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Primary molar pulp therapy--histological evaluation of failure
P J Waterhouse1, J H Nunn, J M Whitworth
1Department of Child Dental Health, School of Dentistry, University of Newcastle upon Tyne, Newcastle upon Tyne NE2 4BW, UK. p.j.waterhouse@ncl.ac.uk
International Journal of Paediatric Dentistry
|April 20, 2001
Summary
Vital pulp therapy in primary molars using formocresol or calcium hydroxide showed histological signs of inflammation and resorption, regardless of treatment. These findings may explain treatment failures in this under-researched area.
Area of Science:
- Pediatric Dentistry
- Endodontics
- Dental Materials Science
Background:
- Vital pulp therapy aims to preserve pulp vitality in primary teeth.
- Formocresol and calcium hydroxide are common medicaments used in vital pulp therapy.
- Treatment failures necessitate understanding underlying histological processes.
Purpose of the Study:
- To qualitatively compare clinical, radiographic, and histological outcomes of two vital pulpotomy methods.
- To investigate the histological basis for treatment failures in cariously exposed primary molars.
Main Methods:
- A longitudinal study compared 20% Buckley's Formocresol with calcium hydroxide powder.
- Primary molars with vital, cariously exposed pulp underwent coronal pulp amputation.
- Extracted teeth (n=5) were evaluated histologically after clinical and radiographic assessment.
Main Results:
- Radiographs showed reactionary dentine barrier formation with calcium hydroxide and root canal narrowing in both groups.
- Histology confirmed reactionary dentine, but also revealed pus cells and resorption of dentine.
- Histological findings correlated with clinical and radiographic outcomes.
Conclusions:
- Histological findings in a small sample suggest inflammation and resorption may contribute to vital pulp therapy failure.
- Further research is needed to elucidate the mechanisms of failure in this under-researched treatment modality.