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Showing 19 results for Pulp

Y. Baradaran Nakhjavani , Gh. Mighani , M. Akhavan ,
Volume 17, Issue 2 (6-2004)

Statement of Problem: Pulpotomoy is considered as one of the most common treatments among primary teeth. Therefore, search for an appropriate and safe material seems necessary. Studies have proved ferosulfate as a therapeutic material in pulpotomy.

Purpose: The goal of the present study was to compare clinical and radiographic changes of pulpotomy using ferosulfate and formocresol in primary molars among 3-8 year old children.

Materials and Methods: In this clinical trial study, fifteen 3-8 years old children, referred to the pedodontics department, faculty of Dentistry, Tehran University of Medical Sciences were selected. All subjects did not show any systemic disease, with at least two clinically and radiographically accepted posterior teeth for pulpotomy technique. Totally, forty- three teeth were studied. For each patient both materials were used. Following treatment, patients were investigated, clinically and radiographically in 3, 6, 9 and 12 month follow-ups. During follow-up periods, teeth with failures were not excluded and investigated. For data analysis, Chi-square and Fisher’s-exact tests were used and treatment success was evaluated, based on clinical as well as radiographic findings.

Results: In all follow-up periods (3, 6, 9 and 12 months after treatment), pulpotomies with formocresol showed more success rate (73.7%) comparing to those with ferosulfate (70.8%), although the difference was not statistically significant (P>0.05). Statistical tests revealed no significant difference between two different treatment techniques regarding pain, external and internal resorption, calcified metamorphosis, abcess, apical root resorption, apical and interradicular radiolucency.

Conclusion: Although ferosulfate, due to its less toxicity, may be considered as a proper substitute for formocresol in primary molars pulpotomies, more studies with longer-term follow up and larger sample size are required to determine its long-term effects.

E. Yasini , M. Pour Kazemi ,
Volume 17, Issue 4 (1-2005)

Statement of Problem: The pulp may be exposed during remove of caries or by traumatic and iatrogenic injuries. The material used to DPC, must be biocompatible, scalable and prevent bacterial leakage.Furthermore, it is better to stimulate dentinogenesis. Calcium hydroxide is most usual material for DPC. But it cannot provide a suitablcbiologic seal. Mineral irioxide aggregate (MTA) is also a suitable material for DPC.
Purpose: The aim of this study was to compare the clinical success of DPC done with MTA or calcium hydroxide cement.

Materials and Methods: In this study eighteen posterior teeth without previous spontaneous pain that involved mechanicaly exposure was randomly selected and capped with MTA or calcium hydroxide. These teeth were evaluated by clinical vitality test and radiograph after 3 and 12 months, and patients were questioned about irritative or spontancus pain in this period. Statistical analysis was carried out by Usher exact
test (a-0.05).
Results: This study showed that in calcium hydroxid groud three had irreversible pulpitis and two teeth had symptom and signs of reversible pulpitis. While, In MTA group all cases were normaL and no clinical sign was evident.
Conclusion: MTA exhibited better results than calcium hydroxide cement for the capping of the pulp in human

S. Khedmat ,
Volume 18, Issue 1 (3-2005)

The purpose of this article was reviewing the literature related to the mutual effects of endodontics and orthodontics on each other providing documented information that can be used by dentists in clinical practice. The effect of orthodontic treatment on the dental pulp and its role in root resorption, the influence of previous trauma to the tooth and endodontic treatment in orthodontic tooth movements and root resorption, recommendations regarding endodontic treatment during orthodontic tooth movement and the role of the orthodontic forces in provision and outcome of endodontic treatment are being discussed. The effect of the orthodontic tooth movement on the pulp is focused primarily on the neurovascular system which can cause degenerative and/or inflammatory responses in the dental pulp. Although, most of these changes are considered reversible, it seems that teeth with complete apical foramen and teeth subjected to previous insults, such as trauma, caries, restorations and periodontal diseases are more susceptible to pulpal irreversible changes. Teeth with root canal treatment that are well cleaned shaped, and three- dimensionally obturated, exhibit less propensity to apical root resorption during orthodontic tooth movement. This outcome depends on the absence of microleakage for bacterial ingress. A traumatized tooth can be moved orthodontically with minimal risk of resorption, provided that the pulp has not been severely injured (infection or necrosis). If there is evidence of pulpal demise, appropriate endodontic treatment is necessary prior to orthodontic treatment .If a previously traumatized tooth exhibits resorption, there is a greater chance that orthodontic tooth movement will enhance the resorptive process. If a tooth has been severely traumatized (intrusion, avulsion) there would be a greater incidence of resorption with tooth movement. It is recommended that teeth requiring root canal treatment during orthodontic movement be initially cleaned and shaped followed by the interim placement of calcium hydroxide. Final canal obturation with gutta-percha should be accomplished upon the completion of orthodontic treatment. Endodontically treated teeth can be moved orthodontically similar to teeth with vital pulps. In case of endodontic procedures like apexification, there may be no need to delay the orthodontic treatment.
Z. Bahrololoomi, M. Emtiyazi , Gh. Hosseini ,
Volume 18, Issue 3 (5-2005)

Background and Aim: Pulpotomy is one of the routine methods for pulp therapy of primary teeth. At present it is a fact that ideal agent for this has not been discovered. The aim of this study was to compare the clinical and radiographic success rates of electrosurgical pulpotomy versus formocresol pulpotomy in human primary molar teeth.

Materials and Methods: In this clinical trial study, pulpotomy was performed on 68 primary molars in children aged from 5 to 10 years. The teeth were treated using either a conventional formocresol (35 teeth), or electrosurgical technique (33 teeth). Following the pulpotomy procedure, the teeth were evaluated regarding clinical and radiographic success for 3, 6 and 9 months periods. The teeth were evaluated clinically and radiographically for the presence of pain, abscess, fistula, mobility, internal and external resorption and radiolucency. Finally clinical and radiographic data were collected and analyzed with Fisher exact test using P<0.05 as the limit of significance.

Results: After 9 months follow up, the clinical and radiographic success rates for the electrosurgery group were 96% and 84% respectively and for formocresol group, 100% and 96.8% respectively. There were no statistically significant differences between the success rates for the two groups (P>0/05).

Conclusion: Although electrosurgical pulpotomy is a nonpharmacological and easy to use technique, further investigations with longer evaluation periods are suggested.

M. Aeinehchi , S. Dadvand ,
Volume 19, Issue 4 (1-2007)

Background and Aim: Vital pulpotomy in primary teeth is performed to maintain the vitality of the pulp and tooth until normal exfoliation. Different materials such as zinc oxide- eugenol, calcium hydroxide and formocresol are used in this procedure. The aim of this study was to evaluate the application of formocresol (FC) and mineral trioxide aggregate (MTA) in pulpotomy of primary molars.

Materials and Methods: In this clinical trial, one hundred and twenty six children (aged 5 to 9 years old) with dental caries that were candidate for pulpotomy were selected and randomly divided into two groups. After removing the roof of the pulp chamber, coronal pulp was cut at the orifices and bleeding controlled. In control group, formocresol was applied for 5 minutes. In case group, MTA paste was used as pulpotomy agent. The crowns of both groups were restored with amalgam and the teeth were evaluated clinically and radiographically after 3 and 6 months follow up. Data were analyzed by Fisher test with p<0.05 as the limit of significance.

Results: No sign of clinical failure was observed after 3 and 6 months follow-up. Comparison between the two methods revealed no significant difference in radiographic findings of the teeth and surrounding tissues after 3 months follow-up. However, after 6 months follow-up, internal resorption was observed radiographically in four cases of formocresol group.

Conclusion: Based on the results of this study, pulpotomy with MTA showed more successful results than formocresol radiographically. MTA is recommended as a good substitute for formocresol in pulpotomy of primary molars.

A. Kowsari , Sh. Azadedel , N. Akhondi ,
Volume 20, Issue 1 (5-2007)

Background and Aim: Formocresol (FC) has been a popular pulpotomy medicament for primary dentition in recent decades. Concerns have been raised about the toxicity and potential carcinogenicity of FC, and alternatives have been proposed. Recently, the physical and biological properties of mineral trioxide aggregate (MTA) have been described in many studies. The aim of this study was to compare the success rate of pulpotomy with MTA (made in Iran) and FC in primary molars.
Materials and Methods: In this clinical trial, 30 primary molars needing pulpotomy treatment were selected and randomly divided into two groups: (15 teeth in FC and 15 in MTA group). The teeth were then pulpotomized and restored. Clinical and radiographic results were recorded at 1-3-6-9 and 12 months and success rates of two groups were compared using Fisher’s exact test with p<0.05 as the level of significance.
Results: After 12 months, there was no statistical significant difference between MTA group (85.8%) and FC group (93.3%) (P 1.0). The only observed radiographic failure was internal resorption.
Conclusion: Based on the results of this study, MTA can be used as an alternative to formocresol in primary teeth pulpotomy.
F. Ezoddini Ardekani, Z. Mohammadi, Z. Hashemian, M. Sadrbafghi, A. Hedayati, Mj. Rahmani Baghemalek,
Volume 22, Issue 1 (8-2009)

Background and Aim: Dental pulp calcification may have the same pathogenesis as vascular calcifications. Pulp stones are calcified mass, which are commonly observed in usual dental radiographs. The purpose of this study was to evaluate the relationship between pulp stones and ischemic CVD.

Materials and Methods: This was a cross-sectional descriptive-analytic study on 20-25-year-old patients who had at least 8 intact teeth and were referred to Afshar hospital for cardiovascular examinations. Relationship between vascular stenosis and dental pulp stone was explored.

Results: Sixty one patients who had undergone angiography were studied. They included 32 male (52.5%) and 29 female (47.5%). 38 patients had at least one stenotic vessel (from one to three vessels) and the others (37.7%) showed normal angiographic findings. 73.8% (31 cases) of the patients with dental pulp stones suffered from coronary narrowing where as only 36.8% (7 cases) of the patients without dental pulp stones showed coronary vessels narrowing. Pulp stones were mostly seen in first and second Molar teeth.

Conclusion: According to the results, we can state that oral and maxillofacial radiology is helpful in screening of cardiovascular diseases.

Ms. Sheikhrezaie, M. Amin Sobhani, K. Oloumi,
Volume 22, Issue 2 (11-2009)

Endodontic treatment of immature permanent teeth accompanies with several issues. The primary goal when treating such teeth is to maintain pulp vitality so that root development can occur normally. Indications and requirements for vital pulp therapy include asymptomatic and reversible pulpitis. Also there are controversial opinions regarding the ultimate clinical treatment of the vital pulp therapy techniques. In this manuscript we report 3 cases of immature symptomatic permanent molars with irreversible pulpitis caused by caries exposure of the pulp that have been undergone vital pulp therapy successfully.

R. Haghgoo, F. Mollaasadolla, F. Abbasi,
Volume 22, Issue 2 (11-2009)

Background and Aim: Several agents were used for pulpotomy in primary molars. Formocresol is the most common drug in this procedure. In some studies it has been shown that, this material has potential some side effects, so it is essential to find other alternatives. The aim of this study was to evaluate clinical and radiographic success rates of mineral trioxide aggregate and formocresol.

Materials and Methods: In this randomized clinical trial study, 70 carious primary teeth of 4 to 7-year-old children were pulpotomized, and remaining pulp was dressed with Root MTA and formocresol. The clinical and radiographic follow up evaluations were performed at 6, 12 months by a blind dentist. The data were analyzed by Fisher's exact test.

Results: At the end of 1-year follow-up period, in formocresol group sinus tract and tenderness to percussion were seen in 2 teeth, internal resorption was seen in 1 tooth, and furcation radiolucency was seen in 2 teeth. Clinical and radiographic signs of failure were not seen in any case of (Iranian) Root MTA group.

Conclusion: Based on the results of this study, Iranian MTA can be used for pulpotomy in primary molars.

M. Tabrizizadeh, Sm. Abrisham, F. Dehghan Marvasti,
Volume 22, Issue 3 (12-2009)

Background and Aim: Extracted teeth used in preclinic should be disinfected. The aim of this study was to evaluate the effects of some disinfectants on microorganisms cultured from pulp chamber of extracted teeth.
Materials and Methods: In this experimental study 54 intact human teeth were collected. After access cavity preparation, 10 8 B. streothermophillus endospors were inoculated into pulp chamber. Then cavities were sealed with a temporary restorative material. Teeth were divided into 5 groups of 10 each. The teeth were then stored in these disinfectants: 5.25% hypochlorite sodium, 5% Microten, 5% Deconex, 2% Glutaraldehyd, and 10% Formalin for 48 hours. Two teeth were autoclaved as negative controls and two were stored in normal saline as positive controls. The teeth were then sectioned in cervical area and cultured in Trypticase Soy Broth. After three days turbidity in tubes was evaluated. Statistical analysis was done by Fisher's exact test.
Results: None of these solutions were able to prevent microorganism growth in all samples however, Formalin was better in six cases than that of other disinfectants. Differences between these five groups were not statistically significant (P=0.384).
Conclusion: Sterilization of the teeth with autoclave is the only absolute method for disinfecting the root canals of extracted teeth and disinfectants are not reliable for this purpose.

R. Haghgoo, F. Abbasi,
Volume 23, Issue 1 (6-2010)

Background and Aims: Formocresol is one of the most common pulpotomy medicaments for primary teeth. Because of its systemic and local side effects, it may be essential to use another material instead of formocresol. The aim of this study was to evaluate the histopothalogy of pulp after pulpotomy teeth with sodium hypochlorite and formocresol.

Materials and Methods: In this randomized clinical trial, 22 canine teeth that must be extracted because of orthodontic treatment were selected. The teeth were randomly divided into 2 groups (n=11) and pulpotomized with formocresol or sodium hypochlorite. These teeth were extracted after 2 months and pulpal response was evaluated according to the degree of inflammation and extent of pulpal involvement. Dentinal bridge formation was also evaluated. The data were analyzed by Mann-Whitney test.

Results: In formocresol group, mild inflammation was seen in 4 and moderate inflammation in 3 and severe inflammation in 4 cases. In sodium hypochlorite group mild inflammation was seen in 6 cases and moderate inflammation in 4 cases and severe inflammation in 1 case. Mann-Whitney test revealed that this difference was not statistically significant (P>0.05). In formocresol group, necrosis was seen in 5 cases, but abscess and internal resorption were not seen in any cases. In sodium hypochlorite group, internal resorption was seen in 3 cases but necrosis and abscess were not seen in any cases.  Mann-Whitney test showed that the difference between two groups was significant in terms of necrosis (P=0.02). In sodium hypochlorite group, dentinal bridge was formed in 3 cases however, no dentinal bridge formation was seen in formocresol group. Mann-Whitney test showed that this difference was not significant statistically (P>0.05).

Conclusion: Based on the results of this study, sodium hypochlorite can be used as a pulpotomy agent in primary teeth.

F. Mashadi Abbas, S. Mojarrad, Z. Yadegary, B. Sharifi,
Volume 24, Issue 2 (4-2011)

Background and Aims: In the last decade, several studies have reported the isolation of stem cell population from different dental sources, while their mesenchymal nature is still controversial. The aim of this study was to isolate stem cells from mature human dental pulp and follicle and to determine their mesenchymal nature before differentiation based on the ISCT (International Society for Cellular Therapy) criteria.
Materials and Methods: In this experimental study, intact human third molars extracted due to prophylactic or orthodontic reasons were collected from patients aged 18-25. After tooth extraction, dental pulp and follicle were stored at 4°C in RPMI 1640 medium containing antibiotics. Dental pulp and follicle were prepared in a sterile condition and digested using an enzyme solution containing 4mg/ml collagenase I and dispase (ratio: 1:1). The cells were then cultivated in α-MEM medium. Passage-3 cells were analyzed by flow cytometry for the expression of CD34, CD45, CD 73, CD90 and CD105 surface markers.
Results: Dental pulp and follicle were observed to grow in colony forming units, mainly composed of a fibroblast-like cell population. Flow cytometry results showed that dental pulp and follicle are highly positive for CD73, CD90 and CD105 (mesenchymal stem cell markers) and are negative for hematopoietic markers such as CD34 and CD 45.
Conclusion: In this study we were able to successfully confirm that dental pulp and follicle stem cells isolated from permanent third molars have a mesenchymal nature before differentiation. Therefore, these two sources can be considered as an easy accessible source of mesenchymal stem cells for stem cell research and tissue engineering.

Jalil Modaresi, Amir Reza Heshmat Mohajer, Hossein Aghili, Morteza Khorshidi, Faramarz Rostami Chavoshlo, Amirmohamad Mahabadi,
Volume 25, Issue 3 (7-2012)

Background and Aims: Electric pulp testing is used for diagnosis of the pulp status. This test is technique sensitive and hence may elicit positive or negative false response in case of inaccurate use. The optimal site for placement of the probe tip has not been determined. The aim of this study was to evaluate the effect of pulp tester probe placement site on the response of maxillary teeth.
Materials and Methods: A total of 378 teeth (126 central incisors, 126 lateral incisors and 126 canines) in 67 voluntary 20-35 year-old patients were selected. Three sites on each tooth (incisal edge, labial and lingual surfaces) were tested with an electrical pulp tester and responses were recorded. Data were analyzed by Repeated Measure ANOVA test.
Results: The central teeth showed significantly lower sensation threshold than lateral and canine teeth (P<0.001). The incisal edge of tooth were significantly more sensitive compared to labial and lingual surfaces (P=0.008).
Conclusion: This study showed that the optimum site for placement of pulp tester probe was incisal edge.

Jalil Modaresi, Fatemeh Mokhtari, Yousef Khalil Sefat, Hossein Shahnazian,
Volume 25, Issue 4 (1-2013)

Background and Aims: The vitality pulp tests are necessary for diagnosis of pulpal disease and differentiation between endodontic and non-endodontic diseases. Thermal and electrical tests are conventional methods for evaluation of pulp vitality. The purpose of this study was to evaluate the effect of thermal changes on the tooth response to the electric pulp tester.

Materials and Methods: In this study, 160 intact maxillary central incisors of 40 voluntaries were evaluated. After isolation, electric pulpal response threshold in patients were recorded. After heat and cold tests, the electrical pulp test was repeated. The degree of response was recorded. The data were analyzed using pair T-test and independent T-test.

Results: The result of this study demonstrated that the average of teeth response to the electric pulp tester before and after cold test was 1.3 and 1.7, respectively. The average was 1.4 and 1.7 before and after heat test, respectively. There was no significant difference (P<0.001) between the pulpal response before and after thermal tests (heat and cold tests). In addition, no significant difference was found between pulpal response after heat and cold tests (P=0.25).

Conclusion: The response of tooth to the electric pulp tester was influenced by heat and cold tests.

Eshagh Ali Saberi, Fereydoon Sargolzaei Aval , Arab Mohammad Reza Mohammad Reza , Seddighe Ebrahimipour ,
Volume 26, Issue 3 (8-2013)

  Background and Aims: The purpose of this study was to evaluate the tissue responses to octacalcium phosphate (OCP) and calcium hydroxide (CH) used as direct pulp capping (DPC) materials in cat teeth.

  Materials and Methods: 72 premolar teeth of 9 cats were selected and divided into 3 groups (Two experimental and one control group). After the cats had been anesthetized, the pulp were exposed and capped directly with OCP, CH or no capping material as control group. The cavities of all three groups were filled with Glass ionomer cement (GI). Histological evaluations were performed at two, four and eight weeks after pulp capping. After tissue preparation procedures, paraffin blocks were prepared. After preparation and staining of the sections, the relevant variables were measured by optical microscope. The results were analyzed using Mann-Whitney U and Chi-square tests ( α =0.05).

  Results: Two weeks after pulp capping, all specimens in three groups showed mild to sever inflammation. The formation of hard tissue (dentinal bridge) at in the exposed areas of the experimental groups was more noticeable for calcium hydroxide than that of octacalcium phosphate group. These differences were statistically significant (P<0.001). At four weeks, hard tissues were observed in both groups which were more evident for the CH group and there were statistically significant difference between two experimental groups (p<0.003). At eight weeks, continuous hard tissues were observed in both groups and there were no statistically significant difference between them (P>0.05), but hard tissues continuity were better for in the OCP than that of the CH.

  Conclusion: It seems that the formation of hard tissue in CH because of its porosities had a worse percentage in sealing of the pulp than the OCP .

Jalil Modaresi, Vahid Shirani, Mohammad Malekzadeh,
Volume 27, Issue 2 (6-2014)

  Background and Aims: Electric pulp tester is a valuable instrument to examine tooth’s pulp vitality. There is no agreement about the response of immature teeth to electric pulp tester and the reason is expressed as the failure of nerve fibers’ development. The aim of this study was to investigate the effect of patient’s age on the tooth response to electric pulp tester.

  Materials and Methods: In this cross-sectional study, 300 maxillary central permanent teeth in 150 volunteers were examined by using electric pulp tester. The volunteers were classified in 5 age groups of 7-8, 9-10, 11-12, 13-4, and 30-35 and teeth lacking sound and healthy pulp were excluded. Data were analyzed using SPSS-16 software, one-way analysis of variance, and Tukey post hoc test.

  Results: The average response to electric pulp tester in age groups of 7-8, 9-10, 11-12, 13-4, and 30-35 years old were 2.9±0.1, 2.8±0.1, 2.3±0.1, 2.2±0.1 and 1.8±0.1 ,respectively. This indicated that by increasing teeth age, they responded to lower level of electric pulp tester. In subjects less than 14 years old, there was no significant difference between neighboring groups (P=0.3) however, a significant difference was observed between subjects less than 14 years old and adults (P<0.001).

  Conclusion: This study showed that immature teeth responded at higher levels to electric test however, all teeth responded to electric pulp tester.

Farzaneh Jabari, Javad Mohammadnejad, Kamal Yavari,
Volume 27, Issue 3 (9-2014)

  Background and Aims: In the last decade, several studies have reported the isolation of stem cell population from different dental sources, while their mesenchymal nature is still controversial. The aim of this study was to introduce the isolating methods for stem cells from human dental pulp and to determine their mesenchymal nature before differentiation.

  Material and methods: One of the best sources for stem cell is dental pulp tissue. Dental Pulp Stem Cells (DPSCs) would be the most convenient source of stem cells because teeth were easy to retrieve and removed throughout life. Pulp is a specialized connective tissue including blood and lymph vessels, nerves, and the interstitial fluid. DPSCs can be found within the ‘‘cell rich zone’’ of pulp. DPSCs have been isolated for the first time in 2000 by Gronthos these cells exhibited a differentiation potential for odontoblastic, adipogenic and neural cytotypes. Gronthos isolated stem cells in 2 different methods: The enzymatic digestion method and the second was out growth, these cells could be cryopreserved in liquid nitrogen. It has also been shown that human DPSCs can be used for complex structures such as pulp or woven bone formation in vivo.

  Conclusion: DPSCs originate from the cranial neural crest and have neural characteristics such as the expression of neurotrophins. Therefore, DPSCs may represent a promising source in cell therapy for neurological disorders. Characterization of these cells and determination of their potentialities in terms of specificity of regenerative response will form the foundation for development of new clinical treatment modalities, whether involving directed recruitment of the cells and seeding of stem cells at sites of injury for regeneration or use of the stem cells with appropriate scaffolds for tissue engineering solutions. Such approaches will provide an innovative and novel biologically based on new generation of clinical treatments for dental disease.

Mohammad Esmaeilzadeh, Fahimeh Daneshyar, Zakieh Donyavi, Bashir Tarighi, Shahin Nasiri,
Volume 31, Issue 3 (11-2018)

Background and Aims: The structural distinction of primary teeth compared to the permanent teeth leads to a faster penetration of the caries into the pulp, which makes effective treatment necessary. The aim of this study was to determine the success rate of pulpotomy in primary molar teeth and its effective factors using formocresol by students and residents at the department of pediatric dentistry of Hamedan dental school.
Materials and Methods: In this cross-sectional study, 113 children who previously had pulpotomy by formecresol in their primary molars (30 children by residents and 83 children by the students) were randomly evaluated based on referral time (at least 12 months after treatment) in terms of clinical and radiographic success rates. Data were analyzed by SPSS20 software using Chi-square and descriptive statistics.
Results: The success of the pulpotomy of primary molar teeth was 81.7%. The success rates of the general students and residents were 79.3% and 87.3%, respectively. The percentage of successful pulpotomy was significantly higher in general students at Stainless Steel Crown (S.S.C), second molar in maxilla (P<0.05), but did not have a significant relationship with age and sex (P>0.05). The percentage of pulpotomy success performed by residents did not have a significant correlation with gender, age, type of repair, type of teeth and jaws (P>0.05). In general, the percentage of success in S.S.C, the second molar and maxillary jaw was higher. Also, the success rate of pulpotomy by residents was significantly higher than that of general- students (P<0.05). The highest rates of pulpotomy failure were related to internal analysis.
Conclusion: Formocresol pulpotomy using S.S.C in the maxillary second molar teeth had higher success rate.

Jalil Modaresi, Hamid Reza Hemati, Mehri Esfandyar, Mohammad Hosein Yousefi,
Volume 32, Issue 4 (1-2020)

Background and Aims: Various methods to induce anesthesia have been investigated in situations where the primary inferior alveolar nerve block (IANB) injections fail. The aim of this study was to compare the effect of synergic effects of anesthetic injection of prilocaine supplemental with that of lidocaine anesthesia in teeth with irreversible pulpitis.
Materials and Methods: This study was a parallel-controlled clinical trial on 58 patients with one mandibular molar tooth having irreversible pulpitis. The first anesthesia was injected with an inferior alveolar block with 2% lidocaine anesthesia. Patients who failed pulpal anesthesia were randomly divided into two groups; case and control groups. In the case group, IANB was injected with 3% prilocaine, and in the control group with 2% lidocaine anesthesia. Anesthesia after the second injection was evaluated by three methods of numerical evaluation of the patient's response to Electric Pulp Tester (EPT), the severity of the patient's response to the cold test, and the extent of pain during the onset of access cavity latency on the Visual Analog Scale (VAS). Statistical analysis was performed using T-test and Mann-Whitney tests.
Results: There was no significant difference between the two groups in terms of depth of anesthesia (P>0.05).
Conclusion: The results of this study showed that there was no difference between 2% lidocaine and 3% prilocaine in the depth of supplemental IANB anesthesia after failure of first IANB in mandibular molar teeth with irreversible pulpitis.

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