Evaluation of bioactive glass and hydroxyapatite crystals as pulpotomy agents in primary molars: A clinical study

Neeraja Govindaraj1Orcid, Kinjal Shah2Orcid, Priya Subramaniam3Orcid, Megha Gupta4Orcid

Highlights

The pulp in the primary teeth has immense potential for repair because of a high degree of cellularity and vascularity in this tissue.
Bioactive Glass and Hydroxyapatite crystals exhibit pulpal biocompatibility, antibacterial property, osteogenic property and good bonding to tooth structure.
Bioactive Glass and Hydroxyapatite Crystals were found to be promising regenerative materials for pulpotomy in primary teeth.

Abstract

Aim: To clinically and radiographically evaluate the potential of bioactive glass and hydroxyapatite crystals as pulpotomy agents in primary molars. Methods: A total of fifty teeth were selected from 25 children (14 boys and 11 girls) aged 4 to 9 years, who had no medical condition that would contraindicate pulp therapy. Each child had at least two primary molars (first and/or second primary molar) requiring pulpotomy. A conventional pulpotomy procedure was performed on the selected teeth using bioactive glass and hydroxyapatite crystals. All molars were evaluated clinically and radiographically at regular intervals over 12 months. The results were subjected to statistical analysis using Fischer exact test. Results: One hundred percent clinical success and 84% radiographic success was observed in both the groups at the end of the study period. Conclusions: The study concluded that both bioactive glass and hydroxyapatite crystals can be used as pulpotomy agents in primary molars.

Keywords: Bioactive Glass; Deciduous Teeth; Hydroxyapatite; Pulpotomy

Author Affiliations

  1. Former Reader, Department of Pedodontics and Preventive Dentistry, The Oxford Dental College and Hospital, Bangalore, India.
  2. Former Post Graduate Student, Department of Pedodontics and Preventive Dentistry, The Oxford Dental College and Hospital, Bangalore, India.
  3. Professor and Head, Department of Pedodontics and Preventive Dentistry , The Oxford Dental College and Hospital, Bangalore, India
  4. Reader, Department of Pedodontics and Preventive Dentistry, Vyas Dental college and Hospital,  Jodhpur, India.(✉ Correspondence: meghamcods@gmail.com)
  1. Coll JA, Seale NS, Vargas K, Marghalani AA, Al Shamali S, Graham L. Primary Tooth vital pulp therapy: a systematic review and metaanalysis. Pediatr Dent 2017;39:16-123
  2. Oliveira TM, Moretti AB, Sakai VT, Lourenço Neto N, Santos CF, Machado MA, et al. Clinical, radiographic and histologic analysis of the effects of pulp capping materials used in pulpotomies of human primary teeth. Eur Arch Paediatr Dent 2013;14:65-71
  3. Ohkura N, Edanami N, Takeuchi R, Tohma A, Ohkura M, Yoshiba, et al. Effects of pulpotomy using mineral trioxide aggregate on prostaglandin transporter and receptors in rat molars. Sci Rep 2017;7:6870-6872
  4. Sonmez D, Sari S, Çetinbas T. A comparison of four pulpotomy techniques in primary molars: a long-term follow-up. J Endod 2008;34:950-955
  5. Moretti AB, Sakai VT, Oliveira TM, Fornetti AP, Santos CF, Machado MA, et al. The effectiveness of MTA, calcium hydroxide and formocresol for pulpotomies in primary teeth. Int Endod J 2008;41:547-555
  6. Sakai VT, Moretti AB, Oliveira TM, Fornetti AP, Santos CF, Machado MA, et al. Pulpotomy of human primary molars with MTA and Portland cement: a randomised controlled trial. Brt Dent J 2009;207:128-129
  7. Ratnakumari N, Thomas B. A histopathological comparision of pulpal response to Chitra—CPC and formocresol used as pulpotomy agents in primary teeth: clinical trial. Int J Clin Pediatr Dent 2012;5:6-13
  8. Ranly DM. pulpotomy therapy in primary teeth: new modalities for old rationales. Pediatr Dent 1994;16:403-409
  9. Torabinejad M, Chivian N. Clinical applications of mineral trioxide aggregate. J Endod 1999;25:197-205
  10. Bengtson A, Bengtson N, Bengtson C, Pinheiro S, Guedes A. pulpotomy in human deciduous teeth and bone morphogenic protein. Rev Clin Pesq Odontol 2008;4:129-136
  11. Mohamed A, Maha MF, Wahba N, Meligy O, Sabbarini J. Comparison of pulpal response following pulpotomy procedure using enamel matrix derivative versus formocresol in primary dentition. Calcif Tissue Int 2004;75:243-252
  12. Kalaskar RR, Damle SG. Compartaive evaluation of lyophilized freeze dried platelet derived preparation with calcium hydroxide as pulpotomy agents in primary molars. Pediatr Dent 2000;4:140-146
  13. McDonald RE, Avery DR, Dean JA. Dentistry for the child and adolescent, 8th ed. St. Louis, Mosby; 2004;389-412
  14. Farooq I, Imran Z, Farooq U, Leghari A. Bioactive Glass: A material for the future. World J Dent 2012;3:199-201
  15. Hench L. Chronology of bioactive glass development and clinical applications. New J Glass Cer 2013;3:67-73
  16. Hargreaves K, Cohen S. Pathways of the pulp. 10th ed. St Louis: Elseiver; 2011. p 822-831
  17. Saltzman B, Sigal M, Clokie C, Rukavina J, Titley K, Kulkarni GV. Assessment of a novel alternative to conventional formocresol-zinc oxide eugenol pulpotomy for the treatment of pulpally involved human primary teeth, diode laser and mineral trioxide aggregate pulpotomy. Int J Paediatr Dent 2005;15:437-447
  18. Junqueira MA, Cunha NNO, Caixeta FF, Marques NCT, Oliveira TM, Moretti ABDS, Cosme-Silva L, Sakai VT. Clinical, Radiographic and Histological Evaluation of Primary Teeth pulpotomy Using MTA And Ferric Sulfate. Braz Dent J 2018;29:159-165
  19. Smaïl-Faugeron V, Courson F, Durieux P, Muller-Bolla M, Glenny AM, Fron Chabouis H. Pulp treatment for extensive decay in primary teeth. Cochrane Database Syst Rev 2014;6:CD003220
  20. Croll TP, Killian CM. Zinc oxide eugenol pulpotomy and stainless steel crown restoration of a primary molar. Quintessence Int 1992;23:383-388
  21. Randal RC, Vrijhoef MMA, Wilson NHF. Efficacy of preformed metal crowns vs amalgam restoration in deciduous molars. Br Dent J 1986;2:177-183
  22. Agamy HA, Barky NS, Mounir MMF, Avery DR. Comparison of mineral trioxide aggregate and formocresol as pulp capping agents in pulpotomized primary teeth. Pediatr Dent 2004; 26:302-309
  23. Jabbarifar E, Razavi SM, Ahmadi N. Histopathologic responses of dog’s dental pulp to mineral trioxide aggregate, bio active glass, formocresol, hydroxyapatite. Dent Res J 2007;4:83-87
  24. Hench L, Greenspan D. Interactions between Bioactive Glass and Collagen: A Review and New Perspectives. J Australian Ceramic Society 2013;49:1–40
  25. Aza PN, De Aza AH, Pena P and De Aza S. Bioactive glasses and glass-ceramic. Bol Soc Esp Ceram V 2007;46:45-55
  26. Eberhard J, Reimers N, Dommisch H, Hacker J, Freitag S, Acil Y, Albers h, Jopsen S. The effect of the topical administration of bioactive glass on inflammatory markers of human experimental gingivitis. Biomaterials 2005;26:1545-1551
  27. Zehnder M, Waltimo T, Sener B, Soderling E. Dentin enhances the effectiveness of bioactive glass S53P4 against a strain of Enterococcus faecalis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2006;101:530-535
  28. Airen P, Shigli A, Airen B. Comparative evaluation of formocresol and mineral trioxide aggregate in pulpotomized primary molars – 2 year follow up. J Clin Pediatr Dent 2012;37:143-147
  29. Salako N, Joseph B, Ritwik P, Salonen J, John P, and Junaid TA. Comparison of bioactive glass, mineral trioxide aggregate, ferric sulfate, and formocresol as pulpotomy agents in rat molar. Dent Traumatol 2003;19:314–320
  30. Humagain M, Nayak DG, Uppoor AS. A clinical evaluation of bioactive glass particulate in the treatment of mandibular class II furcation defects. Braz J Oral Sci 2007;6:1450-1456
  31. Markovic D, Vanja P, Mirjana L, Zorana N. Radiologic assessment of apex formation following use of hydroxyapatite. Acta Veternaria (Beograd) 2007;57:275-287.
  32. Higashi T, Okamoto H. Influence of particle size of calcium phosphate ceramics as a capping agent on the formation of a hard tissue barrier in amputated dental pulp. J Endod 1996;22:281-283
  33. Adlakha VK, Chandana P, Joshi JL, Thomas AM, Singh N. A comparative evaluation of hydroxyapatite crystals and glutaldehyde as agents for pulpotomy in deciduous molars. Int J Clin Pediatr Dent 2009;2:13-22
  34. Frankle G, Kaufan A, Ashenazi M. Clinical and radiographic outcomes of pulpotomized primary molars treated with white or grey mineral trioxide aggregate and ferric sulfate- long term follow up. J Clin Pediatr Dent 2012;37:137-141
  35. Holan H, Eidelman E, Odont, Fucks AB. Long term evaluation of pulpotomy in primary molars using mineral trioxide aggregate or formocresol. Pediatr Dent 2005;27:129-136
  36. Subramaniam P, Konde S, Mathew S, Sugnani S. Mineral trioxide aggregate as pulp capping agent for primary teeth pulpotomy: 2 year follow up study. J Clin Pediatr Dent 2009;33:311-314

Article Info

Contemp Pediatr Dent 2020:1(1):42-51

Received: 30 October 2020

Accepted: 02 December 2020

Online First: 15 December 2020

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					Neeraja Govindaraj, Kinjal Shah Virani, Priya Subramaniam, Megha Gupta. Evaluation of bioactive glass and hydroxyapatite crystals as pulpotomy agents in primary molars: A clinical study. Contemp Pediatr Dent 2020:1(1):42-51.
				
			

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