Letter to the Editor on “Clinical Evaluation of Success of Primary Teeth Pulpotomy Using Mineral Trioxide Aggregate, Laser and Biodentine - An Invivo Study”
This is regarding the research article titled -“Clinical Evaluation of Success of Primary Teeth Pulpotomy Using Mineral Trioxide Aggregate, Laser and Biodentine- An In Vivo Study.” by Niranjani K, Prasad MG, Vasa AA, Gaddam D, Thakur MS, Kanithi S. 2015 April;9(4):ZC35-37, in Journal of Clinical and Diagnostic Research .
We would like to express certain concerns about this article-
1. The title of the article is not self-explanatory. It does not specify which type of study it is .
2. Whether approval from ethical committee was obtained or not is not mentioned and it is a must since the study involves live subjects .
3. The criterion as advocated by American Academy of Pediatric Dentistry  for inclusion of teeth into a pulpotomy group requires that no root resorption is seen pre-operatively, also authors of this study have made use of criteria laid down by Fuks AB and Papagiannoulis L for selection of teeth into pulpotomy group where at least 2/3rd of the root length is present with no signs of internal or other kind of root resorption. But the Intra-Oral Periapical Radiographs (IOPA’s) provided by the authors’s as pre operative IOPA’S, already show root resorption which makes them candidates fit for a pulpectomy procedure hence, the selected cases do not seem to be appropriate.
4. No reference has been quoted for the indications or the criteria of selection of the teeth for pulpotomy .
5. Also, the authors have not described the exact method and technique for placement of MTA and Biodentine [6,7].
6. The authors have made use of Zinc Oxide Eugenol cement over which Stainless Steel crowns were placed. But study by Shifflet K, White SN, state that zinc oxide eugenol shows a greater micro leakage, hence a more definitive restorative material like Glass Ionomer should have been used by the authors. Also whether the stainless steel crowns were placed immediately after the pulpotomy procedure or the placement of crown was deferred is not mentioned. This use of Glass Ionomer/Zinc Phosphate Cement/Reinforced Zinc oxide Eugenol/Metal modified Glass Ionomer cement may have a role in preventing micro leakage and significantly improving the success rates .
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