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Background: Prefabricated Zirconia Crowns (PZCs) are increasingly preferred for restoring primary teeth due to their esthetic appeal and retention. However, their rigid, unmodifiable design requires precise tooth preparation, often leading to aggressive reduction and potential pulp exposure. Pulpotomy, a standard treatment for reversible pulpitis and mechanical pulp exposure, is sometimes employed before PZCs. While pulpotomy is not routinely performed, its use raises important considerations about the interplay between restorative procedures and pulp therapy in pediatric dentistry, particularly regarding the long-term restoration outcomes of PZCs. Purpose: This study aimed to investigate the impact of pulpotomy on the success rate of PZCs. Methods: We examined 81 anterior upper primary teeth treated with PZCs in children aged 2–5 years over a two-year period. Cases were divided into groups with and without pulpotomy. Follow-ups occurred at 6-month intervals, assessing clinical and radiographic outcomes. Analyses were performed using SPSS 25.0 software. The statistical significance was p < 0.05. Results: A total of 81 anterior primary teeth were included. Chi-square analysis showed no association between pulp therapy and PZC success (χ2 = 0.051, p = 0.822). The Kaplan–Meier survival analysis revealed comparable survival curves and the log-rank test showed no statistically significant difference in survival time between pulpotomy-treated and untreated groups (χ2 = 0.051, p = 0.821). Conclusions: Pulpotomy did not significantly affect the success rate of PZCs within 2 years. [ABSTRACT FROM AUTHOR]

Background: The dreaded sensation of pain in the dental chair has a significant impact on children's behavior. This study aimed to compare and contrast the perception of pain and patient behavior between the use of INJEX and the conventional syringe needle technique during pulpotomy among children. Methods: A randomized clinical trial was designed and conducted among pediatric dentistry patients aged 6–12 years old. Fifty-eight children were divided into two groups, conventional syringe needle and INJEX, using simple randomization method applying the sequentially numbered, opaque, sealed envelope method of allocation concealment. Anesthesia was administered to the groups as local infiltration by a single operator following routine behavior guidance techniques. After 3 min, pulpotomy was performed using the standard protocol. The Face, Legs, Activity, Cry, Consolability (FLACC) scale and Wong–Baker FACES Pain Rating Scale (WBS) were used to assess the intensity of pain, while the Frankl behavior rating scale (FBRS) was used to assess the children's behavior. Results: During anesthesia, most of the participants in the INJEX group (median = 3) had higher FBRS scores compared with the conventional syringe needle group (median = 2), and the difference was very highly significant (p-value < 0.001). Analyzing the FLACC scores during local anesthesia administration revealed a high statistical significance (p-value < 0.01) across the two groups. A very high statistically significant difference (p-values < 0.001) with higher WBS scores for pain intensity was seen in the group using conventional syringe needles. Conclusions: INJEX administration significantly reduced the intensity of pain experienced by the children and helped maintain a positive attitude among them during pulpotomy. It provided a positive and comfortable experience for both the child and the practitioner. Therefore, it can serve as an excellent alternative to conventional needle anesthesia. [ABSTRACT FROM AUTHOR]

Objective: The technique of local anesthetic administration is an important consideration in the behavior guidance of a pediatric patient. The study hypothesized that there is no difference in the pain effectiveness in the experimental subjects with the use of single tooth anesthesia and the controls with the use of conventional technique (traditional inferior alveolar nerve block [IANB]).The purpose of this study was to compare the anesthesia effectiveness of traditional IANB; IANB using a computer-controlled local anesthetic delivery system (CCLAD); and intraligamental anesthesia (ILA) using CCLAD in pulpotomy of the primary mandibular second molars. Method and Materials: Ninety-one healthy 5- to 9-year-old children underwent pulpotomy of the mandibular second molars. They were randomly assigned into Group A (traditional IANB), Group B (IANB using CCLAD), or Group C (ILA injection using CCLAD). The effectiveness of anesthesia was measured during different steps of pulpotomy using the sounds, eyes, and motor (SEM) scale. The postoperative complications were recorded after 24 hours. Results: For all five pulpotomy steps, the anesthesia effectiveness was similar among the three anesthesia techniques. Anesthesia effectiveness was not significantly different (based on SEM scores) between the three groups during clamp application, drilling of the tooth, entering the pulp, pulp extirpation, and removal of the clamp (P = .635, P=. 996, P = .630, P = .945, and P = .101, respectively). There was no significant difference in postoperative complications between the three groups. Conclusion: The IANB anesthesia using CCLAD and periodontal ligament anesthesia using CCLAD were as effective as traditional IANB in anesthetizing the primary mandibular molars during pulpotomy. [ABSTRACT FROM AUTHOR]

Introduction: Management of pulpally involved primary teeth has recently gained importance inspite of the barriers faced by general dentists such as limited exposure to paediatric dentistry, skill and chair-side time. The advancements in technological and material sciences necessitate a practicing dentist to update themselves to deliver comprehensive dental care in most effective way. Aim: The study was aimed to assess and compare the perspective of pulpal treatment of primary teeth among general and paediatric dentists of Saudi Arabia. Materials and Methods: Close-ended, multiple-choice questionnaire evaluating their preferences towards pulp therapy in primary teeth was designed as part of a survey and mailed to 100 general dentists and 50 paediatric dentists across Kingdom of Saudi Arabia. Descriptive statistics followed by χ² -test was applied to test of variables in the questionnaire to determine their association. Results: Paediatric dentists (68%) performed pulpal treatment in primary teeth more frequently under rubber dam isolation than general dentists (47%) (p=0.025). Traditional indirect pulp capping was preferred to Indirect Pulp Treatment (IPT) by both groups under local anaesthesia. Caries detector dye was used to facilitate precise caries removal more frequently by Paediatric dentists than general dentists (p=0.001). Pulpotomy was preferred over IPT by both groups when there was a probability of pulp exposure following complete caries excavation. Pulpectomy was infrequently performed. Zinc oxide eugenol was the material preferred for obturation in both groups. Paediatric dentists preferred stainless steel crown whereas General dentists preferred glass ionomer restoration after pulp therapy (p=0.004). There was no significant difference between follow-up schedule followed by general and paediatric dentists even though most dentists recalled their patients immediately and after 3 months follow-up. Conclusion: The survey helps in refining the approaches of dentists towards pulp therapy in primary teeth and ascertains whether they are according to recent trends. [ABSTRACT FROM AUTHOR]

Worldwide, dental schools employ varying approaches to teaching vital pulp therapy (VPT) for primary teeth. However, little is known about the VPT techniques taught in dental schools in Saudi Arabia. Therefore, this study aimed to describe the approaches of VPT for primary teeth taught in undergraduate dental schools in Saudi Arabia. A nationwide cross-sectional study was conducted between January and June 2022, using an online questionnaire distributed to pediatric dentistry faculty members at all dental schools in Saudi Arabia. The questionnaire collected information on socio-demographic characteristics, educational background, work setting, and VPT teaching approaches. Descriptive statistics and logistic regression models assessed the association between participants' characteristics and the VPT techniques taught. Seventy-seven faculty members from 17 out of 27 dental colleges in Saudi Arabia participated in the study. Most respondents reported teaching indirect pulp capping (95%), with glass ionomer cement and calcium hydroxide being the most popular materials. Only 11 participants (14%) taught direct pulp capping, with mineral trioxide aggregate and calcium hydroxide being the most commonly used materials. Pulpotomy procedures were taught in all dental schools, with formocresol being the most commonly used medicament (84%). No significant associations were found between faculty member characteristics and the likelihood of teaching indirect pulp capping. However, older age categories had a significantly higher chance of teaching direct pulp capping (trend odds ratio: 2.27, p = 0.02). In conclusion, most faculty members (95%) reported teaching indirect pulp capping using glass ionomer cement and calcium hydroxide for primary teeth. Only 14% of the respondents taught direct pulp capping, and the use of mineral trioxide aggregate for direct pulp capping appears to be increasing. Formocresol was the most commonly used pulpotomy medicament. Further research is needed to investigate factors that influence the teaching of VPT for primary teeth in Saudi Arabia., Competing Interests: The authors declare no conflict of interest., (©2023 The Author(s). Published by MRE Press.)