  • N. Krämer
    Department of Paediatric Dentistry, Medical Center for Dentistry, University Medical Center Giessen and Marburg, Campus Giessen, Giessen, Germany

DOI:

https://doi.org/10.23804/ejpd.2021.22.04.4

ABSTRACT


Aim

The aim of this systematic review was to evaluate the clinical outcome of partial pulpotomy, pulpotomy and pulpectomy for treating primary teeth with normal or infected pulp or with irreversible pulpitis.

Methods

Two reviewers on Pubmed and ISI Web of Science performed a comprehensive literature review of publications from 1966 until July 2019. Pico outline was used to facilitate literature research. Among abstracts, publications were selected according to the following criteria: prospective clinical study, correct indication for the performed treatment, clear definition of clinical and/or radiographic success criteria and at least 6-month follow-up period. The strict selection criteria under the keywords “pulpotomy”, “partial pulpotomy” and “pulpectomy” resulted in a limited amount of randomised controlled trials (RCT) or controlled clinical trials (CT). Qualitative assessment of the selected clinical studies and level of evidence was included according to the criteria described by the Oxford Centre for Evidence-Based Medicine (CEBM).

Results

Seventy-five clinical studies were included and levels of evidence for papers ranged from Ia to IIa. Several clinical-based recommendations for partial pulpotomy, pulpotomy and pulpectomy were given.

Conclusion

Prerequisites for a successful pulpotomy are symptom-free teeth, sterile removal of coronal pulp and haemostasis. Both MTA and formocresol perform well for partial pulpotomies after caries exposure. Formocresol had been the most popular amputation material for pulpotomies. Due to the potential side effects, other medicaments, such as ferric sulfate, mineral trioxide aggregate (MTA) or NaOCl are suggested. Grey and white MTA yeld the same results. Lasers are not recommended due to their large diversity. Regarding pulpectomy, the conditions, procedures, and evaluation for the treatment were not well defined in the studies. Nevertheless, there is evidence to use calcium hydroxide, zinc oxide eugenol paste or iodoform based pastes as root filling materials for non-vital molars. Pulpectomies showed better success rates than pulpotomies. Stainless steel crowns are recommended as definite restorations after both endodontic treatments. Longer follow-up periods, further clinical studies with comparable conditions and clear definition of evaluation criteria are needed to further confirm the results of endodontic treatment in primary teeth.

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Publication date:

December /2021

Issue:

Vol.22 – n.4/2021

Page:

273 – 285

Publisher:

Ariesdue

Topic:

Pulp therapy for primary & young permanent teeth

Cite:


Harvard: C. Boutsiouki, R. Frankenberger, N. Krämer (2021) "Clinical and radiographic success of (partial) pulpotomy and pulpectomy in primary teeth: A systematic review", European Journal of Paediatric Dentistry, 22(4), pp273-285. doi: 10.23804/ejpd.2021.22.04.4
Vancouver: C. Boutsiouki, R. Frankenberger, N. Krämer. Clinical and radiographic success of (partial) pulpotomy and pulpectomy in primary teeth: A systematic review. European Journal of Paediatric Dentistry [Internet]. 2021Dec.20 [cited 2023Mar.23];22(4):273-285. Available from: https://www.ejpd.eu/abstract-pubmed/clinical-and-radiographic-success-of-partial-pulpotomy-and-pulpectomy-in-primary-teeth-a-systematic-review/
MLA: C. Boutsiouki, R. Frankenberger, N. Krämer Clinical and radiographic success of (partial) pulpotomy and pulpectomy in primary teeth: A systematic review. European Journal of Paediatric Dentistry. 2021;22(4):273-285

Copyright (c) 2021 Ariesdue

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

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    Editor in chief: dott. Luigi Paglia
    European Journal of Paediatric Dentistry © | ISSN (Online): 2035-648X
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    European Journal of Paediatric Dentistry © | ISSN (Online): 2035-648X
    Registrazione del Tribunale di Milano n. 285 del 14.04.1998 | ROC 1946 - 26.09.2001
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