Post-operative pain after vital pulpotomy of primary molars using allium sativum oil versus mineral trioxide aggregate

A randomized pilot clinical study

https://doi.org/10.53730/ijhs.v6nS4.6482

Authors

  • Nourhan Omar Ahmad El-Gebaly Assistant Lecturer of Pediatric Dentistry and Dental Public Health Department, Faculty of Dentistry, Cairo University, Cairo, Egypt
  • Adel Abd-Azim El-Bardissy Associate Professor of Pediatric Dentistry and Dental Public Health Department, Faculty of Dentistry, Cairo University, Cairo, Egypt
  • Randa Youssef Abd Al Gawad Associate Professor of Pediatric Dentistry and Dental Public Health Department, Faculty of Dentistry, Cairo University, Cairo, Egypt
  • Ahmed Mohamed Abd El-Samad Associate Professor of Oral and Maxillofacial Radiology Department, Faculty of Dentistry, Cairo University, Cairo, Egypt

Keywords:

Allium Sativum oil, Mineral trioxide aggregate, primary molars, Pulpotomy, Zinc Oxide

Abstract

Aim: To evaluate clinical and radiographic performance of Allium Sativum oil dressed in Zinc Oxide versus Mineral trioxide aggregate as pulp dressing agent in pulpotomized lower primary molar teeth. Methodology: This randomized pilot clinical trial included 30 lower primary molars indicated for vital pulpotomy and randomly allocated into two equal groups (n=15): Group (I): pulpotomy using A. Sativum oil dressed in ZnO and Group (II): pulpotomy using Mineral trioxide aggregate as pulpotomy agent. All molars were covered with stainless steel crowns and clinical and radiographic assessment was done at 3, 6, 9 and 12 months interval by help of predetermined criteria. Results: Overall clinical success rate of Group (I) and Group (II) at the end of 12 months follow-up was (93.3%) and (100.0%) respectively. There was no statistical significance difference between two groups regarding overall clinical success rate. The overall radiographic success rate at the end of 12 months was (40.0%) and (100.0%) respectively. There was a statistical significant difference regarding overall radiographic success rate at 9 and 12 months follow-up. The overall success rate of Group (I) and Group (II) at the end of 12 months was (40.0%) and (100.0%) showing a statistically significant difference between the two groups.

Downloads

Download data is not yet available.

References

Pimenta HC, Borges ÁH, Bandeca MC, Neves ATS, Fontes RG, da Silva PV, et al. Antimicrobial activity of filling materials used in primary teeth pulpotomy. J Int oral Heal JIOH [Internet]. 2015;7(4):54–7. Available from: http://www.ncbi.nlm.nih.gov/pubmed/25954072%0Ahttp://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=PMC4409797.

Anil S, Anand PS. Early Childhood Caries: Prevalence, Risk Factors, and Prevention. Front Pediatr. 2017 Jul 18;5:157. doi: 10.3389/fped.2017.00157. PMID: 28770188; PMCID: PMC5514393.

Al-Dlaigan YH. Pulpotomy Medicaments used in Deciduous Dentition: An Update. Vol. 16, The journal of contemporary dental practice. 2015. p. 486–503.

Parirokh M, Torabinejad M, Dummer PMH. Mineral trioxide aggregate and other bioactive endodontic cements: an updated overview – part I: vital pulp therapy. Vol. 51, International Endodontic Journal. Blackwell Publishing Ltd; 2018. p. 177–205.

Raju SS, MP S, Kiranmayi M, Reddy ER, Divya SS, Gowtham P. Bio active materials in pediatric dentistry: A review. Int J Appl Dent Sci. 2021 Jan 1;7(1):345–51.

Parisay I, Forghani M, Ghoddusi J. A Review on Vital Pulp Therapy in Primary Teeth Histological Evaluation of the Effect of Platelet-rich Plasma on Pulp Regeneration in Nonvital Open Apex Teeth: An Animal Study View project hypnosis View project A Review on Vital Pulp Therapy in Primary Teeth [Internet]. Vol. 10, IEJ Iranian Endodontic Journal. 2015. Available from: https://www.researchgate.net/publication/271139578.

Bhandari PR. Garlic (Allium sativum L.): A review of potential therapeutic applications. Int J Green Pharm. 2012;6(2):118–29.

Bayan et al. Garlic: a review of potential therapeutic effects. Avicenna J phytomedicine [Internet]. 2014;4(1):1–14. Available from: http://www.ncbi.nlm.nih.gov/pubmed/25050296%0Ahttp://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=PMC4103721

Jaikaria et al. Natural products used in dentistry-A Review. Int J Oral Heal Dent [Internet]. 2016;2(4):209–12. Available from: https://www.innovativepublication.com/innovative-file?file=IJOHD_2%26%2340%3B4%26%2341%3B_209-212.pdf

Subramanyam D, Somasundaram S. Clinical and radiographic outcome of herbal medicine versus standard pulpotomy medicaments in primary molars: A systematic review. J Clin Diagnostic Res. 2017;11(10):ZE12–6.

Mehta SD, Mehta SS, Sihag SR, Bhatnagar S. Allium sativum : A promising therapeutic agent. Int J ayurvedic Herb Med. 2016;6(1):2101–4.

Mohammad SG, Raheel SA, Baroudi K. Clinical and Radiographic Evaluation of Allium sativum Oil as a New Medicament for Vital Pulp Treatment of Primary Teeth. J Int oral Heal JIOH [Internet]. 2014;6(6):32–6. Available from: http://www.ncbi.nlm.nih.gov/pubmed/25628480%0Ahttp://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=PMC4295451.

Mohammad S, Baroudi K. Assessment of the potential of Allium sativum oil as a new medicament for non-vital pulpotomy of primary teeth. J Int Soc Prev Community Dent. 2015;5(4):314.

Kahvand et al. Clinical and Radiographic Evaluation of Allium sativum Oil (Garlic Oil) in Comparison with Formocresol in Primary Molar Pulpotomy. J Int Soc Prev Community Dent. 2019;8(831):34–7.

Hertzog MA. Considerations in determining sample size for pilot studies. Res Nurs Heal. 2008 Apr;31(2):180–91.

American Academy of Pediatric Dentistry (AAPD). Guideline on pulp therapy for primary and immature permanent teeth. www.aapd.org/media/policies_guidelines/g_pulp.pdf (accessed prior to 13 June 2017).

Cohen LL, Lemanek K, Blount RL, Dahlquist LM, Lim CS, Palermo TM, McKenna KD, Weiss KE. Evidence-based assessment of pediatric pain. J Pediatr Psychol. 2008 Oct;33(9):939-55; discussion 956-7. doi: 10.1093/jpepsy/jsm103. Epub 2007 Nov 17. PMID: 18024983; PMCID: PMC2639489.

Niranjani K, Prasad MG, Vasa AA, Divya G, Thakur MS, Saujanya K. Clinical Evaluation of Success of Primary Teeth Pulpotomy Using Mineral Trioxide Aggregate(®), Laser and Biodentine(TM)- an In Vivo Study. J Clin Diagn Res. 2015 Apr;9(4):ZC35-7. doi: 10.7860/JCDR/2015/13153.5823. Epub 2015 Apr 1. PMID: 26023640; PMCID: PMC4437156.

Memarpour M, Fijan S, Asgary S, Keikhaee M. Calcium-Enriched Mixture Pulpotomy of Primary Molar Teeth with Irreversible Pulpitis. A Clinical Study. Open Dent J. 2016 Mar 7;10:43-9. doi: 10.2174/1874210601610010043. PMID: 27326265; PMCID: PMC4911738.

Mohammad. S. G & Baroudi. K. (2015). Assessment of the potential of Allium sativum oil as a new medicament for non vital pulpotomy of primary teeth. Journal of International Society of Preventive and Community Dentistry, 5(4): 314-320. (DOI: 10.4103/2231-0762.161762).

Nasrallah H, El Noueiri B, Pilipili C, Ayoub F. Clinical and Radiographic Evaluations of Biodentine™ Pulpotomies in Mature Primary Molars (Stage 2). Int J Clin Pediatr Dent. 2018 Nov-Dec;11(6):496-504. doi: 10.5005/jp-journals-10005-1564. PMID: 31303737; PMCID: PMC6611544.

Hashem, S., Fawzy, M., Mostafa, M. Comparative Study of Some Natural Materials Versus Traditional Medicaments used for Pulp Treatment of Primary Teeth. Al-Azhar Dental Journal for Girls, 2019; 6(1): 25-30. doi: 10.21608/adjg.2019.28396.

Fouad WA, Abd Al Gawad RY. Is Biodentine, as successful as, mineral trioxide aggregate for pulpotomy of primary molars? A split-mouth clinical trial. Tanta Dent J [serial online] 2019 [cited 2022 Jan 24];16:115-9. Available from: http://www.tmj.eg.net/text.asp?2019/16/2/115/267564.

Divya S, Sujatha S. An insight on the success of various pulpotomy medicaments in pediatric dentistry–a review of literature [Internet]. Vol. 11, Research Journal of Pharmacy and Technology. 2018. p. 2647–55. Available from: http://www.indianjournals.com/ijor.aspx?target=ijor:rjpt&volume=11&issue=6&article=092.

Elheeny AAH. Allium sativum extract as an irrigant in pulpectomy of primary molars: A 12-month short-term evaluation. Clin Exp Dent Res. 2019;5(4):420–6.

Gomaa GR, Allam GG. Clinical and radiographic evaluation of the extract of allium sativum in pulpotomy of primary molars: A randomized clinical trial. Int J Dent Oral Sci. 2020;7(7):747–52.

Mohammad SG ama., Raheel SA hme., Baroudi K. Histological Evaluation of Allium sativum Oil as a New Medicament for Pulp Treatment of Permanent Teeth. J Contemp Dent Pract. 2015;16(2):85–90.

Ahmed HM, Abbott PV. Accessory roots in maxillary molar teeth: a review and endodontic considerations. Aust Dent J. 2012 Jun;57(2):123-31; quiz 248. doi: 10.1111/j.1834-7819.2012.01678.x. Epub 2012 Apr 9. PMID: 22624750.

Abuelniel, G., Eltawil, S. Clinical and Radiographic Assessment of Pulpotomy Materials in Primary Molars. Egyptian Dental Journal, 2018; 64(Issue 2 - April (Orthodontics, Pediatric & Preventive Dentistry)): 951-962. doi: 10.21608/edj.2018.76936.

Sharma S, Logani A, Shah N. Comparative efficacy of photo-activated disinfection and calcium hydroxide for disinfection of remaining carious dentin in deep cavities: a clinical study. Restor Dent Endod. 2014 Aug;39(3):195-200. doi: 10.5395/rde.2014.39.3.195. Epub 2014 Jun 26. PMID: 25110643; PMCID: PMC4125583.

Suresh K. An overview of randomization techniques: An unbiased assessment of outcome in clinical research. J Hum Reprod Sci. 2011 Jan;4(1):8-11. doi: 10.4103/0974-1208.82352. PMID: 21772732; PMCID: PMC3136079.

Bang H, Park JJ. Blinding in clinical trials: a practical approach. J Altern Complement Med. 2013 Apr;19(4):367-9. doi: 10.1089/acm.2012.0210. Epub 2012 Nov 9. PMID: 23140113.

Hróbjartsson A, Emanuelsson F, Skou Thomsen AS, Hilden J, Brorson S. Bias due to lack of patient blinding in clinical trials. A systematic review of trials randomizing patients to blind and nonblind sub-studies. Int J Epidemiol. 2014 Aug;43(4):1272-83. doi: 10.1093/ije/dyu115. Epub 2014 May 30. PMID: 24881045; PMCID: PMC4258786.

Dhar V, Marghalani AA, Crystal YO, Kumar A, Ritwik P, Tulunoglu O, Graham L. Use of Vital Pulp Therapies in Primary Teeth with Deep Caries Lesions. Pediatr Dent. 2017 Sep 15;39(5):146-159. Erratum in: Pediatr Dent. 2020 Jan 15;42(1):12-15. PMID: 29070150.

Kumar M, Chawla R, Goyal M. Topical anesthesia. J Anaesthesiol Clin Pharmacol. 2015 Oct-Dec;31(4):450-6. doi: 10.4103/0970-9185.169049. PMID: 26702198; PMCID: PMC4676230.

Chompu-Inwai P, Sutharaphan T, Nirunsittirat A, Chuveera P, Srisuwan T, Sastraruji T. How Effective are Inferior Alveolar Nerve Block and Supplemental Intraligamentary Injections in Pediatric Patients with Deep Carious Permanent Mandibular Molars? Pediatr Dent. 2018 Nov 15;40(7):437-442. PMID: 31840644.

Mahfouz, S., Wahba, O. Comparative Evaluation of Pulpal Response to Tri-antibiotic Paste and Allium Sativum with Formacresol as Pulpotomy Medication in Primary Teeth:An in vivo Study. Egyptian Dental Journal, 2019; 65(Issue 4 - October (Orthodontics, Pediatric & Preventive Dentistry)): 3131-3142. doi: 10.21608/edj.2019.73990.

American Academy of Pediatric Dentistry. Pulp therapy for primary and immature permanent teeth. The Reference Manual of Pediatric Dentistry. Chicago, Ill.: American Academy of Pediatric Dentistry; 2020:384-92.

Seale & Randall. (2015).The use of stainless steel crowns: a systematic literature review. American Academy of Pediatric Dentistry. 37(2):145-60. PMID: 25905656.

Silva LLCE, Cosme-Silva L, Sakai VT, Lopes CS, Silveira APPD, Moretti Neto RT, Gomes-Filho JE, Oliveira TM, Moretti ABDS. Comparison between calcium hydroxide mixtures and mineral trioxide aggregate in primary teeth pulpotomy: a randomized controlled trial. J Appl Oral Sci. 2019 May 20;27:e20180030. doi: 10.1590/1678-7757-2018-0030. PMID: 31116277; PMCID: PMC6534371.

Durmus B, Tanboga I. In vivo evaluation of the treatment outcome of pulpotomy in primary molars using diode laser, formocresol, and ferric sulphate. Photomed Laser Surg. 2014 May;32(5):289-95. doi: 10.1089/pho.2013.3628. Epub 2014 Apr 9. PMID: 24717147; PMCID: PMC4010162.

Dean et al. (2016). McDonald and Avery dentistry for the child and adolescent tenth edition-E-book. Elsevier Health Sciences.

Fuks et al. (2019). Pulp Therapy for the Primary Dentition, Editor(s): Arthur J. Nowak, John R. Christensen, Tad R. Mabry, Janice A. Townsend, Martha H. Wells, Pediatric Dentistry (Sixth Edition),Elsevier, Pages 329-351.e1, ISBN 9780323608268, https://doi.org/10.1016/B978-0-323-60826-8.00023-7.

Abirami K, Ramkumar H, Senthil D. Clinical and radiographic evaluation of the efficacy of formocresol, Allium sativum oil, and Aloe barbadensis gel as pulpotomy medicaments in primary molars: A randomized controlled trial. Int J Clin Pediatr Dent. 2020;13(5):518–22.

Junqueira MA, Cunha NNO, Caixeta FF, Marques NCT, Oliveira TM, Moretti ABDS, Cosme-Silva L, Sakai VT. Clinical, Radiographic and Histological Evaluation of Primary Teeth Pulpotomy Using MTA And Ferric Sulfate. Braz Dent J. 2018 Mar-Apr;29(2):159-165. doi: 10.1590/0103-6440201801659. PMID: 29898062.

Walid Meslmani, Chaza Kouchaji, Salem Rekab, Majid Aljaber Abo Fakher, Zuhair Al Nerabieah,

he efficacy of Portland cement as a pulpotomy agent in deciduous teeth, Pediatric Dental Journal, Volume 30, Issue 2, 2020, Pages99105,ISSN09172394,https://doi.org/10.1016/j.pdj.2020.02.001.(https://www.sciencedirect.com/science/article/pii/S0917239420300112).

Zewail OB, El Hendawy FA, Beltagy TM. Comparative study of the clinical and radiographic effects of pulpotec and mineral trioxide aggregate on the pulp of the primary molars. Tanta Dent J [serial online] 2020 [cited 2022 Jan 24];17:9-14. Available from: http://www.tmj.eg.net/text.asp?2020/17/1/9/287095.

Odabaş ME, Alaçam A, Sillelioǧlu H, Deveci C. Clinical and radiographic success rates of mineral trioxide aggregate and ferric sulphate pulpotomies performed by dental students. Eur J Paediatr Dent. 2012;13(2):118–22.

Cuadros-Fernández C, Lorente Rodríguez AI, Sáez-Martínez S, García-Binimelis J, About I, Mercadé M. Short-term treatment outcome of pulpotomies in primary molars using mineral trioxide aggregate and Biodentine: a randomized clinical trial. Clin Oral Investig. 2016 Sep;20(7):1639-45. doi: 10.1007/s00784-015-1656-4. Epub 2015 Nov 18. PMID: 26578117.

Perea MB, Mendoza BS, Garcia-Godoy F, Mendoza AM, Iglesias-Linares A. Clinical and radiographic evaluation of white MTA versus formocresol pulpotomy: A 48-month follow-up study. Am J Dent. 2017;30(3):131–6.

Swarnalatha C, Babu J S, Panwar PS, Alquraishi MA, Almalaq SA, Alnasrallah FA, Nayyar AS. Clinical and radiographic evaluation of results of MTA pulpotomy and laser-assisted MTA pulpotomy. Saudi Endod J [serial online] 2020 [cited 2022 Jan 24];10:254-9. Available from: https://www.saudiendodj.com/text.asp?2020/10/3/254/293566.

Sunitha, Puppala R, Kethineni B, Tarasingh P. Clinical and Radiographic Evaluation of Four Different Pulpotomy Agents in Primary Molars: A Longitudinal Study. Int J Clin Pediatr Dent. 2017 Sep;10(3):240–4.

Carti O, Oznurhan F. Evaluation and comparison of mineral trioxide aggregate and biodentine in primary tooth pulpotomy: Clinical and radiographic study. Niger J Clin Pract. 2017 Dec;20(12):1604-1609. doi: 10.4103/1119-3077.196074. PMID: 29378994.

Mythraiye R, Rao VV, Minor Babu MS, Satyam M, R P, Paravada C. Evaluation of the Clinical and Radiological Outcomes of Pulpotomized Primary Molars Treated with Three Different Materials: Mineral Trioxide Aggregate, Biodentine, and Pulpotec. An In-vivo Study. Cureus. 2019 Jun 2;11(6):e4803. doi: 10.7759/cureus.4803. PMID: 31404393; PMCID: PMC6682388.

Çelik BN, Mutluay MS, Arıkan V, Sarı Ş. The evaluation of MTA and Biodentine as a pulpotomy materials for carious exposures in primary teeth. Clin Oral Investig. 2019;23(2):661–6.

Neamatollahi, A. Tajik. Comparison of clinical and radiographic success rates of pulpotomy in primary molars using Formocresol, Ferric Sulfate and Mineral Trioxide Aggregate (MTA). Front Dent. 1;3(1):7-14.

Jamali Z, Alavi V, Najafpour E, Aminabadi NA, Shirazi S. Randomized Controlled Trial of Pulpotomy in Primary Molars using MTA and Formocresol Compared to 3Mixtatin: A Novel Biomaterial. J Clin Pediatr Dent. 2018;42(5):361-366. doi: 10.17796/1053-4625-42.5.7. Epub 2018 May 15. PMID: 29763354.

Swarnalatha C, Babu J S, Panwar PS, Alquraishi MA, Almalaq SA, Alnasrallah FA, Nayyar AS. Clinical and radiographic evaluation of results of MTA pulpotomy and laser-assisted MTA pulpotomy. Saudi Endod J [serial online] 2020 [cited 2022 Jan 24];10:254-9. Available from: https://www.saudiendodj.com/text.asp?2020/10/3/254/293566.

Vilella-Pastor S, Sáez S, Veloso A, Guinot-Jimeno F, Mercadé M. Long-term evaluation of primary teeth molar pulpotomies with Biodentine and MTA: a CONSORT randomized clinical trial. Eur Arch Paediatr Dent. 2021 Aug;22(4):685-692. doi: 10.1007/s40368-021-00616-3. Epub 2021 Mar 8. PMID: 33683572.

Published

27-04-2022

How to Cite

Ahmad El-Gebaly, N. O., El-Bardissy, A. A.-A., Al Gawad, R. Y. A., & El-Samad, A. M. A. (2022). Post-operative pain after vital pulpotomy of primary molars using allium sativum oil versus mineral trioxide aggregate: A randomized pilot clinical study. International Journal of Health Sciences, 6(S4), 1900–1922. https://doi.org/10.53730/ijhs.v6nS4.6482

Issue

Section

Peer Review Articles