Dataset Information

Clinical and Radiographic Evaluation of Nigella sativa and Aloe vera as Pulpotomy Medicaments in Primary Teeth: A Randomized Controlled Trial.

ABSTRACT:

Aim

To evaluate the clinical and radiographic efficacy of Nigella sativa and Aloe vera as pulp medicaments in primary molars in comparison to formocresol.

Materials and methods

This randomized controlled trial is a three-arm, parallel-group study. This research included 66 vital, carious primary molars that required pulpotomy treatment in 4-7-year-old children. Teeth were randomly assigned to one of the three groups: groups (1-3) Nigella sativa, Aloe vera, and formocresol, respectively. All teeth were covered with stainless steel crowns (SSC) after the pulpotomy procedure was done and were assessed clinically and radiographically at 3, 6, and 12 months following Zurn and Seale criteria.

Results

After 12 months, the clinical success rate was found to be 40, 90, and 72.7% for Nigella sativa, Aloe vera, and formocresol groups, respectively. While the radiographic assessment showed a success rate of 20, 72.7, and 81.8%, respectively.

Conclusion

Aloe vera can be considered as an alternative pulpotomy medicament to formocresol. On the other hand, Nigella sativa is not recommended to be used in pulpotomy procedures. Further long-term follow-up clinical studies and histological studies are recommended.

Clinical significance

Although formocresol is the most popular used material in pulp therapy, concerns were raised regarding its toxicity and carcinogenicity by the International Agency for Research on Cancer (IARC). Consequently, herbal medicine is expanding rapidly worldwide nowadays and herbal extracts are suggested as an alternative to formocresol for their proposed antibacterial and anti-inflammatory properties.

How to cite this article

Sharaf RM, Kabil NS, Youssef FS, et al. Clinical and Radiographic Evaluation of Nigella sativa and Aloe vera as Pulpotomy Medicaments in Primary Teeth: A Randomized Controlled Trial. Int J Clin Pediatr Dent 2023;16(S-2):S195-S201.

SUBMITTER: Sharaf RM

PROVIDER: S-EPMC10701163 | biostudies-literature | 2023 Sep

REPOSITORIES: biostudies-literature

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Publications

Clinical and Radiographic Evaluation of <i>Nigella sativa</i> and <i>Aloe vera</i> as Pulpotomy Medicaments in Primary Teeth: A Randomized Controlled Trial.

Sharaf Rana M RM Kabil Noha S NS Youssef Fadia S FS Awad Basma G BG

International journal of clinical pediatric dentistry 20230901 Suppl 2

<h4>Aim</h4>To evaluate the clinical and radiographic efficacy of <i>Nigella sativa</i> and <i>Aloe vera</i> as pulp medicaments in primary molars in comparison to formocresol.<h4>Materials and methods</h4>This randomized controlled trial is a three-arm, parallel-group study. This research included 66 vital, carious primary molars that required pulpotomy treatment in 4-7-year-old children. Teeth were randomly assigned to one of the three groups: groups (1-3) <i>Nigella sativa</i>, <i>Aloe vera</ ...[more]

PMID: 38078020

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Project description:BackgroundPulpotomy is an effective, vital pulp therapy procedure for caries-affected or traumatized primary teeth. Though its efficacy is widely accepted, the superiority of medicaments and techniques remains debatable.AimThe aims of this review were to compare the success rates of various pulpotomy medicaments or techniques, assess the methodological quality of reviews, and grade the level of evidence for each comparison.DesignThis review followed the principles of evidence-based medicine and recommendations for the overview of systematic reviews. An a priori protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO; CRD42021244489). A comprehensive literature search was performed by two reviewers, and studies were selected from various databases according to predefined criteria. Two reviewers independently used a self-designed pilot-tested form to extract data from the selected studies. A quality analysis was performed using A MeaSurement Tool to Assess systematic Reviews-2 (AMSTAR-2) and the ROBIS tool. Reporting characteristics and overlap of the primary studies were also assessed. We used modified Köhler's criteria for evaluating the quality of evidence for outcomes of included systematic reviews and meta-analyses.ResultsThe scrutiny of 62 full-text articles resulted in the inclusion of eight systematic reviews. The quality of four of the reviews was found to be critically low, and the overlap of primary studies in the meta-analyses was found to be high. Pulpotomy medicaments/techniques, except calcium hydroxide, had success rates of more than 80% for all domains and time periods. Most of the comparisons revealed no differences in the clinical, radiographic, or overall success rates. Mineral trioxide aggregate, however, was found to have better radiographic and overall success rates than calcium hydroxide at periods greater than 12 and 18 months. It also had a greater radiographic success rate than full-strength/1:5 diluted and full-strength formocresol at 24 months. Formocresol was found to have better overall success rates than calcium hydroxide at all time periods and better radiographic success rates at 12 months. Only 12 of the 63 comparisons had suggestive or weak evidence, whereas all others had either negligible evidence or insufficient data.ConclusionsThe pulpotomy medicaments/techniques, except calcium hydroxide, showed success rates of more than 80%, whereas most comparisons revealed no differences. Mineral trioxide aggregate, however, was found to be better than calcium hydroxide and formocresol in several respects. This study highlights the lack of evidence regarding the choice of pulpotomy agents for the treatment of caries-affected primary teeth and elucidates the domains that require primary studies in the future.

Project description:ObjectivesWe performed this network meta-analysis to determine the comparative efficacy of formocresol (FC), ferric sulfate (FS), sodium hypochlorite (NaOCl), calcium hydroxide (CH), mineral trioxide aggregate (MTA), biodentine, and laser for pulpotomy of molar teeth.Materials and methodsAn updated search was conducted in PubMed, Embase, and the Cochrane Library to identify relevant randomized controlled trials (RCTs) published before October 30, 2022, after screening previous meta-analyses. The Cochrane risk of bias assessment tool was used to appraise the methodological quality of included studies. Clinical and radiographic success rates were assessed as outcomes. Random network meta-analysis was performed by using STATA software (version 14.0) with "network" command.ResultsA total of 43 RCTs were included. Network meta-analysis indicated that CH was inferior to other medicaments and techniques in all outcomes, and MTA and biodentine was better than FC, FS, and NaOCl in terms of clinical and radiographic success rates. Results of ranking probabilities suggested that MTA ranked first in all outcomes except for clinical success at both 6 months.ConclusionsOur results suggested that MTA was associated with significant improvement in both clinical and radiographic success than other pulpotomy medicaments and techniques, with the highest probability of being the optimal option.Clinical relevanceThe current network meta-analysis determined the comparative efficacy and safety of 7 common pulpotomy medicaments in molar pulpotomy, including FC, FS, NaOCl, CH, MTA, biodentine, and laser, and the pooled results revealed comparable efficacy in clinical and radiographic success rates at 6 and 12 months between FC, FS, and NaOCl in primary molars pulpotomies. However, MTA, biodentine and laser may have more advantages than other pulpotomy medicaments for clinical and radiographic success. Therefore, in clinical practice, practitioners should select MTA, biodentine, or laser as pulpotomy medicaments in molar pulpotomy.