A Clinical Study of Formocresol Pulpotomy versus Root Canal Therapy of Vital Primary Incisors

bjectives: Pulpotomy of primary incisors is a serious challenge due to the lack of a distinct boundary between the coronal and the radicular pulp and the inaccuracy of the clinical indication criteria. The aim of the present study is the clinical and radiographic evaluation of pulpotomy versus root canal therapy(RCT) of vital primary incisors. Study design: A total of 100 incisors in 50 patients (female: 27, male: 23)aged 3-4 years were allocated to formocresol pulpotomy (45 teeth) and RCT (46 teeth) using zinc oxideeugenol. The radiographic and clinical evaluation of treatment outcomes was performed at 12 and 24 months post-operatively. A history of spontaneous pain, missing restorations, recurrent caries, mobility and percussion sensitivity, parulis or fistula, erythema, and swelling were recorded. Data analysis was performed based on two sample proportional test. Results: The clinical success rate was 86.9% for pulpotomy and 95.6% for RCT (P>0.05). The radiographic assessment exhibited no pathologic signs in 76.08% of pulpotomy group and 91.3% of RCT group and the difference was statistically significant (P<0.05). The most common pathologic finding was periodontal widening followed by external/internal root resorption. Periapical radiolucency and fistula in pulpotomized teeth was significantly higher than in RCT-treated teeth(P<0.05) Conclusions: It may be concluded that the root canal therapy of vital primary incisors may be efficiently substituted for the pulpotomy of these teeth.

pulpotomy, root canal therapy, primary incisor

1. Sheihum A. Strategies for promoting oral health care. Rev bras Saude Coletiva, 2: 7–27, 2001.

2. Wanderley MTR, Ferreira SLM, Rodrigues CRMD, Rodrigues Filho LE. Primary anterior tooth restoration using posts with macro-retentiveelements. Quintessence Int, 30: 432–436, 1999.

3. Ramirez-Romito ACD, Wanderley MT, Liverira MDM. Biologic restoration of primary anterior teeth. Quintessence In,t 31: 405–411, 2000.

4. Primosch RE, Ahmadi A, Setzer B, Guelmann M. A retrospective assessment of zinc oxide-eugenol pulpectomies in vital maxillary primary incisors successfully restored with composite resin crowns. Pediatr Dent, 27(6): 470–476, 2005.

5. Goerig SC, Camp JH. Root canal treatment in primary teeth: A review. Pediatr Dent, 5: 33–37, 1983.

6. Fuks AB. Pulp therapy for the primary and young permanent dentitions. Dent Clin North Am, 44: 571–596, 2000.

7, Barr ES, Flaitz CM, Hicks MJ. A retrospective radiographic evaluation of primary molar pulpectomies. Pediatr Dent, 13: 4–9, 1991.

8. AAPD. Guidelines on pulp therapy for primary and young permanent teeth. Pediatr Dent, 26(especial issue): 115–19, 2004.

9. Flaitz CM, Barr ES, Hicks MJ. Radiographic evaluation of pulpal therapy for primary anterior teeth. J Dent Child, 56: 182–85, 1989.

10. Yakobi R, Kenny DJ, Judd PL, et al. Evolving primary pulp therapy technique. J Am Dent Assoc, 122: 83–85, 1991.

11. Payne RG, Kenny DJ, Johnston DH, Judd PL. Two-year outcome study of zinz oxide-eugenol root canal treatment for vital primary teeth. J Can Dent Assoc, 59(6): 528–30, 1993.

12. Coll JA, Josell S, Nassof S, Shelton P, Richards MA. An evaluation of pulpal therapy in primary incisors. Pediatr Dent, 10(3): 178–84, 1988.

13. Pinkham JR, Casamassimo PS, McTigue DJ, Fields HF, Nowak A. Pediatric Dentistry. 3rd ed, Saunders, Philadelphia; 492–3, 2004.

14. Casas MJ, Kenny DJ, Johnston DH, Judd PL, Layug MA. Outcomes of vital primary incisor ferric sulfate pulpotomy and root canal therapy. J Can Den Assoc, 70(1): 34–8, 2004.

15. Habibard ED, Ireland RL. Morphology of root canals of the primary teeth. J Dent Child, 24: 250, 1957.

16. Spedding RH. Endodontic treatment of primary molars. Dent Clin North Am, 17: 105, 1973.

17. McDonald RE, Avery DR. Dentistry for the child and adolescent. 8th ed. Mosby, St. Louis; 433–4, 2005.

18. Mathewson RJ, Primosch RE. Fundamentals of pediatric dentistry. Quintessence; 197–205, 1995.