Allergy tests against formaldehyde, cresol, and eugenol in children with formocresol pulpotomized primary teeth

abstract – One hundred and twenty-eight children in the age range 5—14 years with formocresol pulpotomized teeth were tested for sensitivity against formaldehyde, eugenol, and cresol using the patch test. The number of treated teeth on each child varied from one to six and the time between the pulpotomy and patch test varied from 2 months to 8 years. None of the children showed positive results.     

甲醛甲酚与Vitpex糊剂治疗难治性根尖周炎效果对比

目的：探讨甲醛甲酚与Vitpex糊剂应用于难治性根尖周炎根管内封药消毒的临床疗效。方法：收集2015年3月—2016年3月收治的难治性根尖周炎患者60例（60颗患牙）,随机分为观察组30例,予以Vitpex糊剂封入根管内消毒,对照组30例,予以甲醛甲酚封入根管内消毒,比较两组临床效果,并采用视觉疼痛评分（VAS）进行评估。结果：观察组总有效率为96.67%（29/30）,高于对照组的83.33%（25/30,P＜0.05）。观察组封药后VAS评分为（3.86±1.02）分,显著低于对照组的（6.03±1.53）分（P＜0.05）。结论：难治性根尖周炎患者应用甲醛甲酚与Vitpex糊剂根管内封药消毒均有效,但后者效果更好,疼痛程度更低。     

Evaluation of formocresol versus ferric sulphate primary molar pulpotomy: a systematic review and meta-analysis

AIM: To present a systematic review of the effects of formocresol and ferric sulphate when used as medicaments in pulpotomized primary molar teeth. METHODOLOGY: The study list was obtained by using MEDLINE, the Cochrane Library, EMBASE and SCI search. Only those papers which met the inclusion criteria were accepted. The quality of studies used for meta-analysis was assessed by a series of validity criteria according to Jadad's scale. A systematic review and meta-analysis were performed. RESULTS: Eleven clinical studies comprising four randomized-clinical trials (RCTs), four controlled clinical trials (CCTs) and three retrospective studies were included. The results of the meta-analysis of six prospective clinical trials suggested that the two popular pulpotomy medicaments were not significantly different in terms of clinical outcomes, radiographic findings, prevalence of apical and furcal destruction, internal root resorption or pulp canal obliteration. The relative risk (RR) value and 95% CI for those parameters were 0.72 (0.43-1.23), 0.87 (0.59-1.30), 0.67 (0.27-1.66), 1.77 (0.56-5.58) and 1.41 (0.63-3.15), respectively. The overall clinical and radiographic success rates based on the data of treatments with ferric sulphate from the 11 studies included ranged from 78% to 100% (mean 91.6 +/- 8.15%) and from 42% to 97% (mean 73.5 +/- 18.40%), respectively. CONCLUSIONS: In primary molar teeth with exposure of vital pulps by caries or trauma, pulpotomies performed with either formocresol or ferric sulphate have similar clinical and radiographic success. Ferric sulphate may be recommended as a suitable replacement for formocresol.     

Randomized controlled trial of mineral trioxide aggregate and formocresol for pulpotomy in primary molar teeth

AIM: To compare the outcome after 6 months of the application of formocresol (FC) or mineral trioxide aggregate (MTA) during pulpotomy in primary molar teeth. METHODOLOGY: A maximum of 126 children (aged 5-9 years) with carious primary teeth that required pulpotomy were selected. Following randomization, a standard pulpotomy preparation was undertaken, and the coronal pulp removed and bleeding arrested. In the FC group, cotton balls, soaked in FC, were placed for 5 min, and then the pulp chamber was filled with Zonalin, a pulpotomy agent. In the MTA group, a 1-mm-thick paste of MTA was used as a pulpotomy agent. The crowns in both groups were restored with amalgam or glass ionomer. The teeth of 100 patients were evaluated and compared clinically and radiographically after 3 and 6 months. RESULTS: No signs of clinical failure were observed at the 3- and 6-month follow-up appointments in either group. There were no significant differences in the radiographic findings of the teeth and surrounding tissue at the 3-month follow-up. However, at the 6-month follow-up, significantly more cases (P = 0.036) with root resorption were seen in the FC group; no cases of resorption occurred amongst the MTA cases. The surrounding tissue showed radiographic signs of post-treatment disease in four FC cases; none was seen in the MTA cases. CONCLUSION: After 6 months, pulpotomy with MTA was associated with fewer cases of root resorption and post-treatment disease. MTA appears to be a reliable alternative material for pulpotomy in primary molar teeth.     

大蒜素和甲醛甲酚在治疗慢性根尖周炎中的疗效比较

目的：对比研究大蒜素及甲醛甲酚治疗慢性根尖周炎的近期临床疗效。方法：将185颗慢性根尖周炎患牙常规开髓、清理根管后随机分为3组。大蒜素组（94颗牙）于根管口封大蒜素棉球,甲醛甲酚（FC）组（78颗牙）于根管口封FC棉球,生理盐水组（13颗牙）于根管口封生理盐水棉球。观察3 d内各组封药后急性反应发生率等近期临床反应。结果：封药3 d内,3组出现急性反应的比例分别为前牙5.1%,10.7%,50％;后牙5.5%,8.0%,60％。大蒜素组和FC组前牙（P＞0.05）、后牙（P＞0.05）封药后急性反应率比较差异无显著性,大蒜素组和FC组分别与生理盐水组比较,封药后急性反应率差异有显著性（P＜0.05）。结论：大蒜素治疗慢性根尖周炎的近期临床疗效与FC相似,相对于FC的副作用,大蒜素可取代FC。     

氢氧化钙制剂在根管治疗中的临床应用

目的观察氢氧化钙制剂在根管治疗中的临床应用效果。方法将250例急、慢性根尖周炎患牙随机分为实验组和对照组，实验组采用氢氧化钙糊剂进行根管治疗；对照组采用甲醛甲酚液进行治疗。观察根管治疗暂封1周后临床疗效对比情况。结果实验组疗效优的比率为88．8％，而对照组则为38．4％，差异有显著性（P〈0．01）。暂封一次即可根充者实验组104例（83．2％），对照组64例（51．2％）。结论采用氢氧化钙糊剂作为根管内封药，能够减少甲醛甲酚所带来的不良反应，达到满意的疗效。     

Comparison of the success rate of a bioactive dentin substitute with those of other root restoration materials in pulpotomy of primary teeth: Systematic review and meta-analysis

BackgroundSeveral root canal restoration materials can be used after pulpotomy in primary teeth; however, it is unclear which is the most successful. The authors’ aim in this systematic review and meta-analysis was to compare the radiographic and clinical failure rates of a calcium silicate-based bioactive material (Biodentine, Septodont) with those of other root restoration materials such as mineral trioxide aggregate (MTA), formocresol, and ferric sulfate.Types of Studies ReviewedOn the basis of the determined study strategy, the authors performed a comprehensive search of the MEDLINE, Web of Science, Embase, and Cochrane Central Register of Controlled Trials online databases. The authors considered only randomized controlled trials. In the included studies, the authors compared the clinical and radiographic failure rates at different follow-up times of the pulpotomy of primary teeth with extensive caries treated by using Biodentine and other root restoration materials.ResultsAll of the included studies had an unknown or high risk of bias. On the basis of the Grading of Recommendations Assessment, Development and Evaluation scale, the quality of evidence for the comparison of MTA and Biodentine was moderate. Biodentine had a statically significantly higher radiographic failure rate than did MTA at 6 and at 9 through 12 months after pulpotomy. The authors found no substantial differences between the clinical failure rates of Biodentine and MTA and the radiographic or clinical failure rates of Biodentine and formocresol or of Biodentine and ferric sulfate.Conclusions and Practical ImplicationsMTA has a significantly lower radiographic failure rate than does Biodentine but no difference in clinical failure rates. On the basis of this result, the dentist can weigh the advantages and disadvantages of using Biodentine, MTA, ferric sulfate, and formocresol and can make a more informed decision about using the proper root restoration material.     

Irritating effect of formocresol after pulpectomy in vivo

A study was carried out to investigate the effect of formocresol (formalin-creosote) on the periapical tissue after pulpectomy in rats. A pulpectomy was performed on the mesial root of the right mandibular first molar, and, in group A, a paper point containing saline was inserted into the root canal. In group B, a paper point containing formocresol was inserted, and in group C, a drop of formocresol was applied and a paper point containing formocresol was inserted into the root canal. The periapical tissue was examined histologically and histometrically at 3, 7, 14, and 28 days after insertion, and the inflammatory cells and fibroblasts in the apical granulation tissue were also counted. Histologically, in group A, the inflammation observed was slight at 14 and 28 days, while in groups B and C, a moderate inflammation remained. Histometrically, the area of the apical periodontal ligament in groups B and C was increased significantly compared with that in group A at 14 and 28 days. The inflammatory cell count in groups B and C increased significantly compared with that in group A at 7, 14, and 28 days, whereas the flbroblast count in Groups B and C decreased compared with that in Group A at 7, 14, and 28 days. These results demonstrate that formocresol delayed the healing of periapical tissue after pulpectomy.