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Success rate of MedCem Portland Cement as pulp capping agent in pulpotomy in the primary dentition V.Vilimek, B.Christof Private practice for pediatric and family dentistry Hohenems Austria V.Vilimek, B.Christof Pulpotomy in primary


  1. Success rate of MedCem Portland Cement as pulp capping agent in pulpotomy in the primary dentition V.Vilimek, B.Christof Private practice for pediatric and family dentistry Hohenems – Austria V.Vilimek, B.Christof

  2. Pulpotomy in primary dentition � Is the treatment of choice in cases (AAPD 2012-2013): Reversible pulpits � When caries removal results in pulp exposure � After traumatic exposure � V.Vilimek, B.Christof

  3. Pulpotomy in primary dentition The success of the therapy depends on: Correct diagnosis of the inflamed dental pulp. � Selection of biocompatible and bio-inductive material � Recently, great interest has been focused on the evolution of � Portland cement (PC) as an alternative to MTA. V.Vilimek, B.Christof

  4. Pulpotomy in primary dentition AIM: • To evaluate the clinical and radiographic outcomes of Portland cement (PC) as pulp capping agent in primary teeth pulpotomies. V.Vilimek, B.Christof

  5. Material and Methods: The study included: • 71 primary teeth (9 incisors and 62 molars) of 20 girls and boys (ASA 1) aged 3-8 years • With deep carious lesions: o Presenting a potential risk of pulp exposure during treatment. o With symptoms of inflammation of the coronal pulp. V.Vilimek, B.Christof

  6. Material and Methods: Excluded from the study: • Clinical criteria: • Spontaneous pain. • Mobility. • Radiographic criteria: • Fistula. • Teeth with more than 2/3 root • Abscess (gingival redness and swelling). resorption. • Periodontal ligament widening. • Systemic diseases. • Periodontal and furcation bone resorption V.Vilimek, B.Christof

  7. METHODS : Pulpotomy in primary dentition Treatment was performed under general anesthesia and with the technique of vital amputation. V.Vilimek, B.Christof

  8. METHODS : Pulpotomy in primary dentition The pulp chamber was opened with a high-speed, water cooled diamond bur. Followed by removal of the entire coronal pulp with a low speed, round carbide bur. The pulp chamber was rinsed with a sterile saline. Sterile cotton pellets were applied to the pulp chamber for 2 min to control hemorrhage upon successful hemostasis. MedCem Portland Cement (PC) was used as pulp capping agent. Over the PC GIC ( Ketac Cem radio pac) was placed . The teeth were finally restored: • Incisors with composite • Molars with stainless steel crowns . V.Vilimek, B.Christof

  9. Follow up : • Clinical and radiographic successes and failures were recorded at 3, 6, 12, 18 and 24-month follow-up. • Radiographic success was considered : • Presence of hard tissue barrier formation (HTB). • Pulp calcifications (PC). • Absence of internal or external root resorption (R). • Furcation radiolucency (FRL). V.Vilimek, B.Christof

  10. Follow up : • Clinical and radiographic successes and failures were recorded at 3, 6, 12, 18 and 24-month follow-up. • Criteria to determine failure : • Spontaneous pain (SP). • Swelling (Sw). • Abscess (gingival redness and swelling). • Sensitivity to percussion. • Mobility (M). • Fistula (F). • Periodontal ligament widening. • Periodical and furcation bone resorption (RR). V.Vilimek, B.Christof

  11. Results: N* Clinical criteria x-Ray criteria Total Mth SP M, Sw , F R HTB PC RR FRL S* F* N = 70 1 1 Sw, F 3 mth N= 1 69 2 6 mth N= 12 mth N= 1 – Sw 67 4 18 mth 1 - F N= 1 66 5 24 mth * N – number of teeth, *S – success, *F – failure SW = Swelling F= Fistula Furcation radiolucency = FRL Periodical and furcation bone resorption = RR V.Vilimek, B.Christof

  12. Results: Meas ure S rate 95% CI LB 95% CI UB Group S rate diff test - p 3m 98.59% 92.40% 99.97% 6m 97.18% 90.19% 99.66% > 0.05 12m 97.18% 90.19% 99.66% 18m 94.37% 86.19% 98.45% 24m 92.96% 84.31% 97.68% 3 m 12 m 24 m (р>0,05) V.Vilimek, B.Christof

  13. Results After 3 months the treatment of 70 teeth or 98.59% was assessed as successful. The confidence level is between 92.4 % to 99.97% - After 12 months 69 teeth (97.18 % ) were assessed as successfully treated. After 24 months the treatment of 66 teeth (92.96%) was defined as successful. The difference between the treatment in the beginning 98.59% and in the end 92.96% is statistically not significant. That means the success of 92.96 % after 24 months does not differ to the success after 3 months 98.59%. As to be seen our result showed the success rate of pulpotomies using Mec Cem Portland Cement as pulp agent in primary dentition during the observation period of a 2 years follow up.

  14. Results after pulpotomy with PC Successful treatment even after 24 months ! After 12 months After 24 months Before Treatment 51 after 6 Months of treatment After 18 months crowns were replaced

  15. Results after pulpotomy with PC Before Treatment • Failure after 12 months of treatment tooth 75 showed up internal resorption, no fistula, no abscess, After 12 months no pain • Failure after 24 months of treatment tooth 75 showed up full root resorption and tooth 74 a crown lost and root resorption After 24 months

  16. Pulpotomy in primary dentition CONCLUSION: • Portland Cement may serve as an effective and inexpensive material in primary teeth pulpotomies. • Further studies and longer follow-up assessments are needed. V.Vilimek, B.Christof

  17. Pulpotomy in primary dentition CONCLUSION: According to the achieved results, we recommend Portland Cement Med Cem as a successful pulp agent V.Vilimek, B.Christof

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