Recent advances in pulpotomy medicament

Pratik Surana; Ankita Khandelwal; Ruchi Gopal; Rohit R Koppalkar; Sadia Aafreen; Shubham Gupta

doi:10.4103/ijmo.ijmo_11_20

REVIEW ARTICLE

Year : 2021 | Volume : 6 | Issue : 1 | Page : 22-23

Recent advances in pulpotomy medicament

Pratik Surana¹, Ankita Khandelwal², Ruchi Gopal³, Rohit R Koppalkar⁴, Sadia Aafreen⁵, Shubham Gupta⁶
¹ Senior Lecturer, Department of Pedodontics and Preventive Dentistry, Maitri College of Dentistry and Research Center, Bhilai, Chhattisgarh, India
² Consultant Pediatric Dentist, Pune, Maharashtra, India
³ Senior Lecturer, Department of Pedodontics and Preventive Dentistry, Rungta College of Dental Sciences and Research, Bhilai, Chhattisgarh, India
⁴ Consultant Pediatric Dentist, Gadag, Karnataka, India
⁵ Consultant Pediatric Dentist, Bhilai, Chhattisgarh, India
⁶ RK Dental Clinic, Raniganj, West Bengal, India

Date of Submission	15-Nov-2020
Date of Acceptance	11-Dec-2020
Date of Web Publication	17-Feb-2021

Correspondence Address:
Dr. Pratik Surana
Department of Pedodontics and Preventive Dentistry, Maitri College of Dentistry and Research Center, GE Road, Anjora, Durg - 491 001, Chhattisgarh
India

Source of Support: None, Conflict of Interest: None

DOI: 10.4103/ijmo.ijmo_11_20

Abstract

Pulpotomy is the most commonly used treatment modality used in cariously involved primary vital primary teeth. Formocresol shows a good clinical success rate over the period of years but concerns raised due to its toxicity, mutagenicity, and carcinogenicity. The current review of literature provides an overview of recent advances in pulpotomy medicament that can be used as an alternative to formocresol.

Keywords: Biodentine, formocresol, mineral trioxide aggregate, pulpotomy

How to cite this article:
Surana P, Khandelwal A, Gopal R, Koppalkar RR, Aafreen S, Gupta S. Recent advances in pulpotomy medicament. Int J Med Oral Res 2021;6:22-3

How to cite this URL:
Surana P, Khandelwal A, Gopal R, Koppalkar RR, Aafreen S, Gupta S. Recent advances in pulpotomy medicament. Int J Med Oral Res [serial online] 2021 [cited 2022 May 26];6:22-3. Available from: http://www.ijmorweb.com/text.asp?2021/6/1/22/309660

Introduction

The major objective of pediatric endodontics is to maintain the primary teeth in their position in healthy and functional status until their successor teeth erupt. The primary tooth is as important as permanent tooth as it plays a vital role in mastication, digestion, and integration to the maintenance of arch integrity, stimulation of growth of the jaw, development of speech, and esthetic functions.^[1] Pulpotomy is the most commonly used treatment modality for reversibly inflamed primary teeth. It involves complete removal of the coronal portion of the pulp application of a medication or dressing to preserve the vitality of radicular pulp tissue.^[2] Formocresol pulpotomy was first described by Sweet, and it has been used over the year with immense success rate; however, there are some concerns that have been raised over the formocresol, mainly as a result of its toxicity and potential carcinogenicity.^[3] The current review of literature provides an overview of recent advances in pulpotomy medicament that can be used as an alternative to formocresol.

Ideal Requirement of Pulpotomy Agent

Ideal pulpotomy medicament should leave the remaining radicular pulp in a healthy and vital condition in an odontoblast-lined dentin chamber.^[2]

Recent Advancement in Pulpotomy Medicament

A variety of studies have been carried out to find out ideal pulpotomy agent [Table 1]. Few materials such as mineral trioxide aggregate (MTA), Biodentine, lyophilized freeze-dried platelet, enamel matrix protein, Aloe vera, and honey have shown effective results. These materials can broadly be classified as herbal and nonherbal medicaments.

Table 1: History of pulpotomy

Click here to view

Nonherbal medicament

Lyophilized freeze-dried platelet

In 2004, Kalaskar and Damle compared the efficacy of lyophilized freeze-dried platelet-derived preparation with calcium hydroxide in primary molars and found lyophilized freeze-dried platelet to better than calcium hydroxide in 6-month follow-up.^[9]

Bioactive glass

Bioactive glasses (BAGs) are a biocompatible material which is considered to have osteoconductive property. Salako et al. in 2004 conducted an animal study and found that BAG induced an inflammatory response at 2 weeks with resolution of inflammation at 4 weeks.^[10]

Mineral trioxide

MTA, a bioactive material developed from Portland cement, was first introduced by Dr. Mahmoud Torabinejad at Loma Linda University in 1993 and its first reported use was by Lee et al. in 1993. Eidelman et al. (2001) evaluated the effectiveness of MTA as a pulpotomy agent in primary molars and reported a 100% success rate in 17-month follow-up.^[11]

Biodentine

Biodentine is a bioactive and biocompatible dentine substitute introduced by Septodont group; it is mainly used as a dentine substitute both for restorative and endodontic purposes. Nasrallah et al. clinically and radiographically evaluated the efficacy of Biodentine™ as pulpotomy medicament on deciduous molars and found it very satisfactory.^[12]

Herbal medicament

Honey

It has an excellent antimicrobial and wound healing property. Honey is used to treat various oral lesions such as lichen planus, candidiasis, and stomatitis. Kumari et al. evaluated the efficacy of honey as a pulpotomy agent and found very promising results both clinically and radiographically.^[13]

Turmeric powder

Turmeric is a natural anti-inflammatory and antioxidant which is widely used as an ayurvedic medicine. Purohit et al. in their study found a good clinical and radiographic success with turmeric powder in 6-month follow-up.^[14]

Aloe vera

It has got various properties such as immunomodulatory, antiviral and anti-inflammatory, antibacterial, antifungal as well as protective nature against a broad range of microorganisms. Gupta et al. evaluated the effect of freshly extracted A. vera gel from its leaves as a pulpotomy agent in primary molar teeth and found a good clinical and radiographic success.^[15]

Conclusion

The acceptable outcome of pulpotomy in primary teeth depends on case selection, proper clinical and radiographic evaluation, and most importantly, on aseptic clinical procedure and material used for pulpotomy. Formocresol shows a good clinical success rate over the period of years but concerns raised due to its toxicity, mutagenicity, and carcinogenicity. Other materials such as MTA and Biodentine can be used as an alternative to formocresol.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

References

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