Webinar: Dental Treatment: Pediatric Vital Pulp Therapy - Dr. Cohn

The webinar “Dental Treatment: Pediatric Vital Pulp Therapy” provides an in-depth exploration of clinical indications, diagnostic criteria, and treatment techniques for preserving pulp vitality in primary teeth.

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Dental Article 🔽 Medications Used in Pulpotomies: Properties, Drawbacks, and Brand Names ... Selecting the right medication is crucial for clinical success. Below is an overview of the most commonly used pulpotomy agents, their properties, drawbacks, and commercial names.

Participants will learn how to evaluate cases, determine the most appropriate vital pulp therapy, and apply evidence-based protocols with confidence.

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Special emphasis is placed on calcium silicate–based materials, highlighting their biological benefits, superior sealing ability, and role in long-term success compared to traditional approaches.

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PDF 🔽 Pulp Therapy Procedures Manual for Primary and Immature Permanent Teeth ... Pulp treatments in immature primary and permanent teeth aim to preserve the teeth until natural exfoliation. The pulp treatment to be performed will depend on a correct clinical and radiographic evaluation.

The session bridges clinical decision-making with practical application, offering pediatric dentists a comprehensive guide to modern, minimally invasive pulp therapies designed to maintain function and prevent premature tooth loss.

📌 Watch webinar: "Webinar: Mastering Primary Teeth Pulpotomies: Techniques and Best Practices for Dental Professionals"

Youtube/ Pediatric Dental Seminars

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Tratamientos Endodónticos en Odontopediatría: Conceptos Modernos, Diagnóstico y Protocolos Clínicos

La endodoncia pediátrica es fundamental para preservar dientes primarios y permanentes jóvenes, mantener la integridad del arco dental y garantizar la salud bucal a largo plazo.

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Artículo Odontológico/Vídeo 🔽 Hidróxido de calcio: cómo ayuda a salvar dientes en niños ... El hidróxido de calcio ha sido considerado el estándar de oro en terapias pulpares durante décadas, aunque en la actualidad se compara con biomateriales más recientes como el MTA (mineral trióxido agregado) y el biodentine.

Este artículo revisa los conceptos modernos del tratamiento endodóntico en niños, abarcando diagnóstico, manejo de urgencias, morfología radicular, instrumental, diseño de cavidades de acceso, preparación y obturación de los conductos.

Enlaces Patrocinados

✅ Introducción
El tratamiento endodóntico en odontopediatría ha superado el enfoque limitado de “pulpectomía o pulpotomía”. Hoy se prioriza la preservación biológica, la funcionalidad y los resultados a largo plazo (Govindaraju et al., 2017). Gracias a los avances en diagnóstico, imágenes y biomateriales, la terapia endodóntica en niños es cada vez más predecible y basada en la evidencia.

✅ Diagnóstico y Planificación de Tratamiento
El diagnóstico correcto es clave. Debe incluir:

° Historia del dolor (espontáneo, provocado, nocturno).
° Pruebas de vitalidad pulpar (menos fiables en dientes primarios).
° Evaluación radiográfica con periapicales o mordidas, apoyadas en CBCT en casos complejos.

La planificación debe considerar la edad del niño, su nivel de cooperación, el grado de resorción radicular y la restaurabilidad del diente (Parisay et al., 2015).

✅ Tratamiento de Urgencias Endodónticas en Niños
Las urgencias más comunes incluyen:

° Pulpitis aguda: pulpotomía o pulpectomía.
° Absceso apical agudo: drenaje, y antibióticos si existe compromiso sistémico.
° Traumatismos dentales: procedimientos de apexogénesis o apexificación en dientes permanentes inmaduros.

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✅ Morfología del Sistema de Conductos en Dientes Primarios
Los dientes primarios presentan paredes delgadas, conductos en forma de cinta y numerosos conductos accesorios (Moskovitz & Holan, 2019). Estas particularidades requieren preparaciones conservadoras para evitar perforaciones y preservar estructura.

✅ Instrumental y Materiales Básicos

° Limas manuales (K y H): preferidas por el control táctil.
° Sistemas rotatorios de NiTi: reducen tiempo clínico y mejoran la conformación (Rao et al., 2014).
° Irrigantes: hipoclorito de sodio (1–2.5%), clorhexidina, suero fisiológico.
° Materiales: hidróxido de calcio, pastas a base de yodoformo y selladores biocerámicos.

📊 Tabla comparativa: Diseño de cavidades de acceso en dientes primarios

Diente	Diseño de acceso	Consideraciones
Anteriores primarios	Acceso desde el cíngulo lingual	Preservar esmalte labial por estética
Molares primarios	Acceso desde la fosa central	Extender para exponer todos los conductos y evitar perforaciones
Caninos	Acceso lingual	Mantener la integridad cuspídea
Segundos molares	Acceso triangular o trapezoidal	Ajustar según el número de conductos

✅ Preparación del Conducto Radicular
Se recomienda una preparación mínimamente invasiva para preservar las paredes dentinarias. Se pueden usar técnicas step-back o crown-down. Los sistemas rotatorios pediátricos (como Kedo-S) permiten una conformación eficiente y conservadora (Subramaniam et al., 2019).

✅ Obturación del Conducto
El material debe ser biocompatible, reabsorbible y hacerlo a la par de la raíz primaria. Entre los más usados:

° Óxido de zinc eugenol (OZE): antibacteriano, pero se reabsorbe más lento que la raíz.
° Pastas de hidróxido de calcio: antimicrobianas, con reabsorción más rápida.
° Pastas de yodoformo (Vitapex, Metapex): excelente biocompatibilidad y reabsorción, muy usadas en odontopediatría.

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Artículo Odontológico 🔽 Medicamentos Utilizados en Pulpectomías: Nombres Comerciales, Propiedades y Desventajas ... A continuación, se describen los principales medicamentos utilizados en pulpectomías, sus propiedades, desventajas y nombres comerciales.

💬 Discusión
La endodoncia pediátrica moderna combina principios biológicos de preservación pulpar con materiales e instrumentación avanzados. Aunque los sistemas rotatorios y los selladores biocerámicos muestran resultados prometedores, aún se requieren estudios longitudinales en población infantil. Cada caso debe individualizarse según anatomía, edad y cooperación del paciente.

✍️ Conclusión
El tratamiento endodóntico en odontopediatría es clave para mantener la integridad del arco dental, prevenir pérdidas prematuras y favorecer el desarrollo normal. El dominio en diagnóstico, acceso, instrumentación y materiales asegura el éxito clínico. Los avances en sistemas rotatorios y biocerámicos marcan el futuro de la especialidad.

📚 Referencias

✔ Govindaraju, L., Jeevanandan, G., & Subramanian, E. M. G. (2017). Clinical evaluation of instrumentation of primary molars using manual and rotary techniques: A randomized controlled trial. Journal of Clinical and Diagnostic Research, 11(9), ZC55–ZC58. https://doi.org/10.7860/JCDR/2017/29268.10622
✔ Moskovitz, M., & Holan, G. (2019). The treatment of severely decayed primary teeth using resin-modified glass ionomer cement: A long-term follow-up study. Pediatric Dentistry, 41(1), 30–35.
✔ Parisay, I., Ghoddusi, J., & Forghani, M. (2015). A review on vital pulp therapy in primary teeth. Iranian Endodontic Journal, 10(1), 6–15. https://doi.org/10.7508/iej.2015.01.002
✔ Rao, A., Malhotra, N., & Acharya, S. (2014). Rotary endodontics in pediatric dentistry: A review. International Journal of Clinical Pediatric Dentistry, 7(1), 35–39. https://doi.org/10.5005/jp-journals-10005-1229
✔ Subramaniam, P., Konde, S., Mandanna, D. K., & Naik, S. (2019). Comparative evaluation of cleaning efficacy and instrumentation time between manual and rotary techniques in primary teeth: An in vitro study. International Journal of Clinical Pediatric Dentistry, 12(2), 123–127. https://doi.org/10.5005/jp-journals-10005-1603

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Webinar: Mastering Primary Teeth Pulpotomies: Techniques and Best Practices for Dental Professionals

The webinar “Mastering Primary Teeth Pulpotomies: Techniques and Best Practices for Dental Professionals” explores modern strategies in pulp therapy for vital primary teeth.

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PDF 🔽 Pulp Therapy Procedures Manual for Primary and Immature Permanent Teeth ... The treatment will depend on the vitality of the pulp, in case it is a vital tooth, pulp capping and pulpotomy can be performed. In non-vital teeth, pulpectomies are performed.

It covers indirect and direct pulp treatment approaches, along with coronal pulpotomy, offering clinicians evidence-based options for managing deep carious lesions while preserving tooth vitality.

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Special focus is given to the role of bioceramic materials, their biological advantages, and how they enhance long-term outcomes compared to traditional medicaments.

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Participants will gain practical insights into clinical protocols, case selection, and decision-making criteria essential for successful pulp therapy.

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Designed for pediatric dentists and dental professionals, this session bridges theory and clinical application, empowering practitioners to deliver minimally invasive, biologically driven care that aligns with current standards in pediatric dentistry.

📌 Watch webinar: "Webinar: Mastering Primary Teeth Pulpotomies: Techniques and Best Practices for Dental Professionals"

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Calcium Hydroxide: How It Helps Save Children’s Teeth

Calcium hydroxide is one of the most studied and widely used biomaterials in pediatric dentistry for preserving both primary and immature permanent teeth.

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Video 🔽 Pulp Cap and Pulpotomy in Pediatric Trauma Cases ... When the dental pulp is compromised by a lesion, a pulpectomy, pulpotomy or pulp capping can be performed. The objective of these treatments is to keep the primary tooth in the mouth.

Its antibacterial properties and ability to induce hard tissue formation make it essential in maintaining pulp vitality and achieving successful outcomes in procedures such as pulpotomy and pulp capping.

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✅ Introduction
In pediatric dentistry, preserving primary teeth and immature permanent teeth is crucial for chewing, aesthetics, and normal occlusal development. Calcium hydroxide has been considered the gold standard for pulp therapy for decades, although in recent years it has been compared with modern biomaterials such as mineral trioxide aggregate (MTA) and biodentine.

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✅ Biological Properties of Calcium Hydroxide

° High pH (12.5): strong antibacterial effect.
° Induces reparative dentinogenesis.
° Neutralizes bacterial toxins.
° Good biocompatibility.

✅ Clinical Applications in Pediatric Dentistry

° Direct pulp capping: recommended for small pulp exposures.
° Indirect pulp capping: for deep carious lesions at risk of pulp exposure.
° Pulpotomy: preferred treatment in primary molars with reversible pulpitis.
° Apexification: promotes apical barrier formation in immature necrotic teeth.

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PDF 🔽 Pulp Therapy Procedures Manual for Primary and Immature Permanent Teeth ... We share a complete manual that offers us recommendations for the diagnosis and pulp treatment procedure in vital and non-vital primary and young permanent teeth.

✅ Scientific Evidence
Studies report success rates above 80% in indirect pulp capping and apexification. However, its limited mechanical strength and solubility have led researchers to explore alternative biomaterials with improved longevity.

📊 Comparative Table: Benefits of Calcium Hydroxide in Pediatric Dentistry

Aspect	Advantages	Limitations
Antibacterial Effect	Eliminates bacteria due to its high pH	Efficacy decreases over time
Dentinogenesis	Promotes dentin bridge formation	Bridges may be irregular with microleakage
Biocompatibility	Well tolerated by pulp and tissues	Low mechanical resistance
Accessibility	Affordable and widely available	Less durable than modern biomaterials

💬 Discussion
Calcium hydroxide remains a valid option in pediatric dentistry, particularly in clinical settings where modern biomaterials are not accessible due to their high cost. Although MTA and biodentine show superior physical and biological performance, calcium hydroxide continues to be highly valued for its antimicrobial properties and affordability. Its main limitation is solubility, which may compromise long-term treatment success.

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Dental Article 🔽 Calcium Hydroxide in Pediatric Dentistry: Updated Uses, Benefits, and Clinical Evidence ... Calcium hydroxide (Ca(OH)₂) has been widely used for decades, especially in pulp therapy procedures, thanks to its outstanding biocompatibility and ability to stimulate dentin bridge formation.

✍️ Conclusion
Calcium hydroxide has been, and continues to be, a cornerstone in pediatric pulp therapy due to its ability to maintain pulp vitality and stimulate dentin formation. While modern biomaterials provide better long-term results, calcium hydroxide remains fundamental in clinical practice and dental education.

📝 References

✔ American Academy of Pediatric Dentistry. (2023). Pulp therapy for primary and immature permanent teeth. Reference Manual, 45(6), 384-392.
✔ Schwendicke, F., Brouwer, F., Schwendicke, A., & Paris, S. (2016). Different materials for direct pulp capping: systematic review and meta-analysis and trial sequential analysis. Journal of Dentistry, 48, 1–15. https://doi.org/10.1016/j.jdent.2016.03.002
✔ Fuks, A. B., Peretz, B., & Eidelman, E. (2021). Pulpotomy in primary teeth—New insights and future directions. Pediatric Dentistry, 43(6), 393–400.
✔ Parirokh, M., & Torabinejad, M. (2010). Mineral trioxide aggregate: A comprehensive literature review—Part I: Chemical, physical, and antibacterial properties. Journal of Endodontics, 36(1), 16–27. https://doi.org/10.1016/j.joen.2009.09.006

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Perioral Dermatitis in Children — A Parent’s Guide

Perioral dermatitis is an inflammatory rash that affects the skin around the mouth (sometimes the nose and eyes). In children, it is often linked to topical steroid creams, fluoridated toothpaste, or occlusive skin products.

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Management includes removing triggers, using gentle skincare, and prescribing topical (e.g., metronidazole, azelaic acid) or oral antibiotics in more severe cases.

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✅ Introduction
Perioral dermatitis (also known as periorificial dermatitis) presents as clusters of red papules, sometimes with pustules, sparing a narrow zone next to the lips. Although more common in adults, it is also seen in children and requires treatments tailored for pediatric safety.

✅ Causes and triggers

° Topical corticosteroid creams (e.g., hydrocortisone) — the most common trigger.
° Occlusive moisturizers, cosmetics, fluoridated toothpaste, nasal steroid sprays, and inhalers.

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✅ Diagnosis (for parents)

° Clinical appearance: red papules around the mouth with “grenz zone” of normal skin next to lips.
° Pediatricians/dermatologists may rule out eczema, acne, or rosacea if symptoms persist.

✅ First-line management (parent steps)

1. Stop topical steroids on the face (gradual withdrawal under medical supervision).
2. Discontinue heavy creams, cosmetics, or fluoride toothpaste if suspected. Use gentle cleansers.
3. Avoid scratching, squeezing, or harsh products — “zero therapy” (minimal skincare) often helps.

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✅ Topical treatments (examples & dosing)

Important: Only a pediatrician/dermatologist should prescribe these.
° Metronidazole topical (brands: MetroGel, Noritate): 0.75–1%, apply twice daily (BID) for several weeks. First-line topical.
° Azelaic acid 20% cream (brand: Azelex; Finacea 15% gel for adults): shown effective in children, applied once or twice daily for 4–8 weeks.
° Clindamycin topical (Cleocin T 1%): alternative topical option.
° Tacrolimus/pimecrolimus creams: steroid-sparing agents used off-label in resistant cases.

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✅ Oral treatments (when needed)
Reserved for moderate–severe or resistant cases.

° Erythromycin oral (Erythrocin, E-Mycin): 30–50 mg/kg/day, divided every 6–8 h. Common pediatric alternative since tetracyclines are contraindicated in young children.
° Azithromycin oral (Zithromax): pediatric regimen 10–12 mg/kg on day 1, followed by 5–10 mg/kg for 3–5 days.
° Tetracyclines (doxycycline, minocycline): effective in adults, but contraindicated in children younger than 8 to 12 years due to risks for teeth and bone.

* Disclaimer: Scientific evidence indicates that the use of certain antibiotics, such as tetracyclines, should be avoided in young children due to the risk of dental alterations. Some sources set the limit at under 8 years of age, while others extend the recommendation up to 12 years. Given this variability, parents are advised to always consult a specialist before starting treatment.

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✅ Duration and follow-up

° Average improvement: 4–8 weeks.
° If no response after 8 weeks, re-evaluation is needed.

💬 Discussion
° The key intervention is removing triggers, especially topical steroids. Withdrawal may temporarily worsen symptoms (rebound), but healing occurs in weeks.
° In children, systemic antibiotics (erythromycin, azithromycin) should be prescribed cautiously due to side effects and resistance risk.
° Azelaic acid 20% has shown safety and effectiveness in pediatric cases, making it a strong alternative when avoiding antibiotics.

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✍️ Conclusions (for parents)

1. If your child develops red papules around the mouth, seek medical advice.
2. Avoid steroid creams on the face — they worsen perioral dermatitis.
3. Safe options include metronidazole topical (0.75–1% BID) and azelaic acid 20% cream; oral erythromycin 30–50 mg/kg/day is reserved for more severe cases.
4. Gentle skincare and patience usually lead to improvement within weeks.

📝 References

✔ StatPearls Authors. (2024). Perioral Dermatitis. StatPearls. NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK525968/
✔ Jansen, T. (2004). Azelaic acid as a new treatment for perioral dermatitis: results from an open study. British Journal of Dermatology, 151(4), 933–934. https://pubmed.ncbi.nlm.nih.gov/15491447/
✔ Medscape. (2024). Perioral Dermatitis — Treatment & Management. EMedicine. https://emedicine.medscape.com/article/1071128-treatment
✔ Merck Manual Professional Version. (2024). Perioral Dermatitis. https://www.merckmanuals.com/professional/dermatologic-disorders/acne-and-related-disorders/perioral-dermatitis
✔ Drugs.com. (2025). Metronidazole Topical Dosage & Information. https://www.drugs.com/mtm/metronidazole-topical.html
✔ DermNet NZ. (2024). Periorificial dermatitis in children. https://dermnetnz.org/topics/periorificial-dermatitis-in-children/

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Webinar: Vital Pulp Therapy: A Conservative Alternative in the Treatment of Deep Carious Lesions

The webinar “Vital Pulp Therapy: A Conservative Alternative in the Treatment of Deep Carious Lesions” highlights the importance of preserving pulp vitality in young permanent teeth.

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Dental Article 🔽 Medications for Pulp Capping in Primary Teeth: Indications, Composition, and Clinical Management ... Pulp capping in primary teeth is a conservative procedure aimed at preserving pulp vitality following an accidental or intentional pulp exposure during caries removal.

It reviews current evidence on pulpotomy indications, direct and indirect pulp capping, and other biologically driven strategies that aim to maintain pulp function when lesions are in close proximity to the pulp chamber.

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Emphasis is placed on case selection, material choice, and clinical protocols that reduce the need for more invasive procedures, while ensuring long-term success and continued root development.

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Video 🔽 Pulpotomy and pulpectomy procedures. Indications and Differences ... Pulpectomy is recommended when it is necessary to completely remove the affected dental pulp, and pulpotomy partially removes the dental pulp.

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📌 Watch webinar: "Vital Pulp Therapy: A Conservative Alternative in the Treatment of Deep Carious Lesions"

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Vitaminas y minerales esenciales para fortalecer dientes y encías

La odontología moderna reconoce que la salud bucal no depende exclusivamente de la higiene oral, sino también de factores nutricionales.

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Nutrientes como el calcio, fósforo, vitamina D, vitamina C y flúor intervienen en la mineralización del esmalte, la síntesis de colágeno y la resistencia frente a agentes patógenos. Esta revisión busca integrar evidencia científica actualizada para odontólogos, estudiantes y profesionales de la salud.

Enlaces Patrocinados

✅ Vitaminas

➤ Vitamina C y colágeno
La vitamina C es un cofactor clave para la síntesis de colágeno, proteína fundamental en encías y ligamento periodontal. Una adecuada ingesta favorece la cicatrización, fortalece los tejidos de soporte y disminuye el riesgo de sangrado e inflamación gingival. Su deficiencia se relaciona con escorbuto, sangrado gingival y pérdida de inserción periodontal.

➤ Vitamina D
La vitamina D regula la absorción y el metabolismo del calcio y fósforo. Su deficiencia está asociada con hipomineralización, caries dental y periodontitis. La combinación calcio–vitamina D es determinante en la prevención de enfermedades dentales.

➤ Vitamina A
Mantiene la integridad de mucosas orales y glándulas salivales. La deficiencia genera sequedad bucal y queratinización anormal.

➤ Complejo B (B2, B3, B6, B12, ácido fólico)
Implicado en la salud de la mucosa oral. Deficiencias producen glositis, queilitis angular y retraso en la cicatrización. El ácido fólico mejora la regeneración gingival.

✅ Minerales:

➤ Calcio
El calcio es el principal mineral estructural de dientes y huesos. Durante la formación dental (infancia y adolescencia) es indispensable para lograr un esmalte duro y resistente. En adultos, contribuye a la remineralización del esmalte en fases tempranas de caries, siempre que exista suficiente aporte de flúor y fósforo. Sin embargo, no puede regenerar esmalte perdido en lesiones avanzadas.

➤ Fósforo
En conjunto con el calcio, participa en la mineralización del esmalte y la dentina. Mantiene el equilibrio ácido–base en la saliva, lo que favorece procesos de remineralización.

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➤ Flúor
El flúor refuerza la estructura cristalina del esmalte, haciéndolo más resistente a los ácidos. Puede revertir lesiones incipientes de caries mediante remineralización, pero no regenera esmalte perdido.

➤ Zinc
Participa en la cicatrización, inmunidad oral y control bacteriano. También presente en pastas dentales como agente antiplaca.

➤ Magnesio
Interviene en la formación del esmalte y regulación del metabolismo del calcio. Deficiencias pueden favorecer caries y periodontitis.

📊 Tabla comparativa: Vitaminas y minerales en la salud bucal

Nutriente	Ventajas	Limitaciones
Vitamina C	Favorece síntesis de colágeno, cicatrización y salud periodontal	Deficiencia provoca sangrado gingival y retraso en cicatrización
Vitamina D	Facilita absorción de calcio y fósforo, protege hueso y esmalte	Carencia aumenta riesgo de caries y periodontitis
Vitamina A	Mantiene mucosa oral y producción de saliva	Deficiencia causa sequedad bucal y alteraciones epiteliales
Complejo B	Previene glositis, queilitis y apoya regeneración gingival	Deficiencia genera lesiones mucosas y retraso en cicatrización
Calcio	Fortalece esmalte y hueso alveolar	Su exceso sin vitamina D puede no absorberse adecuadamente
Fósforo	Contribuye a la mineralización dental y ósea	Exceso puede alterar el equilibrio calcio-fósforo
Flúor	Remineraliza esmalte y lo hace más resistente a la caries	Exceso puede causar fluorosis
Magnesio	Favorece formación de esmalte y metabolismo del calcio	Deficiencia aumenta riesgo de caries y periodontitis
Zinc	Apoya inmunidad oral y cicatrización	Exceso puede alterar el sabor y provocar náuseas

💬 Discusión
La literatura científica confirma que una adecuada nutrición es fundamental para mantener la homeostasis oral. Las deficiencias de vitamina C, D y del complejo B están claramente asociadas con enfermedades periodontales y lesiones en mucosa oral. El equilibrio entre calcio, fósforo y magnesio es crucial para la mineralización del esmalte y la densidad ósea. El zinc y el flúor aportan beneficios adicionales en cicatrización y prevención de caries, aunque su exceso puede ser perjudicial.

✍️ Conclusión
Los nutrientes esenciales fortalecen dientes y encías, pero sus beneficios dependen de un aporte equilibrado, acompañado de buenos hábitos de higiene y control odontológico regular. El exceso o déficit de estos micronutrientes puede afectar negativamente la salud oral, lo que resalta la necesidad de educación alimentaria en odontología preventiva.

📝 Recomendaciones

1. Mantener una dieta balanceada rica en calcio, fósforo, vitamina C y vitamina D.
2. Usar productos fluorados supervisados por el odontólogo.
3. Promover la exposición solar moderada para favorecer la síntesis de vitamina D.
4. Realizar controles odontológicos periódicos para identificar lesiones incipientes que puedan remineralizarse.

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📚 Referencias

✔ Hujoel, P. P., Lingström, P., & Bian, Z. (2019). Nutrition, dental caries and periodontal disease: A narrative review. Journal of Clinical Periodontology, 46(Suppl 21), 18–26. https://doi.org/10.1111/jcpe.13045

✔ Moynihan, P., & Petersen, P. E. (2004). Diet, nutrition and the prevention of dental diseases. Public Health Nutrition, 7(1A), 201–226. https://doi.org/10.1079/phn2003589

✔ Touger-Decker, R., & Mobley, C. (2013). Position of the Academy of Nutrition and Dietetics: Oral health and nutrition. Journal of the Academy of Nutrition and Dietetics, 113(5), 693–701. https://doi.org/10.1016/j.jand.2013.03.001

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