Outcome of Partial Pulpotomy in Cariously Exposed Posterior Permanent Teeth: A Systematic Review and Meta-analysis

IntroductionThe current systematic review and meta-analysis aimed to evaluate the success rate of partial pulpotomy in treating permanent posterior teeth with carious vital pulp exposure. A secondary aim was to assess the prognostic factors using a meta-regression.MethodsAn electronic search was performed for studies from January 1950 to November 2018 in the following databases: PubMed, ScienceDirect, and Cochrane. All searches were performed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Clinical studies evaluating the success rate of cariously exposed vital human permanent posterior teeth treated with a partial pulpotomy were selected. Only randomized clinical trials and prospective clinical studies were included for evaluation. The Newcastle-Ottawa Scale and the Cochrane Collaboration’s tool were used to evaluate risk assessment.ResultsFrom the 218 studies identified through the initial search, 11 studies qualified for the final analysis (5 randomized clinical trials and 6 prospective studies). The results of the meta-analysis indicate a success rate of 98% (confidence interval [CI]: 0.94–1), 96% (CI: 0.92–0.99), and 92% (CI: 0.83–0.97) after 6 months and 1 and 2 years of follow-up. Examining the probable prognostic factors using meta-regression analysis, only preoperative pulp status (P = .001) was identified as a significant factor, with studies including teeth with the presumptive diagnosis of irreversible pulpitis displaying significantly lower results. The final solution, pulp capping material, apex closure, and the age of the patient did not affect the treatment success rate (P > .05).ConclusionsThe available data suggest that a partial pulpotomy results in high success rates in treating cariously exposed permanent posterior teeth up to 2 years. Six months of monitoring can be considered an appropriate period when evaluating the success of a partial pulpotomy although more clinical and radiographic controls are essential to ensuring success.     

Color change of primary teeth following exposure to an experimentally synthesized liposomal nano-encapsulated ferrous sulfate drop versus the commercially available iron drops

ObjectivesThis study aimed to assess the color change of primary teeth following exposure to an experimentally synthesized liposomal nano-encapsulated ferrous sulfate drop compared with the commercially iron drops.Materials and methodsIn this in-vitro study, liposomal nano-encapsulated ferrous sulfate (lipo-nano-ferr) drop was first synthesized. Next, 110 extracted primary anterior teeth were randomized into two equal groups (sound and demineralized). Each group was randomly divided into 5 subgroups (n = 11) and exposed to Irofant, Feroglobin, Sideral, and lipo-nano-ferr drops for 540 cycles. One subgroup was remained in artificial saliva as the negative control. Tooth color was analyzed before and after the interventions visually, and the rate of iron adsorption was analyzed by atomic absorption spectrometry (AAS), and energy-dispersive X-ray spectroscopy/scanning electron microcopy (EDS/SEM). Data were analyzed using t-test, one-way ANOVA, and LSD test.ResultsIron adsorption was significantly higher by the demineralized specimens than the sound specimens in all subgroups (P < 0.001). A significant difference was noted in iron adsorption among the four subgroups in each of the sound and demineralized groups (P < 0.001). Iron adsorption in the lipo-nano-ferr subgroup was significantly lower than that in Irofant and Feroglobin groups (P < 0.001). The visual inspection results were similar to AAS results. EDS-SEM showed that the atomic percentage of iron in Sideral and lipo-nano-ferr groups was significantly lower than that in Irofant and Feroglobin groups (P < 0.001).ConclusionUse of nano-encapsulation technology in production of iron drops can significantly decrease the resultant tooth discoloration, causing a clinically negligible color change.     

龋病防治的临床难度评估

龋病是发生于牙体硬组织的慢性感染性疾病,具有发病率高、治疗率低等特点,严重危害口腔和全身健康。加强和完善龋病的规范化治疗是全人群、全生命周期龋病管理面临的关键问题。因此,在龋病诊断和分类的基础上,建立龋病防治临床难度评估系统,主要包括龋病风险评估和龋病治疗难度评估,可为龋病管理提供有效的依据。本文围绕龋病防治难度评估系统,从龋病的诊断和分类、龋病风险评估和龋病治疗难度评估等龋病防治临床管理的重要组成部分进行归纳与阐述。