This study assessed the oral health status of Grade 2 and Grade 6 students in Québec and highlighted trends in their oral health since the late s.
For the first time in Québec, ÉCSBQ used a new visual assessment system, making it possible to study not only non-reversible dental caries, which have been the focus of attention to date, but also reversible dental caries.
Reversible dental caries, also known as non-obvious dental caries, are lesions that are limited to the early stages of the disease and that can be reversed through preventive action. As for non-reversible dental caries, they occur in three forms: untreated later-stage lesions also called obvious dental cariesteeth that have been extracted due to caries and fillings on teeth due to caries.
Pulp treatment for extensive decay in primary teeth
Most non-reversible dental caries are observed among a minority of students in Grades 2 and 6. Follow us on :. Skip to main content. Centre de toxicologie du Québec Mould compendium. From Tiny Tot to Toddler.
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Paul Kenza Djerbib Keven J. Wong Labico Diallo L. Najjar M. Dentists often have to perform one of three pulp treatment techniques: direct pulp capping where a healing agent is placed directly over the exposed pulppulpotomy removal of a portion of the pulp or pulpectomy removal of all of the pulp in the pulp chamber and root canal of a tooth.
Oral Health Country/Area Profile Project
The most common materials used for direct pulp capping are calcium hydroxide, the more recent but more expensive mineral trioxide aggregate, formocresol or an adhesive resin placed directly over the tooth's nerve. After a pulpotomy, one of four materials is generally used: ferric sulphate, formocresol, calcium hydroxide or mineral trioxide aggregate.
After a pulpectomy, a material is put into the space created by pulp removal. This material should not prevent the resorption of the primary tooth's root, to let the permanent tooth to grow in. Review authors working with Cochrane Oral Health carried out this review of randomised controlled trials.
The evidence is current up to August We included 87 trials that investigated the success of pulp treatment of milk teeth. The trials were published between and and provided comparisons of different treatment options.
[The importance of pulp therapy in deciduous teeth].
Pulp treatment for extensive decay in primary teeth is generally successful. The proportion of treatment failures was low, with many of the included trials having no failures with either of the treatments being compared.
After a pulpotomy, mineral trioxide aggregate MTA seems to be the best material in terms of biocompatibility and efficacy to put into contact with the remaining root dental nerve.
The evidence showed it to be less likely to fail than either calcium hydroxide or formocresol. After pulpectomy, it is not clear whether any medicament is superior to another.
Regarding direct pulp capping, the small number of studies undertaking the same comparison limits any interpretation. Formocresol may be superior to calcium hydroxide in terms of clinical and radiological failure, but because of toxic effects associated with formocresol, safer alternatives should be evaluated. We judged the quality of the evidence suggesting the superiority of MTA over calcium hydroxide or formocresol after pulpotomy to be moderate. For other comparisons, the quality of the evidence is low or very low, which means we cannot be certain about the findings.
The low quality is due to shortcomings in the methods used within the individual trials, the small number of children included in the trials and the short-term follow-up after treatment.
Future trials to evaluate which healing agents are best for the three pulp treatments would require a very large sample size and should follow up the participants of a minimum of one year. Many included trials had no clinical or radiological failures in either trial arm, and the overall proportion of failures was low. Any future trials in this area would require a very large sample size and follow up of a minimum of one year.
The evidence suggests MTA may be the most efficacious medicament to heal the root pulp after pulpotomy of a deciduous tooth.
Caries of primary dentition
As MTA is relatively expensive, future research could be undertaken to confirm if Biodentine, enamel matrix derivative, laser treatment or Ankaferd Blood Stopper are acceptable second choices, and whether, where none of these treatments can be used, application of sodium hypochlorite is the safest option.
Formocresol, though effective, has known concerns about toxicity.
Regarding pulpectomy, there is no conclusive evidence that one medicament or technique is superior to another, and so the choice of medicament remains at the clinician's discretion. Research could be undertaken to confirm if ZOE paste is more effective than Vitapex and to evaluate other alternatives.
Regarding direct pulp capping, the small number of studies and low quality of the evidence limited interpretation. Formocresol may be more successful than calcium hydroxide; however, given its toxicityany future research should focus on alternatives.
In children, dental caries tooth decay is among the most prevalent chronic diseases worldwide. Pulp interventions are indicated for extensive tooth decay.
Depending on the severity of the disease, three pulp treatment techniques are available: direct pulp capping, pulpotomy and pulpectomy. After treatment, the cavity is filled with a medicament. Materials commonly used include mineral trioxide aggregate MTAcalcium hydroxide, formocresol or ferric sulphate. This is an update of a Cochrane Review published in when insufficient evidence was found to clearly identify one superior pulpotomy medicament and technique.
To assess the effects of different pulp treatment techniques and associated medicaments for the treatment of extensive decay in primary teeth. OpenGrey was searched for grey literature.