Primary teeth
play a vital role for the development of occlusion, maintenance of arch length,
function of mastication and speech. It also acts as a natural space maintainer
for permanent teeth. Hence pulp therapy is done to sustain the deciduous teeth
in arch and to preserve the normal development of its succedaneous teeth.
Many
obturating materials have been used for primary teeth root canals. These
include zinc oxide eugenol, calcium hydroxide, iodoform pastes, vitapex, maistopaste,
KRI paste and end of las. However, each of these materials has its own
limitations.
Zinc oxide
eugenol is widely used gold standard root canal filling material in the field
of pediatric dentistry. However, it has its own disadvantages such as burning
sensation on contact with soft tissues such as oral mucosa tongue etc. making
the patient uncooperative during treatment, slow resorption as compared to
normal physiologic root resorption of deciduous tooth. Due to its presence periapically,
it may deflect the path of eruption of permanent successor.
Ayurveda is the ancient Indian system of
health care and longevity. The essential oils in the ayurveda have been proven
to be safe and effective through several hundred years of use. One among them
is peppermint oil.
Primary teeth
play a vital role for the development of occlusion, maintenance of arch length,
function of mastication and speech. It also acts as a natural space maintainer
for permanent teeth. Hence pulp therapy is done to sustain the deciduous teeth
in arch and to preserve the normal development of its succedaneous teeth.
Many obturating materials have been used for
primary teeth root canals. These include zinc oxide eugenol, calcium hydroxide,
iodoform pastes, vitapex, maistopaste, KRI paste and end of las. However, each
of these materials has its own limitations.
Zinc oxide eugenol is widely used gold
standard root canal filling material in the field of pediatric dentistry. However,
it has its own disadvantages such as burning sensation on contact with soft
tissues such as oral mucosa tongue etc. making the patient uncooperative during
treatment, slow resorption as compared to normal physiologic root resorption of
deciduous tooth. Due to its presence periapically, it may deflect the path of
eruption of permanent successor.
Ayurveda is the ancient Indian system of
health care and longevity. The essential oils in the ayurveda have been proven
to be safe and effective through several hundred years of use. One among them
is peppermint oil.
Peppermint oil is derived from the leaves of
the peppermint plant. Menthol which is the main constituent of peppermint oil
is used in toothpaste and mouthwashes as it has characteristic odor, taste
followed by a sensation of cold.
In vitro
studies have shown that peppermint oil exhibits antimicrobial property against E.
faecalis which is found in the root canals.
There are no in vivo studies done using
zinc oxide peppermint as obturating material. Therefore, in our study we
consider evaluating zinc oxide peppermint success in primary teeth obturation
in comparison with zinc oxide eugenol.
Study design: Double -blind
randomized controlled clinical trial. (participant and operator)
Hypothesis:
There is
no difference in the clinical and radiographic success rate of zinc oxide
peppermint and zinc oxide eugenol as obturating material in primary teeth.
Ethics and informed consent:
Informed consent and assent will be taken from
the parents and patients.
Period of study:
The time period for the study will be from June 2024
to June 2025
Sample size: 42
Study population:
The study population
includes the children between the age group of 4-8 years reporting to the
Department of Pediatric and Preventive dentistry, VMSDC Salem OPD.
Inclusion criteria:
Children aged 4-8 years.
Children with no history of systemic
illness.
Teeth with caries, diagnosed as having
irreversible pulpitis.
Teeth with two-thirds of root length
intact.
Exclusion criteria:
Primary molars with preshedding
mobility.
Children having systemic medical
conditions.
Presence of external or internal
resorption.
Presence of pulpal canal
calcification.
Non restorable teeth with minimal
crown height and difficulty in placing rubber dam.
An informed consent from the parent and children visiting the
department of Paediatric and Preventive dentistry, VMSDC, Salem will be
obtained for the intervention and the study participants will be randomly
divided into 2 groups.
Randomization:
The
randomization is achieved by simple randomization technique using lottery
method.
Procedure:
Based on the inclusive and exclusive
criteria a total of 42 children in the age group of 4-8 years will be selected
for the study
Informed consents and assents will be obtained
from the patients and parents.
Study participants will be divided into 2 groups.
Blinding of the study participants will be done. The operator and the
participants are blinded. Pre-op
diagnostic radiographs with IOPA will be taken.Rubber dam will be placed to
isolate the tooth. Local anesthesia will be used to
obtain anesthesia.Cavity preparation will be done and pulp chambers will
be opened under aseptic conditions with high-speed diamond burs. Fine-barbed broaches will be used to remove
the coronal and radicular pulp. Copious saline irrigation will be performed to
remove dentinal debris and pulp tissue remnants.Working length at 1–2 mm short
of the apex on the radiograph will be set for all the canals. Pedoflex rotary
files in sequential step back technique will be used for cleaning and shaping.Sterile
paper points will be used to achieve dry canals.
In Group 1 Commercially available peppermint oil will be
mixed with zinc oxide powder and will be obturated using lentulo spiral, the
access cavity will be restored with GIC and stainless-steel crown will be
cemented as a final restoration.
In Group 2 commercially available Eugenol will be mixed with
zinc oxide powder and will be obturated using
lentulo spiral, followed by restoration with glass
ionomer cement and stainless-steel crown will be cemented as a final
restoration.Immediate postoperative IOPA radiographs will be taken. The patient
will be followed up clinically for evaluation of pain and radiographically for material
resorption for 3and 6 months respectively.
Clinical Assessment:
The evaluations will be performed at baseline of 3 and
6 months intervals through a clinical examination according to Zurn and Seale
pain rating scale.
Radiographic Assessment:
The evaluations
will be performed at baseline, 3 and 6 month intervals through a
radiological examination.
Radiographic success will
be confirmed by the absence of any pathological root resorption, furcal radiolucency, internal/external
resorption root resorption,resorption
of material in canal.
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