Effectiveness of 4 Pulpotomy Techniques—Randomized Controlled Trial

Abstract

Pulpotomy is the accepted therapy for the management of cariously exposed pulps in symptom-free primary molars; however, evidence is lacking about the most appropriate technique. The aim of this study was to compare the relative effectiveness of the Er:YAG laser, calcium hydroxide, and ferric sulfate techniques with that of dilute formocresol in retaining such molars symptom-free. Two hundred primary molars in 107 healthy children were included and randomly allocated to one of the techniques. The treated teeth were blindly re-evaluated after 6, 12, 18, and 24 months. Descriptive data analysis and logistic regression analysis, accounting for each patient's effect by a generalized estimating equation (GEE), were used. After 24 months, the following total and clinical success rates were determined (%): formocresol 85 (96), laser 78 (93), calcium hydroxide 53 (87), and ferric sulfate 86 (100). Only calcium hydroxide performed significantly worse than formocresol (p = 0.001, odds ratio = 5.6, 95% confidence interval 2.0-15.5). In conclusion, calcium hydroxide is less appropriate for pulpotomies than is formocresol.

Clinical Assessment of Pulp Therapy for Primary Molars Performed Under General Anesthesia, Using Two Pulpotomy Agents-A Retrospective Cohort Study

“…Similar to our study, in their researches assessing the clinical success rate of amputations with FS; Fei et al [20] observed a 100% success rate at the end of 12 months, Markovic et al [21] observed 89% at the end of 18 months, and Huth et al [22] observed 100% at the end of 24 months.…”

Pulpotomy of human primary molars with MTA and Portland cement: a randomised controlled trial

“…[1][2][3][4][5][6][7] Basically, this technique consists of removing the coronal pulp and maintaining the vitality of the radicular pulp. The purpose is to remove the bacterial infection leaving the treated tooth asymptomatic until its exfoliation.…”

“…The purpose is to remove the bacterial infection leaving the treated tooth asymptomatic until its exfoliation. [3][4][5][6][7] Medicaments applied to radicular pulp tissue after pulpotomy have included formocresol, 1,3,4 ferric sulphate, 3,4 calcium hydroxide 4 and mineral trioxide aggregate (MTA). 1,[8][9][10][11][12][13][14] Objective This study compared the clinical and radiographic effectiveness of mineral trioxide aggregate (MTA) and Portland cement (PC) as pulp dressing agents in carious primary teeth.…”

Importance of the diagnosis in the pulpotomy of immature permanent teeth

“…If the stimulus or damage is severe, the pulp healing capacity may be exceeded and it may progress to an irreversibly inflamed condition and to necrosis. However, if pulp exposure is discrete in primary or young permanent teeth, some procedures may be performed in an attempt to reestablish pulpal health and maintain its vitality (1)(2)(3).…”

“…Pulpotomy comprises coronal pulp amputation and placement of a protective agent over the remaining viable root pulp in order to preserve its vitality and function (2,3). It is indicated for primary or young permanent teeth with inflamed and/or infected coronal pulp.…”