Clinical and radiographic comparison of primary molars after formocresol and electrosurgical pulpotomy: a randomized clinical trial.
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BACKGROUND: Vital pulpotomy is a single-stage procedure defined as the surgical amputation of the coronal portion of exposed vital pulp, usually as a means of preserving the vitality and function of the remaining radicular portion. OBJECTIVES: The aim of this study was to compare the clinical and radiographic success rates for electrosurgical vs formocresol pulpotomy in human primary molar teeth. SETTINGS AND DESIGN: This was a prospective, randomized clinical trial. MATERIALS AND METHODS: In this randomized clinical trial, pulpotomies were performed on 70 primary molars in children aged 5-10 years. The teeth were treated using either a conventional formocresol (35 teeth) or electrosurgical technique (35 teeth). Following the pulpotomy procedure, the teeth were evaluated for clinical and radiographic success for three, six and nine months. The teeth were evaluated for the presence of pain, abscess, fistula, mobility, internal and external resorption, and radiolucency. STATISTICAL ANALYSIS: The data were assessed with Fishers' Exact test. RESULTS: After nine months of follow-up, the clinical and radiographic success rates were 96 and 84% respectively in the electrosurgical group and 100 and 96.8% respectively in the formocresol group. There was no statistically significant difference between the success rates in the two groups ( P > 0.05). CONCLUSIONS: Our results showed the failure rates for electrosurgical pulpotomy to be equal to those for formocresol pulpotomy. Although electrosurgical pulpotomy is a nonpharmacological technique giving favorable results, it is still a preservative technique. Further studies using larger samples and longer evaluation periods are recommended. (+info)
Evaluation of the dental structure loss produced during maintenance and replacement of occlusal amalgam restorations.
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Immune function effects of dental amalgam in children: a randomized clinical trial.
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BACKGROUND: Dental amalgam is a widely used restorative material containing 50 percent elemental mercury that emits mercury vapor. No randomized clinical trials have determined whether there are adverse immunological effects associated with this low-level mercury exposure in children. The objective of this study was to evaluate a subpopulation of the participants in the New England Children's Amalgam Trial for in vitro manifestations of immunotoxic effects of dental amalgam. METHODS: The authors conducted a randomized clinical trial in which children requiring dental restorative treatment were randomly assigned to receive either amalgam for posterior restorations or resin-based composite restorations. They assessed 66 children, aged 6 to 10 years, for total white blood cell counts, specific lymphocyte (T-cell and B-cell) counts and lymphocyte, neutrophil and monocyte responsiveness across a five-year period. Because of the small number of participants, the authors acknowledge that the study is exploratory in nature and has limited statistical power. RESULTS: The mean number of tooth surfaces restored during the five-year period was 7.8 for the amalgam group and 10.1 for the composite group. In the amalgam group, there was a slight, but not statistically significant, decline in responsiveness of T cells and monocytes at five to seven days after treatment; the authors consistently observed no differences at six, 12 or 60 months. CONCLUSIONS: The findings of this study confirm that treatment of children with amalgam restorations leads to increased, albeit low-level, exposure to mercury. In this exploratory analysis of immune function, amalgam exposure did not cause overt immune deficits, although small transient effects were observed five to seven days after restoration placement. CLINICAL IMPLICATIONS: These findings suggest that immunotoxic effects of amalgam restorations are minimal and transient in children and most likely do not need to be of concern to practitioners considering the use of this restorative dental material. (+info)
Quantitative and qualitative analysis of student feedback on ePortfolio learning.
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At the University of British Columbia, we introduced an ePortfolio assignment in the operative dentistry clinical simulation module and conducted a pilot study to explore the usefulness of ePortfolios as a learning tool for dental students. Qualitative assessments included student self-reflections on the ePortfolio experience. In the quantitative evaluation, ePortfolio learning was hypothesized as a multidimensional experience with four dimensions: 1) an ePortfolio experience is valuable for learning operative dentistry; 2) an ePortfolio is time-consuming, but overall a useful experience; 3) ePortfolio learning requires technical skills that are manageable; and 4) ePortfolio experience may be beneficial for lifelong learning. Overall, both quantitative and qualitative assessments demonstrated that students valued ePortfolio learning as a positive experience. In multivariate analyses (confirmatory factor analysis), the four-dimensional model of ePortfolio learning was confirmed. Future studies are needed to validate or revise the four-factor model of ePortfolio learning in different student cohorts. (+info)
Nephrotoxicity, neurotoxicity, and mercury exposure among children with and without dental amalgam fillings.
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In vitro-evaluation of secondary caries formation around restoration.
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The objective of this in vitro study was to evaluate demineralization around restorations. Class V preparations were made on the buccal and lingual surfaces of each tooth. TPH (Group 1), Fuji II LC (Group 2), Tetric (Group 3), Dyract (Group 4), GS 80 (Group 5) and Chelon Fil (Group 6) were randomly placed in equal numbers of teeth. The teeth were submitted to a pH-cycling model associated with a thermocycling model. Sections were made and the specimens were examined for the presence of demineralization under polarized light microscopy. Demineralization was significantly reduced with Chelon Fil (Group 6). Furthermore, a similar inhibitory effect on the development of demineralization was observed in Groups 2, 4 and 5. (+info)