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Clinico pathological studies on the influence of camphorated p mono chloro phenol penicillin compounds to the exposed human vital pulp tissues


, : Clinico pathological studies on the influence of camphorated p mono chloro phenol penicillin compounds to the exposed human vital pulp tissues. Shikwa Gakuho 81(4): 753-795

In Japan, Europe and USA, various kinds of endodontic medicaments were developed and used clinically. p-Monochlorophenol has been widely used for a disinfective agent on pulp or periapical tissue. This agent has been clinically employed as compounds with camphor or guaiacol. The influence of camphorated p-monochlorophenol with penicillin to exposed pulp wounds in human teeth was clinico-pathologically evaluated. Adult human teeth (100) with no evidence of carious or previous operative procedures were obtained from patients ranging 9-63 yr. Preoperative clinical and radiological examinations were performed, including electric pulp testing, degree of mobility, sensitivity to percussion and periodontal involvement. Only those teeth which fell within normal limits in the preoperative examinations were included. The teeth were isolated with rubber dams or cotton rolls. Black's simple class 1 cavity was prepared and the pulp was intentionally exposed in each tooth with a diamond point by a high-speed air-turbine under local anesthesia with 2% xylocaine. The cavity and exposed pulp surface were cleaned with distilled water and dried with absorbent materials. The experimental paste made by mixing camphorated p-monochlorophenol with 50,000 U benzyl-penicillin potassium, was applied to the pulp wound surface. The cavity was lined with gutta-percha temporary stopping and the rest of the cavity was filled with Ag amalgam. The teeth were clinically observed at various intervals from immediately to 576 days after operation and were then extracted under local anesthesia and prepared for histopathological study. Of 100 experimental cases, 30 (30%) showed no clinical symptoms. Clinical discomfort recognized were: spontaneous pain (13), disagreeable sensation (29), thermal hypersensitivity to cold water (10), thermal hypersensitivity to hot water (17) and percussion discomfort (44). Clinical results were evaluated in 55 cases (55%) as good, 31 cases (31%) as satisfactory and 14 cases (14%) as failure. Histopathological changes observed were: hyperemia (52), hemorrhage (11), round cell infiltration (66), suppurative inflammation (15), coagulation necrosis (48), atrophy (25), cicatrization of pulp (60), formation of denticle (13), apposition of dentin on chamber wall (13) and resorption of dentin in chamber wall (6). Histopathological results were evaluated in 43 cases (43%) as good, 28 cases (28%) as fail and 29 cases (29%) as bad. When the experimental paste was used directly on pulp wound surface, there were many cases of clinical discomfort. This paste showed only a disinfection effect without sedation and analgesia of camphorated p-monochlorophenol. This agent caused a fair degree of histopathological damage to the pulp tissue.

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