Thesis (M.D.S. 1977) from the Department of Dental Health, University of Adelaide.

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Thesis (M.S.)--University of Michigan, Ann Arbor, 1963. / Typescript (photocopy). Includes bibliographical references (leaves 81-85). Also issued in print.

Thesis (M.S.)--University of Michigan, Ann Arbor, 1963. / Typescript (photocopy). eContent provider-neutral record in process. Description based on print version record. Includes bibliographical references (leaves 81-85).

Indiana University-Purdue University Indianapolis (IUPUI) / Pulpotomy procedures for the treatment of pulp exposure or disease have traditionally used an approach from the occlusal surface in primary molars, with a rotating bur or a spoon excavator being used to excise the pulp under clean conditions and with a medicament being applied to the amputation site. The purpose of this study was: (1) to determine the feasibility of performing a sterile scalpel excision of coronal pulpal tissue and (2) to evaluate wound healing after a shield has been placed to prevent all substances from touching the blood clot at the amputation site. Using sterile operating room procedures, four of five teeth in five dogs were rendered free of cultivable bacteria after antimicrobial treatments were applied. These findings replicated a preliminary in vivo experiment of 45 teeth which demonstrated that antimicrobial agents applied to tooth enamel in dogs were effective beyond the 0.001 level of significance, as compared to a control group. Furthermore, in the main study, negative cultures were obtained during 72 percent of the trials following each of the five major steps in the pulpotomy procedure. This included 80 percent negative cultures for bacteria after pulpal excision and blood clot formation, and 100 percent freedom from cultivable bacteria after a resin diaphragm was cemented to place. In eight experimental teeth (three from the preliminary study and all five from the main study) the buccal dentin over the coronal portion of the pulp was removed by use of a tissue-protecting device without grossly macerating the pulpal tissue. In seven of these eight teeth, the coronal portion of the pulp tissue was amputated with a scalpel severance and pulpal biopsies were removed through the buccal preparation. In all eight teeth, the cavity preparation was accomplished without applying medicaments to the blood clot at the amputation site. A resin-stainless steel diaphragm was constructed under sterile conditions and secured in a buccal preparation without touching the pulpal amputation for a convalescence of 14-21 days, and this shield provided a buccal wall for closure with an amalgam restoration. In one animal which had not received a previous autotransfusion for medical research, histologic sections of the pulp tissue in two root canals demonstrated satisfactory wound healing (a moderate and a mild inflammatory infiltrate was considered reversible). Three of the five dogs in the main study exhibited pulpal necrosis which was attributed to an interference in the immune system by previous autotransfusion research, and histologic evaluation of pulpal wound healing was therefore inconclusive. This study demonstrates that the enamel surface can be rendered free of cultivable bacteria in the dog and the operative site can be maintained in this condition throughout pulpotomy, with the coronal portion of the pulp being removed without grossly macerating the pulp. Under these conditions there appears to be a potential for satisfactory wound healing, with possible implications for the clinical situation.

Indiana University-Purdue University Indianapolis (IUPUI) / Formocresol pulpotomy has been recommended for all infected primary molars irrespective of pulp vitality. Microscopic evidence is lacking when teeth with less than optimal pulpal preoperative conditions are treated. This study evaluated clinically, radiographically, and microscopically the effect of the five-minute formocresol pulpotomy in primary and permanent teeth of dogs with induced pulpal and periapical pathoses. Radicular pulps of 18 permanent and 12 primary teeth were exposed to the oral flora for 28 and 14 days, respectively, to produce pathoses that would contraindicate routine use of the pulpotomy. The five-minute formocresol pulpotomy was performed and nine permanent teeth were evaluated after four weeks and another nine after 12 weeks; the primary teeth were evaluated after 14 days. Eight permanent and four primary "control” teeth had their radicular pulps exposed to the oral flora for identical periods but were not treated by formocresol. In permanent teeth clinical success was 90 per cent, radiographic success was 30 per cent, and microscopic success of bloc sections was 10 per cent. The vital pulp reacted to formocresol by forming a homogenous band of markedly eosinophilic tissue, interpreted as "fixation;" very pale staining tissue was apical to this. A second area of marked eosinophilic tissue was in the apical part of all vital canals, apical to which was vital normal pulp. Similar trends were seen in the primary teeth. No "fixation," organization or repair was seen within any periapical lesion. The microscopic periapical appearance of related vital permanent and all necrotic canals indicated that formocresol pulpotomy is not particularly effective in teeth with induced pulpal and periapical pathoses. The findings suggest that it be used only under optimal clinical conditions.

Indiana University-Purdue University Indianapolis (IUPUI) / Formocresol is the most commonly used pharmacologic pulpotomy agent. Concerns over its safety have led investigators to search for new pulpotomy medicaments. This study compared the electrosurgical pulpotomy with the formocresol pulpotomy in teeth requiring pulp therapy after carious involvement. There were 25 pulpotomies performed in each group. The teeth were evaluated for clinical and radiographic success after at least six months. In the electrosurgical group, the clinical and radiographic success rates were 96 percent and 84 percent, respectively. The age range at the time of treatment was 26 to 97 months, with a mean treatment age of 63.6 months. The postoperative observation time range was six to 31 months, with the mean being 10.9 months. In the formocresol group, the clinical and radiographic success rates were 100 percent and 92 percent, respectively. The age range at the time of treatment was 32 to 126 months, with a mean treatment age of 68.2 months. The postoperative observation time ranged from five to 25 months, with the mean being 11.5 months. The electrosurgical and forrnocresol groups were compared for differences in the percentage of successes by using a Fisher's Exact test. There were no statistical differences between the two groups at the p < 0.05 level. Therefore, this study failed to demonstrate a statistically significant difference in the success rate between the electrosurgical and formocresol pulpotomy techniques and supports the use of the electrosurgical pulpotomy as a viable and safe alternative to formocresol.

Indiana University-Purdue University Indianapolis (IUPUI)

Indiana University-Purdue University Indianapolis (IUPUI) / Formocresol is the most commonly used pharmacologic pulpotomy agent. Concerns over its safety have led investigators to search for new pulpotomy medicaments. This study compared the electrosurgical pulpotomy with the formocresol pulpotomy in teeth requiring pulp therapy after carious involvement. There were 25 pulpotomies performed in each group. The teeth were evaluated for clinical and radiographic success after at least six months. In the electrosurgical group, the clinical and radiographic success rates were 96 percent and 84 percent, respectively. The age range at the time of treatment was 26 to 97 months, with a mean treatment age of 63.6 months. The postoperative observation time range was six to 31 months, with the mean being 10.9 months. In the formocresol group, the clinical and radiographic success rates were 100 percent and 92 percent, respectively. The age range at the time of treatment was 32 to 126 months, with a mean treatment age of 68.2 months. The postoperative observation time ranged from five to 25 months, with the mean being 11.5 months. The electrosurgical and formocresol groups were compared for differences in the percentage of successes by using a Fisher's Exact test. There were no statistical differences between the two groups at the p < 0.05 level. Therefore, this study failed to demonstrate a statistically significant difference in the success rate between the electrosurgical and formocresol pulpotomy techniques and supports the use of the electrosurgical pulpotomy as a viable and safe alternative to formocresol.

Thesis (M.S.)--University of Michigan, 2003. / Includes bibliographical references.