Guideline: Antibiotics for Dental Pain and Swelling

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This new guideline from the American Dental Association is about the the appropriate use of systemic antibiotics for the urgent management of symptomatic irreversible pulpitis with or without symptomatic apical pulpitis, pulp necrosis and symptomatic apical periodontitis and pulp necrosis and localized acute apical abscess.

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Partial pulpotomy for permanent posterior teeth with carious vital pulp exposure

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This review of the success rate of partial pulpotomy in treating permanent posterior teeth with carious vital pulp exposure included 11 studies 5 of which are RCTs. The findings suggest that partial pulpotomy is a reliable treatment option.

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Pulpotomy in immature permanent teeth

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This review of different pulpotomy dressing agents for pulpotomy treatment in immature permanent teeth. While the review suggested that the various agents tested had similar success rates the findings should be viewed cautiously as all the studies were at high risk of bias.

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Pulpotomy for permanent teeth with irreversible pulpitis?

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This review of success rates of coronal pulpotomy in carious teeth with signs and symptoms indicative of irreversible pulpitis included 8 studies only one of which was a RCT. The data suggest this this procedure may be an alternative to root canal treatment.

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Pulpotomy for permanent teeth

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This review of the efficacy and cost-effectiveness of pulpotomy and associated medicaments in permanent teeth with pulp exposure included 17 RCTs some os which are still ongoing. The findings suggest that pulpotomy may be a potential treatment option for permanent teeth but more research is needed.

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Vital pulp treatments in mature molars

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4 different vital pulp treatments for deep caries management of mature permanent molars were tested in this stud .The findings suggest that these techniques could be used but other approaches are available.

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Pulp treatments in primary teeth

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This Cochrane review of pulp treatments for primary teeth included 87 trials. Pulp treatments were generally successful with many trials having no clinical or radiological failure in either arm.
Mineral trioxide aggregate (MTA) may be the best medicament to apply after pulpotomy. For pulpectomy there was no conclusive evidence that one medicament or technique is superior to another.

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Irrigants for pulpectomy in primary teeth- little evidence available

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This review of irrigants for pulpectomy in primary teeth only identified 7 small RCTs providing little conclusive evidence. More high quality studies are needed.

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Coronal pulpotomy in permanent molars

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This review of coronal pulpotomy in permanent teeth demonstrated good survival at 2 years 92% (95%CI; 84 -100). However as the majority of studies were observational they should be viewed cautiously until further high quality RCTs are available.

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