Printer Friendly

Effects of folk medicinal plant extract Ankaferd Blood Stopper[R] in vital primary molar pulpotomy.

Introduction

Ankaferd Blood Stopper[R] (ABS; Ankaferd Health Products Ltd., Istanbul, Turkey) is a traditional folk medicinal plant extract product that has been approved for the management of external haemorrhage and bleedings after dental surgery (www.ankaferd.com). ABS comprises a standardised mixture of the plants Thymus vulgaris, Glycyrrhiza glabra, Vitis vinifera, Alpinia officinarum and Urtica dioica. Several studies have shown that each of these plants has some effect on endothelium, blood cells, angiogenesis, cellular proliferation, vascular dynamics and cell mediators [Matsuda et al., 2006; Lee et al., 2007] .

The basic mechanism of action for ABS is the formation of an encapsulated protein network that provides focal points for vital erythrocyte aggregation. ABS-induced protein network formation with blood cells particularly erythrocytes covers the primary and secondary haemostatic system without disturbing individual coagulation factors [Goker et al., 2008].

Exaggerated bleeding, particularly in patients with hereditary or acquired haemorrhagic diatheses, is a challenging problem for the dental profession on a daily basis. Anti-thrombotic, procoagulant and anti-fibrinolytic medications are frequently used for the management of bleeding in dentistry. ABS may, therefore, be effective both in individuals with normal haemostatic parameters and in patients with deficient primary and/or secondary haemostasis [Goker et al., 2008; Bilgili et al., 2009]. Safety of ABS was demonstrated in animal studies and healthy volunteers. After preclinical animal studies, topical safety of ABS in normal healthy human volunteers was shown in a randomised double-blind cross-over Phase I clinical trials [Bilgili et al., 2009; Firat et al., 2009].

Pulpotomy in a primary tooth is defined as a procedure performed when the coronal pulp tissue is exposed by caries during removal or trauma. The inflamed and infected coronal pulp is amputated, leaving vital and uninfected radicular pulp tissue. The pulp stumps can be treated by electrosurgery, Er:YAG laser, or with a dressing such as formocresol (FC), calcium hydroxide (CH), glutaraldehyde, enriched collagen solution, ferric sulphate (FS) or mineral trioxide aggregate (MTA) which can protect the remaining pulp tissue and promote healing [Peng et al., 2006].

After amputation of the inflamed coronal pulp (pulpotomy), recovery of the non-inflamed radicular pulp can develop along one of three lines:

* Devitalisation: by using drugs or other methods, the pulp in the orifice becomes non-vital and non-functional, for example the formocresol technique is classified in this category.

* Preservation: the function of the remaining pulp demonstrates minimal changes which are reversible. Preservation is exemplified by the ferric sulphate technique.

* Regeneration: The remaining pulp is not only vital and functional but is also stimulated to form a dentine bridge. In addition regeneration causes odontoblasts to surround the pulp. The mineral trioxide aggregate technique is considered a typical example of regeneration [Neamatollahi and Tajik, 2006].

From the review of Fuks, [2008] it can be observed that, all the studies comparing MTA with FC showed that MTA presented better results, even though in some of the studies there was no statistical difference as a result of the small number of teeth tested. In some studies, it was stated that FS was also better than FC, and similar to FC in others, whereas three studies with CH showed inferior outcomes. The author concluded that longer follow-up and more clinical studies were needed to confirm these results [Fuks, 2008].

The diagnosis and subsequent management of pulp pathology in carious primary molars remain challenging and clinical guidelines written by various bodies can assist dentists. The UK National Clinical Guidelines in Paediatric Dentistry recommend FC, FS, CH or MTA for direct application to vital radicular pulp [Rodd et al., 2006]. The American Academy of Pediatric Dentistry [AAPD, 2009] states that Buckley's formocresol, ferric sulphate, electrocautery, and MTA have shown long-term success in pulpotomies. The British Society of Paediatric Dentistry has produced a range of clinical guidelines. An update reflects a shift in treatment modalities away from formocresol and discusses pulp therapy, vital pulpotomy, desensitising pulpotomy and pulpectomy [Rodd and Boissonade, 2006]. Although many techniques have been suggested, Fuks and Papagiannoulis [2006] have stated that consensus is lacking as to which is the most appropriate technique.

Only one scientific study was available for ABS usage as a pulpotomy agent, and more clinical studies to prove its efficacy are essential. The present study was, therefore, planned to evaluate the efficacy of ABS as a pulpotomy agent in primary molars. The aim of this study was to compare the clinical and radiographic success rates of two pulpotomy agents for vital pulpotomy technique: formocresol (FC) and Ankaferd Blood Stopper[R] (ABS), in primary molars during a 12-month follow-up period.

Methods

Ethical approval was obtained from the Ethics Committee of the Medical Faculty of Istanbul University, Istanbul, Turkey (2011/1138-620). The procedure and its possible discomfort and benefits were explained fully to the parents of the children involved and their written consent was obtained prior to the investigation. Thirty healthy children aged 6-9 years old (13 females and 17 males) with two carious primary molar teeth in different quadrants requiring pulpotomies were selected and were randomly (spin of a coin) assigned to receive FC and ABS pulpotomies.

Primary molar teeth requiring pulpotomies were diagnosed by one examiner who was a specialist in paediatric dentistry. A total of 60 primary molars in 30 patients were selected based on clinical and radiographic criteria. The inclusion criteria were: cooperative children; presence of deep carious lesion; no more than two-thirds of root resorption and at least two-thirds of crown remaining for restoration. The exclusion criteria were: history of systemic disease; spontaneous tooth pain or tenderness to percussion; pathological mobility; presence of any internal resorption; apical or furcal radiolucency; presence of widened periodontal ligament space; presence of sinus tract; presence of primary teeth without permanent successor; and haemostasis requiring more than 5 minutes.

A conventional pulpotomy technique was undertaken by three paediatric dentists who were experienced in the standard pulpotomy procedure. After the administration of local analgesia and rubber dam isolation dental caries was removed. The pulp chamber was opened with a sterile high speed diamond bur and the coronal pulp tissue was removed by a sharp spoon excavator and the chamber was then irrigated with sterile saline solution. The teeth were treated as follows depending on the group to which they were assigned (Table 1):

Group 1--A cotton pellet was dipped in a 1:5 dilution of Buckley's FC (Sultan Chemists Inc, Englewood, NJ), squeezed dry and placed on the pulp tissues for 5 minutes; after haemorrhage control a freshly mixed zinc oxide eugenol (ZOE) base was placed.

Group 2--After coronal pulp removal, a cotton pellet was dipped in ABS solution, squeezed dry and placed on the pulp tissues for 10-15 seconds then observed for complete haemostasis during one minute. ABS was flushed away from the pulp chamber with sterile saline and a freshly mixed ZOE base was placed.

Following the pulpotomies, the ZOE cement was allowed to set completely, and the teeth were restored with amalgam. The children were recalled for clinical and radiographic examinations after 3, 6 and 12 months. They were examined clinically and radiographically by three experienced paediatric dentists (not the operators) blinded to the technique, and in cases of disagreement, consensus was arrived at. They were calibrated for the assessment of the radiographs and clinical examination. The inter- and intra-examiner reproducibility were calculated by Cohen's unweighted kappa statistic (Cohen's [KAPPA] =0.75, [KAPPA]=1). Pulpotomy was considered a failure clinically and/or radiographically if one or more of the following signs were present: pain; swelling; mobility; percussion pain; internal root resorption; and furcation and/or periapical bone destruction. Internal root resorption was regarded as a failure in all instances. Pulp canal obliteration was not regarded as a failure.

The data were analysed to assess the clinical, radiographic, and total success rates of the pulpotomies at each follow-up period. The statistical analysis was completed using PASS 2007 software (NCSS, Kaysville, Utah) and the Chi-square test; the level of significance was set at p<0.05.

Results

Thirty children (17 males, 13 females) had a mean age at the time of initial treatment of 7.3 [+ or -] 1.2 years (range = 6-9 years). Two children who were not available at the 12 month follow-up were excluded from the study. At 12 month follow-up there were 28 teeth per group to assess. Clinical and radiographic assessments of the study groups are presented in Tables 2 and 3. The total success rates at the 3, 6 and 12 month follow-ups are shown in Table 4.

The clinical and radiographic evaluations at 3 months revealed total success rates of 100% in both FC and ABS groups. At 6 months follow-up, one tooth demonstrated external root resorption in the FC group. Pain was observed in one tooth and another tooth demonstrated internal root resorption treated with ABS. At 6 months follow-up, the total success rates in the FC and ABS groups were 96.7% and 93.3% respectively. No statistically significant differences in total success rates were determined between the groups at 6 months.

At the 12 months follow-ups, the total success rates in the FC, and ABS groups were 89.3% and 85.7%, respectively. All teeth in both groups were clinically successful at 12 months follow-ups. Three teeth in the ABS group and two teeth in the FC group showed internal root resorption. External root resorption was observed in one tooth for both FC and ABS groups. No significant differences in success rates were found between the groups at 3, 6 and 12 months follow-up.

Discussion

This study evaluated the clinical and radiographic success of two pulpotomy agents; FC and ABS in primary molars. The results of this study showed that the total success rate of ZOE and ABS pulpotomies after 12 months was 85.7%, which was similar with ZOE and FC. The ZOE and FC group in this study showed a total success rate of 89.3% that was comparable to results from other pulpotomy studies with FC [Jabbarifar et al., 2004; Fuks and Papagiannoulis, 2006; Alacam et al., 2009].

Odabas et al., [2011a] evaluated the effect of the application of ABS on the clinical and radiographic success of calcium hydroxide (CH) pulpotomies in primary molars. They found no statistical differences in overall clinical and radiographic success rates for CH and CH plus ABS pulpotomies in their 12 month follow-up study.

Formocresol has been a popular pulpotomy medicament in the primary dentition for the past 70 years since its introduction by Sweet in 1932, and it is still considered the most universally taught and preferred pulp treatment for primary teeth [Fuks, 2008]. However, during the last three decades, concerns have been raised over its use in children mainly as a result of its toxicity and potential carcinogenicity [Ansari and Ranjpour, 2010]. There has been a significant amount of discussion in the dental literature about the appropriateness and safety of using aldehyde-based products in paediatric dentistry [Fuks, 2008]. FC is no longer used in some countries, mainly as a result of safety concerns [Ni Chaollai et al., 2009]. Milnes [2006] published an extensive and detailed review of the more recent research on the metabolism, pharmaco-kinetics and carcinogenicity of formaldehyde and concluded that it is not a potent human carcinogen under conditions of low exposure. FC is still used in pulp therapy of primary teeth due to its high clinical success rates at one and two year follow-ups [Peng et al., 2007; Ng and Messer, 2008; Erdem et al., 2011].

In this study, 1:5 dilution of Buckley's FC was used and the coronal pulp chamber was filled with ZOE according to the clinical guidelines presented by AAPD [2009]. A split-mouth design was used with two primary molars in different quadrants for each patient randomly assigned to receive FC or ABS pulpotomies. The attractiveness of the design is that it removes inter-individual variability from the estimates of the treatment effect.

Studies have also been conducted on the effectiveness as well as safety of other materials and techniques, including the use of glutaraldehyde (GA), ferric sulphate and more recently mineral trioxide aggregate. This change in clinical practice has been directed at reducing the need for fixation of remaining pulp tissue and has also included electrosurgical techniques, the use of lasers for enhancing coagulation and healing of remaining pulp tissue [Ansari and Ranjpour, 2010]; [Olivi and Genovese, 2011.]

Calcium hydroxide, which is capable of promoting pulp repair and healing, has increased in popularity and represents a significantly more biocompatible alternative to FC [Odabas et al., 2011a]. The use of CH in pulpotomy treatment frequently results in the development of internal resorption. Moretti et al., [2008] compared MTA, FC and CH pulpotomies in carious primary teeth. They reported that internal root resorption was the most common radiographic finding up to 24 months after pulpotomies were performed with CH. Odabas et al., [2011a] reported the most common radiographic failure as internal root resorption in both groups treated with CH and ABS plus CH.

Internal root resorption has been identified as a failure in most studies. Previous authors have stated that pulpotomy cannot be regarded as successful if it presents internal resorption or any other pathological consequence of the treatment, even if the permanent successor erupts into its proper location and presents no enamel defect [Peng et al., 2006; Moretti et al., 2008]. Other authors argued, however, that internal root resorption should be regarded as a failure only if the process reached a root's outer surface, thereby inducing an inflammatory process in the periodontal ligament and surrounding bone.

Arrest of internal root resorption with calcifying metamorphosis of the pulp has not been regarded as a failure [Papagiannoulis, 2002; Holan et al., 2005]. In this study, internal root resorption was identified as a sign of failure in all instances as in recent studies [Peng et al., 2007; Moretti et al., 2008. Erdem et al., 2011; Odabas et al., 2011a]. In the present study, three teeth in the ABS group and two teeth in the FC group showed internal resorption at 12 months follow-up. No premature exfoliations were detected during the follow-up periods.

ZOE was chosen as a base material in this study, as it is still used in pulpotomy procedures [AAPD, 2009], as reported in several studies [Jabbarifar et al., 2004; Holan et al., 2005; Sonmez et al., 2008; Erdem et al., 2011]. The investigations of ZOE as a pulpotomy agent or base for pulpotomies suggest that ZOE can cause pulp inflammation with a risk of subsequent internal resorption [Fuks et al., 1997; Jabbarifar et al., 2004]. The placement of ZOE directly over the pulp tissue has been suggested as the cause of the internal resorption. It cannot preclude, however, the development of internal resorption with longer follow-up periods as a response to other base materials.

Several factors influence the success of direct pulp capping/ pulpotomy. One factor is control of pulp bleeding, which is necessary to improve the favourable prognosis of vital pulp therapy. If pulp bleeding cannot be controlled, a blood clot on the wound surface would prevent intimate contact between the capping material and pulp tissue, thus provoking a chronic inflamatory response whilst impairing the healing process [Odabas et al., 2011b]. The effective control of bleeding is necessary to improve favourable prognosis of vital therapy. A number of agents have been used to control pulpal haemorrhage for this purpose. The widest used technique to control pulpal bleeding is applying mechanical pressure to the wound surface with a sterile cotton pellet. Other techniques include the application of mechanical pressure with pellets soaked in saline, hydrogen peroxide, sodium hypochlorite (NaOCl), anaesthetic solutions containing epinephrine, chlorhexidine or ferric sulphate [Odabas et al., 2011b]. Ferric sulphate, a non-aldehyde chemical, has been proposed as a pulpotomy agent. It acts as a haemostatic agent by agglutination of blood protein without the presence of a blood clot. The agglutination of blood proteins results from the reaction of blood with ferric and sulphate ions. This ferric-ion-protein complex mechanically seals the cut vessel and produces haemostasis. By forming plugs that occlude cappillary orifices, the protein complex also prevents the formation of blood clots and thereby minimises chances for inflammation and internal resorption in pulp therapy [Lemon et al., 1993].

Although ferric sulphate and MTA have been proposed as the most appropriate alternatives for primary teeth pulpotomies in place of FC [Peng et al., 2006] routine use of MTA might be limited in developing countries due to economic and commercial reasons. In this study, ABS was used to control pulpal haemorrhage following the mechanical exposure of pulps. This study reports the effects of ABS, a new haemostatic agent, for primary molar pulpotomy compared with formocresol pulpotomies. It's stated that the effect of ABS takes place in a matter of split seconds in vitro and seconds in vivo environments (www.ankaferd.com). In this study, ABS was placed on the pulp tissues for 10-15 seconds and observed for complete haemostasis for one minute which was similar to the Odabas et al. study [2011a]. In our study haemostasis was achieved in all of the teeth.

For centuries, ABS has had a historical role in traditional Turkish medicine as a topical haemostatic. ABS has been approved for the management of dental surgey and external haemorrhage by the Turkish Ministry of Health. ABS' mechanism involves formation of a protein network that acts as focal points for erythrocyte aggregation without affecting any individual clotting factor [Bilgili et al., 2009].

The failure of pulpotomy in primary molars has been attributed to several factors, one of which is the leakage of the final restoration of pulpotomised primary molars. Preformed metal crowns (PMC) were highly recommended for treating pulpotomised teeth, based on the assumption that there is less leakage in crowned teeth than those restored with amalgam [Croll and Killian, 1992]. In this study, the unavailability of PMC's because of financial constraints dictated the treatment using amalgam restorations in all the pulpotomised molars.

A systematic review of the durability of amalgam, when used to restore interproximal (class II) cavities in primary molars, suggests that it can be expected to survive a minimum of 3.5 years but potentially in excess of 7 years. Given the limited lifespan of most primary molars, amalgam remains an appropriate treatment option for the management of caries in children [Kilpatrick and Neumann, 2007].In this study, during the follow-up period, any signs of restoration failure such as fracture were not detected.

According to the results of our study, ABS has demonstrated potential for being an alternative pulpotomy agent, however further investigations are required to define its efficacy and safety, long-term studies and follow-ups should be performed.

Conclusion

FC and ABS were found to be successful as pulp dressings in primary molars at 12 months follow-up. ABS appears to be an alternative pulpotomy agent but periodical follow-ups must be considered to evaluate long term success rates.

References

Alacam A, Odabac ME, Tuzuner T, Sillelioglu H, Baygin O. Clinical and radiographic outcomes of calcium hydroxide and formocresol pulpotomies performed by dental students. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2009; 108: e127-133.

American Academy of Paediatric Dentistry. Guideline on pulp therapy for primary and immature permanent teeth. Reference Manual, revised 2009; 33: 212-219.

Ansari G, Ranjpour M. Mineral trioxide aggregate and formocresol pulpotomy of primary teeth: 2-year follow-up. International Endodontic Journal 2010; 43: 413-418.

Bilgili H, Kosar A, Kurt M et al. Haemostatic efficacy of Ankaferd Blood Stopper (r) in a swine bleeding model. Med Prin Pract 2009; 18: 165-169.

Croll TP, Killian CM. Zinc oxide-eugenol pulpotomy and stainless steel crown restoration of a primary molar. Quintessence Int 1992; 23: 383-388.

Erdem AP, Guven Y, Balli B et al. Success rates of mineral trioxide aggregate, ferric sulphate, and formocresol pulpotomies: a 24-month study. Pediatr Dent 2011; 33: 546-551.

Firat HC, Ozdemir O, Kosar A, Goker H, Haznedaroglu IC: Annual review of Ankaferd 08-09. Naviga publications, Istanbul, 2009, pp.13-19.

Fuks AB, Holan G, Davis JM, Eidelman E. Ferric sulphate versus dilute formocresol in pulpotomized primary molars: Long-term follow up. Pediatr Dent 1997; 19: 327-330.

Fuks AB, Papagiannoulis L. Pulpotomy in primary teeth: Review of the literature according to standardized assessment criteria. Eur Arch Paediatr Dent 2006; 7: 64-71.

Fuks AB. Vital pulp therapy with new materials for primary teeth: New directions and treatment perspectives. J. Endod 2008; 34(7S): S18-24.

Goker H, Haznedaroglu IC, Ercetin S et al. Haemostatic actions of the folkloric medicinal plant extract Ankaferd Blood Stopper[R]. J Int Med Res 2008; 36: 163-170.

Holan G, Eidelman E, Fuks AB. Long-term evaluation of pulpotomy in primary molars using mineral trioxide aggregate or formocresol. Pediatr Dent 2005; 27: 129-136.

Jabbarifar SE, Khademi AA, Gahsemi D. Success rate of formocresol pulpotomy versus mineral trioxide aggregate in human primary molar tooth. J Res Med Sci 2004; 6: 304-307.

Kilpatrick NM, Neumann A. Durability of amalgam in the restoration of class II cavities in primary molars: a systematic review of the literature. Eur Arch Paediatr Dent 2007; 8: 5-13.

Lee SJ, Umano K, Shibamoto T, Lee KG. Identification of volatile components in basil (Ocimum basilicum L.) and thyme leaves (Thymus vulgaris L.) and their antioxidant properties. Food Chem 2007; 91: 131-137.

Lemon RR, Steele PJ, Jeansonne BG. Ferric sulphate haemostasis: Effect on osseous wound healing left in situ for maximum exposure. J Endod 1993; 19: 170-173.

Matsuda H, Ando S, Kato T, Morikawa T, Yoshikawa M. Inhibitors from the rhizomes of Alpinia officinarum on production of nitric oxide in lipopolysaccharide-activated macrophages and the structural requirements of diarylheptanoids for the activity. Bioorg Med Chem 2006; 14: 138-142.

Milnes AR. Persuasive evidence that formocresol use in pediatric dentistry is safe. J Can Den Assoc 2006; 72: 247-248.

Moretti AB, Sakai VT, Oliveira TM et al. The effectiveness of mineral trioxide aggregate, calcium hydroxide, and formocresol for pulpotomies in primary teeth. Int Endod J 2008; 41: 547-555.

Ng FK, Messer LB. Mineral trioxide aggregate as a pulpotomy medicament: A narrative review. Eur Arch Paediatr Dent 2008; 9: 4-11.

Ni Chaollai A, Monteiro J, Duggal MS. The teaching of management of the pulp in primary molars in Europe: a preliminary investigation in Ireland and the UK. Eur Arch Paediatr Dent 2009; 10: 98-103.

Odabas ME, Cinar C, Tulunoglu O, Isik B. A new haemostatic agent's effect on the success of calciumhydroxide pulpotomy in primary molars. Pediatric Dentistry 2011a; 33: 546-551.

Odabac ME, Erturk M, Cinar C, Tuzuner T, Tulunoglu O. Cytotoxicity of a new haemostatic agent on human pulp fibroblasts in vitro. Med Oral Patol Oral Cir Bucal 2011b; 16 : e584-587.

Olivi G, Genovese MD. Laser reflcetive dentistry in children and adolescents. Eur Arch Paediatr Dent 2011; 12: 68-78.

Papagiannoulis L. Clinical studies on ferric sulphate as a pulpotomy medicament in primary teeth. Eur J Paediatr Dent 2002; 3: 126-132.

Peng L, Ye L, Tan H, Zhou X. Evaluation of the formocresol vs mineral trioxide aggreagate primary molar pulpotomy: a meta-analysis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2006; 102: e40-44.

Peng L, Ye L, Guo X et al. Evaluation of formocresol versus ferric sulphate primary molar pulpotomy: a systematic review and meta-analysis. In Endod J 2007; 40: 751-757.

Rodd HD, Boissonade FM. Immunocytochemical investigation of immune cells within human primary and permanent tooth pulp. Int J Paediatr Dent 2006; 16: 2-9.

Rodd HD, Waterhouse PJ, Fuks AB, Fayle SA, Moffat MA. Pulp therapy for primary molars. UK National Clinical Guidelines in Paediatric Dentistry. Int J Paediatr Dent. 2006; 16: 15-23.

Sonmez D, Sari S, Cetinbas T. A comparison of four pulpotomy techniques in primary molars: A long-term follow-up. J Endod 2008; 34: 950-955

E. Yaman, F. Gorken, A. Pinar Erdem, E. Sepet, Z. Aytepe Department of Paediatric Dentistry, Faculty of Dentistry, Istanbul University, Capa, Istanbul, Turkey.

Postal address: Prof Dr E. Sepet, Department of Paedodontics, Faculty of Dentistry, Istanbul University, Capa, 34093 Istanbul, Turkey.

Email: elifsepet@hotmail.com
Table 1. Distrubution of the primary teeth
according to the pulpotomy material

                       FC   ABS   Total

Maxillary
Primary first molar    2     2      4
Primary second molar   15   18     33

Mandibular
Primary second molar   13   10     23
Total                  30   30     60

FC=formocresol; ABS=Ankaferd Blood Stopper

Table 2. Clinical assessment, number of teeth (n), success rates
(%), of the study groups at 3, 6 and 12 months follow, up for ABS
versus FC

                  3 months   3 months   6 months

                     FC        ABS         FC
                    n=30       n=30       n=30

Pain              30,100%    30,100%    30,100%
Sinus tract       30,100%    30,100%    30,100%
Swelling          30,100%    30,100%    30,100%
Mobility          30,100%    30,100%    30,100%
Percussion pain   30,100%    30,100%    30,100%

                  6 months   12 months   12 months

                    ABS         FC          ABS
                    n=30       n=28        n=28

Pain              29,96.7%    28,100%     28,100%
Sinus tract       30,100%     28,100%     28,100%
Swelling          30,100%     28,100%     28,100%
Mobility          30,100%     28,100%     28,100%
Percussion pain   30,100%     28,100%     28,100%

FC=formocresol; ABS=Ankaferd Blood Stopper

Table 3. Radiographic assessment, number of teeth (n), success
rates (%), of the study groups at 3, 6 and 12 months follow-up
for ABS versus FC

                           3 months   3 months   6 months

                              FC        ABS         FC
                             n=30       n=30       n=30

Periapical radiolucency    30,100%    30,100%    30,100%
Furcal radiolucency        30,100%    30,100%    30,100%
Internal root resorption   30,100%    30,100%    30,100%
External root resorption   30,100%    30,100%    29,96.7%
Pulp canal obliteration    30,100%    30,100%    30,100%

                           6 months   12 months   12 months

                             ABS         FC          ABS
                             n=30       n=28        n=28

Periapical radiolucency    30,100%     28,100%     28,100%
Furcal radiolucency        30,100%     28,100%     28,100%
Internal root resorption   29,96.7%   26,92.9%    25,89.3%
External root resorption   30,100%    27,96.4%    27,96.4%
Pulp canal obliteration    30,100%     28,100%     28,100%

FC=formocresol; ABS=Ankaferd Blood Stopper

Table 4. Total success rates at 3, 6 and
12 months follow-up for ABS and FC pulpotomies

Materials   Results          Follow-up times (months)

                      3 n (%)      6 n (%)        12 n (%)

FC          Success   30(100)     29(96.7)        25(89.3)
ABS         Success   30(100)     28(93.3)        24(85.7)
p-value                            p=0,150         p=0,639
                                [chi square]:   [chi square]:
                                    2,07            0,22

Materials   McNemar's   McNemar's
              test        test
             (3/6 M)    (3/12 M)
             P-value     P-value

FC              1           1        0.5
ABS             1           1       0.625
p-value

FC=formocresol; ABS=Ankaferd Blood Stopper
COPYRIGHT 2012 European Academy of Paediatric Dentistry
No portion of this article can be reproduced without the express written permission from the copyright holder.
Copyright 2012 Gale, Cengage Learning. All rights reserved.

Article Details
Printer friendly Cite/link Email Feedback
Author:Yaman, E.; Gorken, F.; Erdem, A. Pinar; Sepet, E.; Aytepe, Z.
Publication:European Archives of Paediatric Dentistry
Article Type:Report
Geographic Code:7TURK
Date:Aug 1, 2012
Words:4387
Previous Article:Service evaluation of patients with orofacial granulomatosis and patients with oral Crohn's disease attending a paediatric oral medicine clinic.
Next Article:Early prognostic indicators and outcome prediction model for replanted avulsed teeth.
Topics:

Terms of use | Privacy policy | Copyright © 2019 Farlex, Inc. | Feedback | For webmasters