Pulpotomy as an alternative to canine tooth extraction in monkeys [Macaca mulatta].
An effective method for sealing pulp canals after partial removal of canine tooth crowns from adult rhesus monkeys is described.
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An effective method for sealing pulp canals after partial removal of canine tooth crowns from adult rhesus monkeys is described.
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A 36-month retrospective study compared the results of vital pulp therapy based on the duration of pulp exposure for complicated crown fracture of 97 permanent canine teeth in 76 dogs. Postoperative oral and radiographic examinations were performed at 3, 12, and 36-months following treatment. Based on the 36-month postoperative examinations 88.2%, 41.4 %, and 23.5% of teeth were vital when treated within 48-hours, 1-week, and 3-weeks of pulp exposure, respectively. There was a significant difference in the incidence of tooth vitality between groups. The duration of pulp exposure following complicated crown fracture influenced the success of vital pulp therapy. Vital pulp therapy should be performed as soon as possible following traumatic pulp exposure.
Subjective owner assessment of the success of vital pulp therapy was performed for complicated crown fracture (n = 9) and crown reduction (n = 54) of canine teeth in dogs and cats. Our results documented that owners are not able to accurately determine the outcome of vital pulp therapy. Objective assessment of vital pulp therapy for teeth receiving crown reduction indicated maintenance of vitality in 28 of 28 (100%) teeth. Subjective and objective assessments of vital pulp therapy performed > 7-days following complicated crown fracture indicated 9 of 9 (100%) teeth were non-vital. A poor prognosis for maintenance of tooth vitality is warranted for vital pulp therapy of complicated crown fractures with prolonged pulp exposure regardless of the age of the patient. Whereas, an excellent prognosis can be provided for vital pulp therapy following crown reduction. Semiannual, postoperative oral and radiographic examinations are recommended for a minimum of 2-years to assess vitality in all teeth receiving vital pulp therapy.
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Analysis of these results shows that complete hard tissue bridges, aside from occurring with great frequency, produce a satisfactory protection to the pulp. In a case in which the barrier is incomplete, some future clinical problems may result as an incomplete barrier does not offer adequate protection as shown by the chronic inflammatory reaction in the remaining pulp tissue.
Calcium hydroxide pulpotomies were performed in 17 carious primary mandibular molars. Variables in the pulpotomy procedure were recognized and controlled in an attempt to obtain a more favorable result or end product. The effects of two methods of hemorrhage control were also evaluated. The duration of treatment for the study ranged from three to nine months. Treatment was clinically successful for all 17 teeth. The radiographic evaluations were more favorable for the experimental group than for the control group. Treatment was radiographically successful for 15 teeth, questionable for one tooth, and unsuccessful for one other tooth. The results of this study suggest that the aluminum chloride-calcium hydroxide pulpotomy may be a viable alternative to formocresol pulpotomies in the primary dentition. Although these findings encourage continued research, including a long-term follow-up, a histologic study is indicated.
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Deficiencies of pulpotomy and pulpectomy treatment of primary teeth have promoted considerable laboratory and clinical research. Some of these findings and their implications are reviewed.
Certain clinical and biological studies have reported that prepared dentin and the underlying pulp must be protected with a calcium hydroxide base and liners that supposedly impart biological and structural integrity to tissues. Since the mid-1950s, dentists have relied on a number of calcium hydroxide medicaments for this goal. But recent studies imply that clinicians need to re-evaluate the generous use of certain calcium hydroxide medicaments under restorations.
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