International Journal of Clinical Pediatric Dentistry

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VOLUME 17 , ISSUE 3 ( March, 2024 ) > List of Articles

ORIGINAL RESEARCH

Success Rates of Antibiotic Sterilization, Indirect Pulp Treatment, and Pulpotomy in the Management of Primary Teeth with Deep Carious Lesions

Deeksha Saxena

Keywords : Antibiotic sterilization, Deep caries, Indirect pulp treatment, Primary teeth, Pulpotomy, Vital pulp therapy

Citation Information : Saxena D. Success Rates of Antibiotic Sterilization, Indirect Pulp Treatment, and Pulpotomy in the Management of Primary Teeth with Deep Carious Lesions. Int J Clin Pediatr Dent 2024; 17 (3):237-242.

DOI: 10.5005/jp-journals-10005-2742

License: CC BY-NC 4.0

Published Online: 01-06-2024

Copyright Statement:  Copyright © 2024; The Author(s).


Abstract

Background and aim: A new concept of antibiotic sterilization has come into existence which can be used to sterilize the demineralized portion of the teeth with minimal or ultraconservative excavation of caries in deep dentinal carious lesions as an alternative for indirect pulp therapy (IPT) and pulpotomy to avoid further complications. This study was undertaken to compare the success rates of antibiotic sterilization, indirect pulp treatment, and pulpotomy in the management of primary teeth with deep carious lesion. Materials and methods: Ninety teeth involving deep carious lesions approaching pulp in primary molars were selected and randomly divided into three groups containing 30 teeth. Group I was treated with antibiotic sterilization using 3Mix-MP paste, group II was treated with indirect pulp treatment using calcium hydroxide, and group III was treated with conventional pulpotomy using 15.5% ferric sulfate (FS) solution. Clinical and radiographic analysis of all three groups was performed at 1, 3, 6, 9, and 12 months to evaluate the success of treatment procedures using predetermined criteria. Pearson's Chi-squared test and McNemar test were used for statistical analysis. Results: At the end of the 12-month follow-up period, the overall clinical and radiographic success was determined to be 96.3% for group I, 100% for group II, and 96.4% for group III. There were no statistically significant differences observed between the success of three groups, suggesting that either of the procedures can be adopted for the management of deep carious lesions approaching pulp in primary teeth. Conclusion: Antibiotic sterilization can be introduced as a newer modality in the management of deep carious lesions approaching pulp in primary teeth which is ultraconservative in nature and reduces the risk of pulp exposure in comparison with indirect pulp treatment and pulpotomy procedures.


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  1. Caufield PW, Li Y, Dasanayake A. Dental caries: an infectious and transmissible disease. Compend Contin Educ Dent 2005;26(5 Suppl 1):10–16.
  2. Coll JA. Indirect pulp capping and primary teeth: Is the primary tooth pulpotomy out of date? Pediatr Dent 2008;30(3):230–236.
  3. American Academy of Pediatric Dentistry. Clinical guidelines on pulp therapy for primary and young permanent teeth: reference manual. Pediatr Dent 2014;38:280–288.
  4. Anderson G. Effective treatment with indirect pulp capping. Dent Stud 1982;61(3):22–25.
  5. Hoshino E, Iwaku M, Sato M, et al. Bactericidal efficacy of metronidazole against bacteria of human carious dentin in vivo. Caries Res 1989;23(2):78–80. DOI: 10.1159/000261161
  6. Hoshino E, Kota K, Iwaku M. Sterilization of carious lesions by antibacterial drugs. New attempt to conserve pulp. (Part 1). The basic approach. Dent Outlook 1990;75:1379–1386.
  7. Trairatvorakul C, Sastararuji T. Indirect pulp treatment vs antibiotic sterilization of deep caries in mandibular primary molars. Int J Pediatr Dent 2014;24(1):23–31. DOI: 10.1111/ipd.12022
  8. Vidya KB, Patil SB, Anegundi RT. Is pulpotomy obsolete? A clinical study on the success rates of indirect pulp capping and pulpotomy in the treatment of deep dentinal caries in primary second molars. J Int Clin Dent Res Org 2015;7(1):24–29. DOI: 10.4103/2231-0754.153491
  9. Raval R, Pandya P, Thummar NK, et al. Comparison of pulpotomy using ferric sulphate, glutaraldehyde and MTA- a randomised controlled trial. J Commun Health Med Res 2017;3:84–89. DOI: 10.21276/ijchmr.2017.3.1.17
  10. Fuks AB. In: Pulp therapy for the primary dentition. Pingham, Cassamassimo, Fields, Mctigue, Nowak: Dentistry Infancy Through Adolescence. 4th Edition, Saunders; 2005; p.384–385.
  11. Fuks AB. Current concepts in vital primary pulp therapy. Eur J Pediatr Dent 2002;3(3):115–120.
  12. Tziafas D. The future role of a molecular approach to pulp-dentinal regeneration. Caries Res 2004;38(3):314–320. DOI: 10.1159/000077771
  13. Dorfman A, Stephan RM, Muntz JA. In vitro studies of carious dentin. II. Extent of infection in carious lesions. J Am Dent Assoc 1943;30:1901.
  14. Al-Zayer MA, Straffon LH, Feigal RJ, et al. Indirect pulp treatment of primary posterior teeth: a retrospective study. Pediatr Dent 2003;25(1):29–36.
  15. Monea M, Monea A. Histological evaluation of indirect pulp capping procedures with calcium hydroxide and mineral trioxide aggregate. Eur Sci J 2014;10:1–10.
  16. Gruythuysen RJM, van Strijp AJP, Gunawan MIM, et al. Indirect pulp treatment in primary and permanent teeth with deep carious lesions. Caries Res 2007;41:269.
  17. Miyashita H, Worthington HV, Qualtrough A, et al. Pulp management for caries in adults: maintaining pulp vitality. Cochrane Database Syst Rev 2007;(2):CD004484. DOI: 10.1002/14651858.CD004484.pub2
  18. Naik S, Hegde AH. Mineral trioxide aggregate as a pulpotomy agent in primary molars: an in vivo study. J Ind Soc Pedod Prev Dent 2005;23(1):13–16. DOI: 10.4103/0970-4388.16020
  19. Alacam A, Odabaş ME, Tüzüner T, et al. Clinical and radiographic outcomes of calcium hydroxide and formocresol pulpotomies performed by dental students. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2009;108(5):e127–e133. DOI: 10.1016/j.tripleo.2009.07.017
  20. Sweet CA. Procedure for treatment of exposed and pulpless deciduous teeth. J Am Dent Assoc 1930;17(6):1150–1153. DOI: 10.14219/jada.archive.1930.0158
  21. Srinivasan V, Patchett CL, Waterhouse PJ. Is there life after Buckley's formocresol? Part I – a narrative review of alternative interventions and materials. Int J Paediatr Dent 2006;16(2):117–135. DOI: 10.1111/j.1365-263X.2006.00688.x
  22. Nadin G, Goel BR, Yeung CA, et al. Pulp treatment for extensive decay in primary teeth. Cochrane Database Syst Rev 2003;(1):CD003220. DOI: 10.1002/14651858.CD003220
  23. Loh A, O'Hoy P, Tran X, et al. Evidence-based assessment: evaluation of the formocresol versus ferric sulfate primary molar pulpotomy. Pediatr Dent 2004;26(5):401–409.
  24. Farsi DJ, El-Khodary HM, Farsi NM, et al. Sodium hypochlorite versus formocresol and ferric sulfate pulpotomies in primary molars: 18-month follow-up. Pediatr Dent 2015;37(7):535–540.
  25. Pukallus ML, Plonka KA, Holcombe TF, et al. A randomized controlled trial of a 10 percent CPP-ACP cream to reduce mutans streptococci colonization. Pediatr Dent 2013;35(7):550–555.
  26. Vijayaraghavan R, Mathian VM, Sundaram AM. Triple antibiotic paste in root canal therapy. J Pharm Bioallied Sci 2012;4(Suppl 2):S230–S233. DOI: 10.4103/0975-7406.100214
  27. Takushige T, Cruz EV, Asgor Moral A, et al. Endodontic treatment of primary teeth using a combination of antibacterial drugs. Int Endod J 2004;37:132–138. DOI: 10.1111/j.0143-2885.2004.00771.x
  28. Windley W 3rd, Teixeira F, et al. Disinfection of immature teeth with a triple antibiotic paste. J Endod 2005;31(6):439–443. DOI: 10.1097/01.don.0000148143.80283.ea
  29. Haapasalo M, Orstavik D. In vitro infection and disinfection of dentinal tubules. J Dent Res 1987;66(8):1375–1379. DOI: 10.1177/00220345870660081801
  30. Kuswandari S, Chrisnawati R, Lukito E. Endodontic treatment on deciduous molars with 3Mix-MP. Dent J Maj Ked Gigi 2007;11:75–78.
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