Department of Pediatric Dentistry
Lutheran Medical Center
Resident’s Name: Mark Dawoud, DMD Date: 04/20/16
Title: The effect of sodium hypochlorite application on the success of
calcium hydroxide and mineral trioxide aggregate pulpotomies in primary teeth
Authors: Akcay, M., Sari, S Major Topic: resin composites in pediatric dentistry
Journal: Pediatr Dent (2014) 36: 316-321
Type: randomized, controlled, clinical trial
Main Purpose: This study’s purpose was to evaluate the success of calcium hydroxide (CH) and mineral trioxide aggregate (MTA) pulpotomies following the use of five percent sodium hypochlorite (NaOCl) as an antibacterial agent to clean the chamber prior to application of the pulpotomy agent.
· Methods: A total of 128 teeth in 64 children were randomly divided into two pulpotomy groups (CH or MTA). The teeth in each pulpotomy group, CH and MTA, were further randomly divided into subgroups to receive either the NaOCl (experimental) or saline (control) cleaning agent prior to applying the pulpotomy agent.
o The following inclusion criteria were used to select the teeth in this study:
o 1. no clinical symptoms or evidence of pulp degeneration, such as pain on percussion, history of swelling, or sinus tracts;
o 2. no spontaneous pain;
o 3. no radiographic signs of internal/external resorption or widened periodontal ligament space or furcal/ periapical radiolucency;
o 4. no more than one third physiological root resorption;
o 5. teeth would be restorable with stainless steel crowns (SSCs).
· The treatments were followed clinically and radiographically for 12 months.
o clinical success was confirmed by the absence of spontaneous pain, pathologic mobility, tenderness to percussion, swelling, fistula, or gingival inflammation. Radiographic success was considered when internal/external root resorption and periapical/furcal radiolucency was not observed. Calcific metamorphosis of the pulp was not considered a failure.
· Results: The radiographic success rates were 84 percent for CH NaOCl, 74 percent for CH saline control, 97 percent for MTA NaOCl, and 100 percent for MTA saline control.
· There were no significant differences between the radiographic success rates in the CH and MTA subgroups (CH NaOCl-CH control and MTA NaOCl-MTA control); no significant differences were observed when comparing the CH NaOCl-MTA NaOCl groups and the CH NaOCl-MTA control groups.
· Conclusion: Use of sodium hypochlorite as an antibacterial agent prior to application of the pulpotomy agent improved the success of calcium hydroxide pulpotomies to equal the success of mineral trioxide aggregate pulpotomies for observation up to 12 months