Journal of Endodontics
Volume 34, Issue 7, Supplement , Pages S18-S24 , July 2008

Vital Pulp Therapy with New Materials for Primary Teeth: New Directions and Treatment Perspectives

  • Anna B. Fuks, CD

      Affiliations

    • Corresponding Author InformationAddress requests for reprints to Dr Fuks at

References 

  1. Tziafas D. The future role of a molecular approach to pulp-dentinal regeneration. Caries Res. 2004;38:314–320
  2. Fuks AB. Current concepts in vital primary pulp therapy. Eur J Paediatr Dent. 2002;3:115–120
  3. Baume LJ. The biology of pulp and dentine. In:  Myers HM editors. Monographs in oral science. Basel, Switzerland: Karger; 1980;p. 67–182
  4. Smith AJ, Sloan AJ, Matthews JB, Murray PE, Lumley P. Reparative process in dentine and pulp. In:  Addy M,  Embery G,  Edgar WM,  Orchardson R editor. Tooth wear and sensitivity. London, UK: Dunitz; 2002;p. 53–66
  5. Bjorndal L, Mjor IA. Pulp-dentin biology in restorative dentistry: 4—dental caries: characteristics of lesions and pulpal reactions. Quintessence Int. 2001;32:717–736
  6. Kitamura C, Kimura K, Nakayama T, Toyoshima K, Terashita M. Primary and secondary induction of apoptosis in odontoblasts after cavity preparation of rat molars. J Dent Res. 2001;80:1530–1534
  7. Bjorndal L, Darnnavan T. A light microscopic study of odontoblastic and nonodontoblastic cells involved in tertiary dentinogenesis in well-defined cavitated carious lesions. Caries Res. 1999;33:50–60
  8. Nyborg H. Healing process in the dental pulp on capping: a morphologic study—experiments on surgical lesions of the pulp in dog and man. Acta Odontol Scand. 1955;13(Suppl 16):1–130
  9. Kakehashi S, Stanley HR, Fitzgerald RJ. The effects of surgical exposure on dental pulps in germ-free and conventional laboratory rats. Oral Surg Oral Med Oral Pathol. 1965;20:340–349
  10. Yamamura T. Differentiation of pulpal cells and inductive influences of various matrices with reference to pulpal wound healing. J Dent Res. 1985;64:530–540
  11. Bergenholz G. Factors in pulpal repair after oral exposure. Adv Dent Res. 2001;15:84
  12. Fitzegerald M, Ghiego JD, Heis R. Autoradiographic analysis of odontoblasts replacement following pulp exposures in primate teeth. Arch Oral Biol. 1990;35:707–715
  13. Mjor IA, Dahl E, Cox CF. Healing of pulp exposure: an ultrastructural study. J Oral Pathol Med. 1991;20:496–501
  14. Ricketts DNJ, Kidd EAM, Innes N, Clarkson J. Complete or ultraconservative removal of decayed tissue in unfilled teeth. Cochrane Database Syst Rev. 2006;CD003808
  15. Farooq NS, Coll JA, Kuwabara A, Shelton P. Success rates of formocresol pulpotomy and indirect pulp treatment of deep dentinal caries in primary teeth. Pediatr Dent. 2000;22:278–286
  16. Straffon LH, Loos P. The indirect pulp cap: a review and commentary. Isr J Dent Sci. 2000;17:7–14
  17. Falster CA, Araujo FB, Straffon LH, Nor JE. Indirect pulp treatment: In vivo outcomes of am adhesive resin system vs calcium hydroxide for protection of the dentin-pulp complex. Pediatr Dent. 2002;24:241–248
  18. Al-Zayer MA, Straffon LH, Feigal RJ, Welch KB. Indirect pulp treatment of primary posterior teeth: a retrospective study. Pediatr Dent. 2003;25:29–36
  19. Marchi JJ, de Araujo FB, Froner AM, Straffon LH, Nor JE. Indirect pulp capping in the primary dentition: a 4-year follow-up study. J Clin Pediatr Dent. 2006;31:68–71
  20. Fuks AB. Pulp therapy for the primary dentition. In: Pediatric dentistry: infancy through adolescence. St Louis, MO: Elsevier; 2005;p. 11830
  21. Caicedo R, Abbott PV, Alongi DJ, Alarcon MY. Clinical, radiographic and histological analysis of the effects of mineral trioxide aggregate used in direct pulp capping and pulpotomies of primary teeth. Aust Dent J. 2006;51:297–305
  22. Primosch RE, Glom TA, Jerrell RG. Primary tooth pulp therapy as taught in predoctoral pediatric dental programs in the United States. Pediatr Dent. 1997;19:118–122
  23. Vij R, Coll JA, Shelton P, Farooq NS. Caries control and other variables associated with success of primary molar vital pulp therapy. Pediatr Dent. 2004;26:214–220
  24. Holan G, Eidelman E, Fuks AB. Long-term evaluation of pulpotomy in primary molars using mineral trioxide aggregate and formocresol. Pediatr Dent. 2005;27:129–136
  25. Auerbach C, Moutschen-Damen M, Moutschen M. Genetic and cytogenetical effects of formaldehyde and related compounds. Mutat Res. 1977;39:317–361
  26. Pruhs RJ, Olen GA, Sharma PS. Relationship between formocresol pulpotomies on primary teeth and enamel defects on their permanent successors. J Am Dent Assoc. 1977;94:698–700
  27. Block RM, Lewis RD, Sheats JB, Burke SG. Antibody formation to dog pulp tissue altered by formocresol within the root canal. Oral Surg. 1978;45:282–292
  28. Myers DR, Shoaf HK, Dirksen TR, Pashley DH, Whitford GM, Reynolds KE. Distribution of 14c formaldehyde after pulpotomy with formocresol. J Am Dent Assoc. 1978;96:805–813
  29. Judd PL, Kenny DJ. Formocresol concerns: a review. J Can Dent Assoc. 1987;53:401–404
  30. Sun HW, Feigal RJ, Messer HH. Cytotoxicity of glutaraldehyde and formaldehyde in relation to time of exposure and concentration. Pediatr Dent. 1990;12:303–307
  31. International Agency for Research on Cancer. Press release no. 153. http://www.iarc.fr/ENG/Press_Releases/archives/pr153a.htmlAccessed June 15, 2004
  32. Srinivasan V, Patchett CL, Waterhouse JP. Is there life after Buckley's formocresol? (part I: a narrative review of alternative interventions and materials). Int J Paediatr Dent. 2006;16:117–135
  33. Milnes AR. Persuasive evidence that formocresol use in pediatric dentistry is safe. J Can Den Assoc. 2006;72:247–248
  34. Zarzar PA, Rosenblatt A, Takahashi CS, Takeuchi PL, Costa Junior LA. Formocresol mutagenicity following primary tooth pulp therapy: an in-vivo study. J Dent. 2003;31:479–485
  35. Rolling I, Thylstrup A. A 3-year follow-up study of pulpotomized primary molars treated with the formocresol technique. Scand J Dent Res. 1975;83:47–53
  36. Fishman SA, Udin RD, Good DL, Rodef F. Success of electrofulguration pulpotomies covered by zinc oxide and eugenol or calcium hydroxide: a clinical study. Pediatr Dent. 1996;18:385–390
  37. Sasaki H, Ogawa T, Koreeda M, Ozaki T, et al. Electrocoagulation extends the indication of calcium hydroxide pulpotomy in the primary dentition. J Clin Pediatr Dent. 2002;26:275–277
  38. Elliot RD, Roberts MW, Burkes J, Phillips C. Evaluation of carbon dioxide laser on vital human primary pulp tissue. Pediatr Dent. 1999;21:327–331
  39. Saltzman B, Sigal M, Clokie C, et al. Assessment of a novel alternative to conventional formocresol-zinc oxide eugenol pulpotomy for the treatment of pulpally involved human primary teeth: diode laser-mineral trioxide aggregate pulpotomy. Int J Paediatr Dent. 2005;15:437–447
  40. Alacam A. Long-term effects of primary teeth pulpotomies with formocresol, glutaraldehyde-calcium hydroxide, and glutaraldehyde-zinc oxide eugenol on succedaneous teeth. J Pedod. 1989;18:123–132
  41. Prakash C, Chandra S, Jaiswal JN. Formocresol and pulpotomies in primary teeth. J Pedod. 1989;13:314–322
  42. Fuks AB, Bimstein E, Klein H, Guelmann M. Assessment of a 2% buffered glutaraldehyde solution in pulpotomized primary teeth of schoolchildren. J Dent Child. 1990;57:371–375
  43. Shumayrikh NM, Adenubi JO. Clinical evaluation of glutaraldehyde with calcium hydroxide and glutaraldehyde with zinc oxide eugenol in pulpotomy of primary molars. Endod Dent Traumatol. 1999;15:259–264
  44. Araujo FB, Ely LB, Pergo AM, Pesce HF. A clinical evaluation of 2% buffered glutaraldehyde in pulpotomies of human deciduous teeth: a 24-month study. Braz Dent J. 1995;6:41–44
  45. Schroder U. A 2-year follow-up of primary molars, pulpotomized with a gentle technique and capped with calcium hydroxide. Scand J Dent Res. 1978;86:273–278
  46. Gruythuysen RJ, Weerheijm KL. Calcium hydroxide pulpotomy with a light-cured, cavity-sealing material after two years. J Dent Child. 1997;64:251–253
  47. Huth KC, Paschos E, Hajek-Al-Khatar N, et al. Effectiveness of 4 pulpotomy techniques: Randomized controlled trial. J Dent Res. 2005;84:1144–1148
  48. Fadavi S, Anderson AW. A comparison of the pulpal response to freeze-dried bone, calcium hydroxide, and zinc oxide-eugenol in primary teeth in two cynomolgus monkeys. Pediatr Dent. 1996;18:52–56
  49. Nakashima M. Induction of dentine formation on canine amputated pulp by recombinant human bone morphogenetic proteins (BMP)-2 and 4. J Dent Res. 1994;73:1515–1522
  50. Rutherford RB, Wahle J, Tucker M, Roger D, Charette M. Induction of reparative dentine formation in monkeys by recombinant human osteogenicprotein-1. Arch Oral Biol. 1993;38:571–576
  51. Fei AL, Udin RD, Johnson R. A clinical study of ferric sulfate as a pulpotomy agent in primary teeth. Pediatr Dent. 1991;13:327–332
  52. Fuks AB, Holan G, Davis JM, Eidelman E. Ferric sulfate vs dilute formocresol in pulpotomized primary molars: long-term follow-up. Pediatr Dent. 1997;19:327–330
  53. Smith NL, Seale NS, Nunn ME. Ferric sulfate pulpotomy in primary molars: a retrospective study. Pediatr Dent. 2000;22:192–199
  54. Ibrevic H, Al-Jame Q. Ferric sulfate as pulpotomy agent in primary teeth: twenty-month clinical follow-up. J Clin Pediatr Dent. 2000;24:269–272
  55. Burnett S, Walker J. Comparison of ferric sulfate, formocresol, and a combination of ferric sulfate/formocresol in primary tooth vital pulpotomies: a retrospective radiographic survey. J Dent Child. 2002;69:44–48
  56. Markovic D, Zibojinovic V, Bucetic M. Evaluation of three pulpotomy medicaments in primary teeth. Eur J Paediatr Dent. 2005;6:133–138
  57. Agamy HA, Bakry NS, Mounir MM, Avery DR. Comparison of mineral trioxide aggregate and formocresol as pulp-capping agents in pulpotomized primary teeth. Pediatr Dent. 2004;26:302–309
  58. Naik S, Hegde AM. Mineral trioxide aggregate as a pulpotomy agent in primary molars: an in vivo study. J Indian Soc Pedod Prev Dent. 2005;23:13–16
  59. Farsi N, Alamoudi N, Balto K, Mushayt A. Success of minerals trioxide aggregate in pulpotomized primary molars. J Clin Pediatr Dent. 2005;29:307–311
  60. Vargas KG, Packam BS, Lowman D. Preliminary evaluation of sodium hypochlorite for pulpotomies in primary molars. Pediatr Dent. 2006;28:511–517
  61. Nadin G, Goel BR, Yeung CA, Glenny AM. Pulp treatment for extensive decay in primary teeth. Cochraine Database Syst Rev. 2003;CD0033220
  62. Loh A, O'Hoy P, Tran X, et al. Evidence-based assessment: evaluation of the formocresol vs ferric sulfate primary molar pulpotomy. Pediatr Dent. 2004;26:401–409
  63. Fuks AB, Papagiannoulis L. Pulpotomy in primary teeth: review of the literature according to standardized assessment criteria. Eur Arch Paediatr Dent. 2006;7:64–71
  64. Curzon MJ, Toumba KJ. Restoration of primary teeth: criteria for assessment of the literature. Eur Arch Paediatr Dent. 2006;7:48–52
  65. Peng L, Ye L, Tan H, Zhou X. Evaluation of the formocresol vs mineral trioxide aggregate primary molar pulpotomy: a meta-analysis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2006;102:e40–e44
  66. Deery C. Formocresol and ferric sulfate have similar success rates in primary molar pulpotomy: in carious primary molars does a pulpotomy performed with ferric sulphate, compared with formocresol, result in greater clinical/radiographic success?. Pediatr Dent. 2004;26:401–409
  67. What is meta-analysis?. http://www.evidence-based-medicine.co.ukAccessed February 27, 2008
  68. Egger M, Davey Smith G, Phillips AN. Meta-analysis: principles and procedures. Br Med J. 1997;315:1533–1537
  69. Norbert V. The challenge of meta-analysis: discussion, indication, and contraindications for meta-analysis. J Clin Epidemiol. 1955;48:5–8
  70. Sutton AJ, Abrams KR, Johns DR. An illustrated guide to the methods of meta-analysis. J Eval Clin Pract. 2001;7:135–148
  71. Cuisia ZE, Musselman R, Schneider P, Dummet CJR. A study of mineral trioxide aggregate pulpotomies in primary molars (abstract). Pediatr Dent. 2001;23:168
  72. Jabbarifar SE, Khadeni DD, Ghaseni DD. Success rates of formocresol pulpotomy vs mineral trioxide aggregate in human primary molar tooth. J Res Med Sci. 2004;6:55–58
  73. Aktoren O, Gencay K. A two-year clinical-radiographic follow-up of the pulpotomies in primary molars (abstract). J Dent Res. 2000;79:543
  74. Papagiannoulis L. Clinical studies on ferric sulphate as a pulpotomy medicament in primary teeth. Eur J Paediatr Dent. 2002;3:126–132
  75. Waterhouse PJ, Nunn JH, Whitworth JN. An investigation of the relative efficacy of Buckley's formocresol and calcium hydroxide in primary molars vital pulp therapy. Br Dent J. 2000;188:32–36
  76. Liu JF. Effects of Nd:YAG laser pulpotomy on human primary molars. J Endod. 2006;32:404–407

 Conflict of Interest: Anna B. Fuks, CD, reports no financial interests or potential conflicts of interest.This article is being published concurrently in Pediatric Dentistry, May/June 2008; Volume 30, Issue 3. The articles are identical. Either citation can be used when citing this article.

PII: S0099-2399(08)00194-5

doi: 10.1016/j.joen.2008.02.031

Journal of Endodontics
Volume 34, Issue 7, Supplement , Pages S18-S24 , July 2008