Pulpectomy in children is performed during endodontic therapy in cases where the root canals are infected. This is a very common condition in pediatric clinical cases with the presence of caries on deciduous teeth.
Pulpectomy in children: can it be avoided?
Pulpectomy involves the removal of the infected pulp through specific mechanical tools and then continues with the filling of the tooth with composite materials.
It is often a traumatic treatment for the child because it requires long dental sessions.
Under the scrutiny of dentists there is a new therapeutic approach, less traumatic for young patients, which can still guarantee the disinfection of carious lesions and tissue repair.
It is a biological treatment that can be used in any case of carious lesion, regardless of the involvement of the tooth pulp, based on three different antibiotics:
- metronidazole;
- ciprofloxacin;
- minocycline.
The name of this new blend for dental treatment that would avoid pulpectomy in children is 3Mix.
How 3Mix works
The mixture of the three 3Mix antibiotics acts directly on the necrotic pulp and on the infected root dentin and sterilizes every part of it.
In some clinical cases, a better result has been experienced using cefaclor instead of minocycline and ornidazole instead of metronidazole.
The action of 3Mix could therefore avoid pulpectomy in children, but the clinical success of this type of therapy is still under study.
Researchers have published in the J Indian Soc Pedod Prev Dent a study relating to the evaluation of clinical success and the results on radiographs of three different techniques for the treatment of carious lesions in children.
Caries care in children: are alternatives to pulpectomy valid?
The sample on which the study was based was made up of 50 children aged between 4 and 8 years.
The analyzed teeth were 63 first and second deciduous molars with carious lesions that reached the dental pulp.
Clinical and radiographic data were recorded before the treatment and after the treatment carried out for all by the same dentist.
The children, divided into 3 groups, received the following treatments:
- Group I: removal of the coronal pulp only and placement of a dressing with modified 3Mix antibiotic paste in the pulp chamber, seal with glass ionomer cement (20 teeth);
- Group II: removal of both coronal and root pulp and placement of a dressing with modified 3Mix antibiotic paste in the pulp chamber, seal with GIC (21 teeth);
- Group III: Coronal pulp removal and placement of a chloramphenicol, tetracycline and eugenic zinc oxide (CTZ) dressing in the pulp chamber, sealed with GIC (22 teeth).
The results of the research
All children were examined clinically with a follow-up at 1, 6 and 12 months, and radiographically at 6 and 12 months.
No significant statistical difference was found between the different therapies, the same result also for the diagnostic analysis with radiographs one, six and twelve months later.
All three different dental treatments have been shown to be effective and can be considered a valid alternative to pulpectomy in children.
In particular, the therapy with the 3Mix antibiotic mixture has shown greater efficacy in each clinical case considered for the research.
