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CC BY-NC-ND 4.0 · European Journal of General Dentistry 2014; 3(01): 3-10
DOI: 10.4103/2278-9626.126201
Review Article

Pulpectomy procedures in primary molar teeth

Hany Mohamed Aly Ahmed
Department of Restorative Dentistry, School of Dental Sciences, Universiti Sains Malaysia, Kubang Kerian, 16150, Kelantan, Malaysia
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Abstract

Premature loss of primary molars can cause a number of undesirable consequences including loss of arch length, insufficient space for erupting premolars and mesial tipping of the permanent molars. Pulpectomy of primary molar teeth is considered as a reasonable treatment approach to ensure either normal shedding or a long-term survival in instances of retention. Despite being a more conservative treatment option than extraction, efficient pulpectomy of bizarre and tortuous root canals encased in roots programmed for physiologic resorption that show close proximity to developing permanent tooth buds presents a critical endodontic challenge. This article aims to provide an overview of this treatment approach, including partial and total pulpectomy, in primary molar teeth. In addition, the recommended guidelines that should be followed, and the current updates that have been developed, while commencing total pulpectomy in primary molars are discussed.

Keywords

Deciduous molars - partial pulpectomy - primary molars - total pulpectomy


Publication History

Article published online:
01 November 2021

© 2014. European Journal of General Dentistry. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/.)

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  • References

  • 1 Dummett CO Jr, Kopel HM. Pediatric endodontics. In: Ingle JI, Bakland LK, editors. Endodontics. 5 th ed. Hamilton: BC Decker Inc.; 2002. p. 861-902.
  • 2 Ounsi HF, Debaybo D, Salameh Z, Chebaro A, Bassam H. Endodontic considerations in pediatric dentistry: A clinical perspective. Int Dent South Afr 2009;11:40-50.
  • 3 Berk H, Krakow AA. A comparison of the management of pulpal pathosis in deciduous and permanent teeth. Oral Surg Oral Med Oral Pathol 1972;34:944-55.
  • 4 Nordquist I, Lennartsson B, Paulander J. Primary teeth in adults - A pilot study. Swed Dent J 2005;29:27-34.
  • 5 Aktan AM, Kara I, Sener I, Bereket C, Celik S, Kirtay M, et al. An evaluation of factors associated with persistent primary teeth. Eur J Orthod 2012;34:208-12.
  • 6 Ith-Hansen K, Kjaer I. Persistence of deciduous molars in subjects with agenesis of the second premolars. Eur J Orthod 2000;22:239-43.
  • 7 Sletten DW, Smith BM, Southard KA, Casko JS, Southard TE. Retained deciduous mandibular molars in adults: A radiographic study of long-term changes. Am J Orthod Dentofacial Orthop 2003;124:625-30.
  • 8 Bjerklin K, Al-Najjar M, Kårestedt H, Andrén A. Agenesis of mandibular second premolars with retained primary molars: A longitudinal radiographic study of 99 subjects from 12 years of age to adulthood. Eur J Orthod 2008;30:254-61.
  • 9 Robinson S, Chan MF. New teeth from old: Treatment options for retained primary teeth. Br Dent J 2009;207:315-20.
  • 10 Kokich VG, Kokich VO. Congenitally missing mandibular second premolars: Clinical options. Am J Orthod Dentofacial Orthop 2006;130:437-44.
  • 11 Jha P, Jha M. Management of congenitally missing second premolars in a growing child. J Conserv Dent 2012;15:187-90.
  • 12 Ahmed HM. Anatomical challenges, electronic working length determination and current developments in root canal preparation of primary molar teeth. Int Endod J 2013;46:1011-22.
  • 13 Gardner AF. Partial pulpectomy, an accepted treatment for primary and young permanent teeth. Oral Surg Oral Med Oral Pathol Oral Radiol 1950;3:498-503.
  • 14 McDonald RE, Avery DR, Dean JA. Treatment of deep caries, vital pulp exposure and pulpless teeth. In: Dean JA, Avery DR, McDonald RE, editors. McDonald and Avery′s Denitstry for the Child and Adolescent. 9 th ed. Missouri: Mosby Elsevier; 2011. p. 343-65.
  • 15 Ruby JD, Cox CF, Mitchell SC, Makhija S, Chompu-Inwai P, Jackson J. A randomized study of sodium hypochlorite versus formocresol pulpotomy in primary molar teeth. Int J Paediatr Dent 2013;23:145-52.
  • 16 Camp JH, Fuks AB. Pediatric endodontics: Endodontic treatment for the primary and young permanent dentition. In: Cohen S, Hargreaves K, editors. Pathways of the Pulp. 9 th ed. St. Louis: Mosby Elsevier; 2006. p. 822-82.
  • 17 Roberts JF. Treatment of vital and non-vital primary molar teeth by one-stage formocresol pulpotomy: Clinical success and effect upon age at exfoliation. Int J Paediatr Dent 1996;6:111-5.
  • 18 Hill MW. The survival of vital and non-vital deciduous molar teeth following pulpotomy. Aust Dent J 2007;52:181-6.
  • 19 Zarzar PA, Rosenblatt A, Takahashi CS, Takeuchi PL, Costa Júnior LA. Formocresol mutagenicity following primary tooth pulp therapy: An in vivo study. J Dent 2003;31:479-85.
  • 20 Lucas Leite AC, Rosenblatt A, da Silva Calixto M, da Silva CM, Santos N. Genotoxic effect of formocresol pulp therapy of deciduous teeth. Mutat Res 2012;747:93-7.
  • 21 Takushige T, Cruz EV, Asgor Moral A, Hoshino E. Endodontic treatment of primary teeth using a combination of antibacterial drugs. Int Endod J 2004;37:132-8.
  • 22 Prabhakar AR, Sridevi E, Raju OS, Satish V. Endodontic treatment of primary teeth using combination of antibacterial drugs: An in vivo study. J Indian Soc Pedod Prev Dent 2008;26 Suppl 1:S5-10.
  • 23 Nakornchai S, Banditsing P, Visetratana N. Clinical evaluation of 3Mix and Vitapex as treatment options for pulpally involved primary molars. Int J Paediatr Dent 2010;20:214-21.
  • 24 Pinky C, Shashibhushan KK, Subbareddy VV. Endodontic treatment of necrosed primary teeth using two different combinations of antibacterial drugs: An in vivo study. J Indian Soc Pedod Prev Dent 2011;29:121-7.
  • 25 Trairatvorakul C, Detsomboonrat P. Success rates of a mixture of ciprofloxacin, metronidazole, and minocycline antibiotics used in the non-instrumentation endodontic treatment of mandibular primary molars with carious pulpal involvement. Int J Paediatr Dent 2012;22:217-27.
  • 26 Rodd HD, Waterhouse PJ, Fuks AB, Fayle SA, Moffat MA, British Society of Paediatric Dentistry. Pulp therapy for primary molars. Int J Paediatr Dent 2006;16 Suppl 1:15-23.
  • 27 Ruviére DB, Leonardo MR, da Silva LA, Ito IY, Nelson-Filho P. Assessment of the microbiota in root canals of human primary teeth by checkerboard DNA-DNA hybridization. J Dent Child (Chic) 2007;74:118-23.
  • 28 Rocha CT, Rossi MA, Leonardo MR, Rocha LB, Nelson-Filho P, Silva LA. Biofilm on the apical region of roots in primary teeth with vital and necrotic pulps with or without radiographically evident apical pathosis. Int Endod J 2008;41:664-9.
  • 29 Tavares WL, Neves de Brito LC, Teles RP, Massara ML, Ribeiro Sobrinho AP, Haffajee AD, et al. Microbiota of deciduous endodontic infections analysed by MDA and checkerboard DNA-DNA hybridization. Int Endod J 2011;44:225-35.
  • 30 Qudeimat MA, Fayle SA. The longevity of space maintainers: A retrospective study. Pediatr Dent 1998;20:267-72.
  • 31 Rajab LD. Clinical performance and survival of space maintainers: Evaluation over a period of 5 years. ASDC J Dent Child 2002;69:156-60, 124.
  • 32 Kargul B, Caglar E, Kabalay U. Glass fiber-reinforced composite resin as fixed space maintainers in children: 12-month clinical follow-up. J Dent Child (Chic) 2005;72:109-12.
  • 33 Moore TR, Kennedy DB. Bilateral space maintainers: A 7-year retrospective study from private practice. Pediatr Dent 2006;28:499-505.
  • 34 Subramaniam P, Babu G, Sunny R. Glass fiber-reinforced composite resin as a space maintainer: A clinical study. J Indian Soc Pedod Prev Dent 2008;26 Suppl 3:S98-103.
  • 35 Sasa IS, Hasan AA, Qudeimat MA. Longevity of band and loop space maintainers using glass ionomer cement: A prospective study. Eur Arch Paediatr Dent 2009;10:6-10.
  • 36 Allen KR. Endodontic treatment of primary teeth. Aust Dent J 1979;24:347-51.
  • 37 Kabnick LS. Should deciduous teeth with nonvital pulps be treated? Int J Orthod Dent Child 1933;19:1043-9.
  • 38 Tannure PN, Barcelos R, Portela MB, Gleiser R, Primo LG. Histopathologic and SEM analysis of primary teeth with pulpectomy failure. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2009;108:e29-33.
  • 39 Barr ES, Flatiz CM, Hicks MJ. A retrospective radiographic evaluation of primary molar pulpectomies. Pediatr Dent 1991;13:4-9.
  • 40 Moskovitz M, Sammara E, Holan G. Success rate of root canal treatment in primary molars. J Dent 2005;33:41-7.
  • 41 Moskovitz M, Yahav D, Tickotsky N, Holan G. Long-term follow up of root canal treated primary molars. Int J Paediatr Dent 2010;20:207-13.
  • 42 Cleghorn BM, Boorberg NB, Christie WH. Primary human teeth and their root canal systems. Endod Top 2012;23:6-33.
  • 43 Ahmed HM. Different perspectives in understanding the pulp and periodontal intercommunications with a new proposed classification for endo-perio lesions. ENDO (Lond Engl) 2012;6:87-104.
  • 44 Hori A, Poureslami HR, Parirokh M, Mirzazadeh A, Abbott P. The ability of pulp sensibility tests to evaluate the pulp status in primary teeth. Int J Paediatr Dent 2011;21:441-5.
  • 45 Karayilmaz H, Kirzioğlu Z. Evaluation of pulpal blood flow changes in primary molars with physiological root resorption by laser Doppler flowmetry and pulse oximetry. J Clin Pediatr Dent 2011;36:139-44.
  • 46 Pozzobon MH, de Sousa Vieira R, Alves AM, Reyes-Carmona J, Teixeira CS, de Souza BD, et al. Assessment of pulp blood flow in primary and permanent teeth using pulse oximetry. Dent Traumatol 2011;27:184-8.
  • 47 AAPD. Guideline on pulp therapy for primary and immature permanent teeth. Pediatr Dent 2012;34:222-9.
  • 48 Dunston B, Coll JA. A survey of primary tooth pulp therapy as taught in US dental schools and practiced by diplomates of the American board of pediatric dentistry. Pediatr Dent 2008;30:42-8.
  • 49 Ahmed HM, Abbott PV. Discolouration potential of endodontic procedures and materials: A review. Int Endod J 2012;45:883-97.
  • 50 Milledge JT. Endodontic therapy for primary teeth. In: Ingle JI, Bakland LK, Baumgartner JC, editors. Ingle′s Endodontics. 6 th ed. Hamilton: BC Decker Inc.; 2008. p. 1400-30.
  • 51 Barcelos R, Santos MP, Primo LG, Luiz RR, Maia LC. ZOE paste pulpectomies outcome in primary teeth: A systematic review. J Clin Pediatr Dent 2011;35:241-8.
  • 52 Coll JA, Sadrian R. Predicting pulpectomy success and its relationship to exfoliation and succedaneous dentition. Pediatr Dent 1996;18:57-63.
  • 53 Mortazavi M, Mesbahi M. Comparison of zinc oxide and eugenol, and Vitapex for root canal treatment of necrotic primary teeth. Int J Paediatr Dent 2004;14:417-24.
  • 54 Koshy S, Love RM. Endodontic treatment in the primary dentition. Aust Endod J 2004;30:59-68.
  • 55 Ranly DM, Garcia-Godoy F. Current and potential pulp therapies for primary and young permanent teeth. J Dent 2000;28:153-61.
  • 56 Barja-Fidalgo F, Moutinho-Ribeiro M, Oliveira MA, de Oliveira BH. A systematic review of root canal filling materials for deciduous teeth: Is there an alternative for zinc oxide-eugenol? ISRN Dent 2011;2011:367318.
  • 57 Tchaou WS, Turng BF, Minah GE, Coll JA. In vitro inhibition of bacteria from root canals of primary teeth by various dental materials. Pediatr Dent 1995;17:351-5.
  • 58 Praveen P, Anantharaj A, Karthik V, Prathiba R, Sudhir R, Jaya A. A review of obturating materials for primary teeth. Streamdent 2011;2:42-4.
  • 59 Liu H, Zhou Q, Qin M. Mineral trioxide aggregate versus calcium hydroxide for pulpotomy in primary molars. Chin J Dent Res 2011;14:121-5.
  • 60 Ozalp N, Saroğlu I, Sönmez H. Evaluation of various root canal filling materials in primary molar pulpectomies: An in vivo study. Am J Dent 2005;18:347-50.
  • 61 Kielbassa AM, Uchtmann H, Wrbas KT, Bitter K. In vitro study assessing apical leakage of sealer-only backfills in root canals of primary teeth. J Dent 2007;35:607-13.
  • 62 Sari S, Okte Z. Success rate of Sealapex in root canal treatment for primary teeth: 3-year follow-up. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2008;105:e93-6.
  • 63 Dogra S. Comparative evaluation of calcium hydroxide and zinc oxide eugenol as root canal filling materials for primary molars: A clinical and radiographic study. World J Dent 2011;2:231-6.
  • 64 Chen J, Jorden M. Materials for primary tooth pulp treatment: The present and the future. Endod Top 2012;23:41-9.
  • 65 Cerqueira DF, Mello-Moura AC, Santos EM, Guedes-Pinto AC. Cytotoxicity, histopathological, microbiological and clinical aspects of an endodontic iodoform-based paste used in pediatric dentistry: A review. J Clin Pediatr Dent 2008;32:105-10.
  • 66 Vargas-Ferreira F, Angonese M, Friedrich H, Weiss R, Friedrich R, Praetzel J. Antimicrobial action of root canal filling pastes used in deciduous teeth. Rev Odonto Ciênc 2010;25:65-8.
  • 67 Nurko C, Garcia-Godoy F. Evaluation of a calcium hydroxide/iodoform paste (Vitapex) in root canal therapy for primary teeth. J Clin Pediatr Dent 1999;23:289-94.
  • 68 Nurko C, Ranly DM, García-Godoy F, Lakshmyya KN. Resorption of a calcium hydroxide/iodoform paste (Vitapex) in root canal therapy for primary teeth: A case report. Pediatr Dent 2000;22:517-20.
  • 69 Trairatvorakul C, Chunlasikaiwan S. Success of pulpectomy with zinc oxide-eugenol vs calcium hydroxide/iodoform paste in primary molars: A clinical study. Pediatr Dent 2008;30:303-8.
  • 70 Asokan S, Sooriaprakas C, Raghu V, Bairavi R. Volumetric analysis of root canal fillings in primary teeth using spiral computed tomography: An in vitro study. J Dent Child (Chic) 2012;79:46-8.
  • 71 Subramaniam P, Gilhotra K. Endoflas, zinc oxide eugenol and metapex as root canal filling materials in primary molars - A comparative clinical study. J Clin Pediatr Dent 2011;35:365-9.
  • 72 Amorim Lde F, Toledo OA, Estrela CR, Decurcio Dde A, Estrela C. Antimicrobial analysis of different root canal filling pastes used in pediatric dentistry by two experimental methods. Braz Dent J 2006;17:317-22.
  • 73 Reddy S, Ramakrishna Y. Evaluation of antimicrobial efficacy of various root canal filling materials used in primary teeth: A microbiological study. J Clin Pediatr Dent 2007;31:193-8.
  • 74 Gangwar A. Antimicrobial effectiveness of different preparations of calcium hydroxide. Indian J Dent Res 2011;22:66-70.
  • 75 Portenier I, Haapasalo H, Rye A, Waltimo T, Ørstavik D, Haapasalo M. Inactivation of root canal medicaments by dentine, hydroxylapatite and bovine serum albumin. Int Endod J 2001;34:184-8.
  • 76 Johnson MS, Britto LR, Guelmann M. Impact of a biological barrier in pulpectomies of primary molars. Pediatr Dent 2006;28:506-10.
  • 77 Harokopakis-Hajishengallis E. Physiologic root resorption in primary teeth: Molecular and histological events. J Oral Sci 2007;49:1-12.
  • 78 Bjerklin K, Bennett J. The long-term survival of lower second primary molars in subjects with agenesis of the premolars. Eur J Orthod 2000;22:245-55.
  • 79 Canoglu H, Tekcicek MU, Cehreli ZC. Comparison of conventional, rotary, and ultrasonic preparation, different final irrigation regimens, and 2 sealers in primary molar root canal therapy. Pediatr Dent 2006;28:518-23.
  • 80 Bolla N, Naik BD, Kavuri SR, Velagala LD. Obturation of a retained primary mandibular second molar with missing successor using gutta-percha: A case report. J Indian Dent Assoc 2011;5:194-5.
  • 81 O′Sullivan SM, Hartwell GR. Obturation of a retained primary mandibular second molar using mineral trioxide aggregate: A case report. J Endod 2001;27:703-5.
  • 82 Tunc ES, Bayrak S. Usage of white mineral trioxide aggregate in a non-vital primary molar with no permanent successor. Aust Dent J 2010;55:92-5.
  • 83 Sharaf AA, Farsi NM. A clinical and radiographic evaluation of stainless steel crowns for primary molars. J Dent 2004;32:27-33.
  • 84 Bin Alshaibah WM, Ahmed E-S, Abdo E-D, Reda AR. Comparative study on the microbial adhesion to preveneered and stainless steel crowns. Indian J Dent 2011;2:123-8.
  • 85 Stallaert KM. A Retrospective Study of Root Canal Therapy in Non-vital Primary Molars. Toronto: University of Toronto; 2011.