Formocresol 20% dental liquid

The challenge of effectively managing primary teeth with irreversible pulpitis in pediatric dentistry is of interest. The clinical and radiographic success of different pulpotomy materials, including Mineral Trioxide Aggregate (MTA), in comparison to conventional materials like formocresol, ferric sulfate, calcium hydroxide, and Biodentine is reported. Therefore, it is of interest to evaluate the effectiveness of materials like MTA in pulpotomies for primary teeth with irreversible pulpitis. The meta-analysis revealed that MTA pulpotomies had a clinical success rate of 97.02% and a radiographic success rate of 94.21%, outperforming ferric sulfate, Biodentine and calcium hydroxide. CEM and Calcium Silicate Cements showed comparable success rates to MTA. Thus, MTA demonstrated superior clinical and radiographic outcomes for pulpotomy in primary teeth with irreversible pulpitis, showing statistically significant differences compared to other materials.

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In vitro studies have shown that garlic extracts are effective against microorganisms commonly associated with root canal infections, with the ability to penetrate bacterial biofilms and inhibit the growth of resistant strains. Building upon this preclinical evidence, the objective of the present systematic review was to identify, critically analyze, and synthesize the available clinical trials on the efficacy of garlic as a therapeutic agent in the management of pulp infections. The review was conducted following PRISMA guidelines and registered in PROSPERO, including clinical trials evaluating garlic-based treatments. A literature search was performed, studies were screened, data extracted, and the risk of bias was assessed using the Cochrane tool and the Newcastle-Ottawa Scale. Certainty of evidence was graded with the GRADE approach. Sixteen studies were included, of which 13 evaluated garlic-derived compounds as intracanal medicaments. Clinical success rates were generally high (≥ 90%), with outcomes comparable to formocresol and MTA, and at lower costs. Radiographic success ranged from 55% to 100%, with some studies showing superior results in reducing periapical signs. Microbiological analyses demonstrated a significant short-term reduction in bacterial load, with superior efficacy compared to conventional agents. Three additional studies investigated garlic-based irrigants, reporting moderate-to-high clinical success (around 75%). Overall, the included studies demonstrated a low risk of bias. The certainty of evidence was rated as moderate for randomized controlled trials and low for non-randomized trials. Low-to-moderate certainty evidence suggests garlic-derived formulations may improve clinical and radiographic outcomes when used as irrigants or intracanal medicaments in pulpotomy and pulpectomy procedures in endodontic practice. However, evidence remains limited, and well-designed, standardized clinical trials with long-term follow-up are needed to confirm their efficacy and safety.

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The aim of this systematic review was to evaluate the clinical and radiographic success rates of primary teeth pulpotomy using 3Mixtatin compared to mineral trioxide aggregate (MTA). A comprehensive literature search identified relevant studies, which were screened for inclusion, with the risk of bias assessed using Cochrane collaboration tools. Data on success rates, follow-up periods, and methodological quality were extracted, and the protocol was registered in PROSPERO (ID: CRD42024562155). Among the four analyzed studies, Jamali et al. reported 24-month clinical success rates of 90.5%, 88.1%, and 78.9% for 3Mixtatin, MTA, and formocresol, respectively. Chak et al. observed a 95.7% clinical success rate for 3Mixtatin over 12 months, with no data on MTA, while Mushtaq et al. found comparable success rates for both 3Mixtatin and MTA. Reddy et al. reported clinical and radiographic success rates of 91.7% and 81.7% for formocresol, 100% and 91.7% for MTA, and 95% and 85% for 3Mixtatin at 6 and 12 months, respectively. Radiographically, 3Mixtatin demonstrated slightly better short-term outcomes than MTA. These findings suggest that both 3Mixtatin and MTA are effective for pulpotomy in primary dentition, with 3Mixtatin offering potential advantages due to its antibiotic and statin properties that may enhance healing and antibacterial effects. Additional studies involving larger and more diverse populations are required to confirm these findings.

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ObjectivesWe performed this network meta-analysis to determine the comparative efficacy of formocresol (FC), ferric sulfate (FS), sodium hypochlorite (NaOCl), calcium hydroxide (CH), mineral trioxide aggregate (MTA), biodentine, and laser for pulpotomy of molar teeth.Materials and methodsAn updated search was conducted in PubMed, Embase, and the Cochrane Library to identify relevant randomized controlled trials (RCTs) published before October 30, 2022, after screening previous meta-analyses. The Cochrane risk of bias assessment tool was used to appraise the methodological quality of included studies. Clinical and radiographic success rates were assessed as outcomes. Random network meta-analysis was performed by using STATA software (version 14.0) with "network" command.ResultsA total of 43 RCTs were included. Network meta-analysis indicated that CH was inferior to other medicaments and techniques in all outcomes, and MTA and biodentine was better than FC, FS, and NaOCl in terms of clinical and radiographic success rates. Results of ranking probabilities suggested that MTA ranked first in all outcomes except for clinical success at both 6 months.ConclusionsOur results suggested that MTA was associated with significant improvement in both clinical and radiographic success than other pulpotomy medicaments and techniques, with the highest probability of being the optimal option.Clinical relevanceThe current network meta-analysis determined the comparative efficacy and safety of 7 common pulpotomy medicaments in molar pulpotomy, including FC, FS, NaOCl, CH, MTA, biodentine, and laser, and the pooled results revealed comparable efficacy in clinical and radiographic success rates at 6 and 12 months between FC, FS, and NaOCl in primary molars pulpotomies. However, MTA, biodentine and laser may have more advantages than other pulpotomy medicaments for clinical and radiographic success. Therefore, in clinical practice, practitioners should select MTA, biodentine, or laser as pulpotomy medicaments in molar pulpotomy.

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BackgroundPulpotomy is an effective, vital pulp therapy procedure for caries-affected or traumatized primary teeth. Though its efficacy is widely accepted, the superiority of medicaments and techniques remains debatable.AimThe aims of this review were to compare the success rates of various pulpotomy medicaments or techniques, assess the methodological quality of reviews, and grade the level of evidence for each comparison.DesignThis review followed the principles of evidence-based medicine and recommendations for the overview of systematic reviews. An a priori protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO; CRD42021244489). A comprehensive literature search was performed by two reviewers, and studies were selected from various databases according to predefined criteria. Two reviewers independently used a self-designed pilot-tested form to extract data from the selected studies. A quality analysis was performed using A MeaSurement Tool to Assess systematic Reviews-2 (AMSTAR-2) and the ROBIS tool. Reporting characteristics and overlap of the primary studies were also assessed. We used modified Köhler's criteria for evaluating the quality of evidence for outcomes of included systematic reviews and meta-analyses.ResultsThe scrutiny of 62 full-text articles resulted in the inclusion of eight systematic reviews. The quality of four of the reviews was found to be critically low, and the overlap of primary studies in the meta-analyses was found to be high. Pulpotomy medicaments/techniques, except calcium hydroxide, had success rates of more than 80% for all domains and time periods. Most of the comparisons revealed no differences in the clinical, radiographic, or overall success rates. Mineral trioxide aggregate, however, was found to have better radiographic and overall success rates than calcium hydroxide at periods greater than 12 and 18 months. It also had a greater radiographic success rate than full-strength/1:5 diluted and full-strength formocresol at 24 months. Formocresol was found to have better overall success rates than calcium hydroxide at all time periods and better radiographic success rates at 12 months. Only 12 of the 63 comparisons had suggestive or weak evidence, whereas all others had either negligible evidence or insufficient data.ConclusionsThe pulpotomy medicaments/techniques, except calcium hydroxide, showed success rates of more than 80%, whereas most comparisons revealed no differences. Mineral trioxide aggregate, however, was found to be better than calcium hydroxide and formocresol in several respects. This study highlights the lack of evidence regarding the choice of pulpotomy agents for the treatment of caries-affected primary teeth and elucidates the domains that require primary studies in the future.

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