Journal of Pharmacy And Bioallied Sciences
Journal of Pharmacy And Bioallied Sciences Login  | Users Online: 1614  Print this pageEmail this pageSmall font sizeDefault font sizeIncrease font size 
    Home | About us | Editorial board | Search | Ahead of print | Current Issue | Past Issues | Instructions | Online submission




 
 Table of Contents  
ORIGINAL ARTICLE
Year : 2021  |  Volume : 13  |  Issue : 6  |  Page : 1251-1258  

To evaluate and compare the clinical and radiographic outcomes of formocresol, mineral trioxide aggregate, electrocautery, and bioactive glass when used for pulpotomy in human primary teeth


1 lecturer, Department of Pedodontics and Preventive Dentistry, Patna Dental College and Hospital, Patna, India
2 Professor, Department of Pedodontics and Preventive Dentistry, Career Post Graduate Institute of Dental Science, Lucknow, Uttar Pradesh, India
3 Department of Pedodontics and Preventive Dentistry, Sadar Hospital, Jehanabad, India
4 lecturer, Department of Periodontics and oral Implantology, Patna Dental College and Hospital, Patna, India
5 Private Dental Practitioner, Samastipur, Bihar, India
6 Assistant Professor, Department of oral and maxillofacial pathology and microbiology, Career post graduate institute of dental science, Lucknow, Uttar Pradesh, India

Date of Submission15-Jan-2021
Date of Decision01-Feb-2021
Date of Acceptance22-Feb-2021
Date of Web Publication10-Nov-2021

Correspondence Address:
Safia Haideri
Patna Dental College and Hospital, Bankipur, Patna, Bihar
India
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jpbs.jpbs_23_21

Rights and Permissions
   Abstract 


Aims: The aim of the present study is to evaluate and compare the clinical and radiographic outcomes of formocresol (FC), mineral trioxide aggregate (MTA), electrocautery, and bioactive glass (BAG) when used for pulpotomy in human primary teeth. Settings and Design: The present study comprised of total four Groups A, B, C, and D; the selected children for the procedure were randomly divided into four groups according to the type of agent used as Group A, Group B, Group C, and Group D, respectively, having 20 teeth. Methodology: In this study, pulpotomies were performed on the respective teeth. The teeth were treated using either FC, MTA, electrocautery, and BAG. Following the pulpotomy procedure, the teeth were evaluated for the clinical and radiographic success for 3, 6, and 12 months. The teeth were evaluated for the presence of pain, swelling, internal and external resorption, and radiolucency. Statistical Analysis Used: Fisher's exact test and Yates corrected Chi-square test is used. Results: After 12 months of follow-up, the clinical and radiographic success rates were high. Comparing the frequency (%) of overall clinical success rate of four groups at 12 months, the Chi-square test revealed significantly different and higher overall clinical success rate in MTA as compared to other groups, especially FC and EC at 12 months. Comparing the frequency (%) of overall radiographic success rate of four groups at 12 months, the Chi-square test revealed significantly different and higher overall radiographic success rate in MTA as compared to other groups, especially FC and EC at 12 months. Conclusions: In this study, the success rates of MTA, BAG, and FC are matching their physical and chemical properties which have been detailed and explained earlier.

Keywords: Bioactive glass, electrocautery, formocresol, mineral trioxide aggregate, pulpotomy


How to cite this article:
Haideri S, Koul M, Raj R, Salam SA, kalim MS, Gupta V. To evaluate and compare the clinical and radiographic outcomes of formocresol, mineral trioxide aggregate, electrocautery, and bioactive glass when used for pulpotomy in human primary teeth. J Pharm Bioall Sci 2021;13, Suppl S2:1251-8

How to cite this URL:
Haideri S, Koul M, Raj R, Salam SA, kalim MS, Gupta V. To evaluate and compare the clinical and radiographic outcomes of formocresol, mineral trioxide aggregate, electrocautery, and bioactive glass when used for pulpotomy in human primary teeth. J Pharm Bioall Sci [serial online] 2021 [cited 2022 Jun 25];13, Suppl S2:1251-8. Available from: https://www.jpbsonline.org/text.asp?2021/13/6/1251/330024




   Introduction Top


Treating primary and permanent teeth that are pulpally inflamed is a type of challenge unique in many aspects. As clinical symptoms do not match the histological pulpal status, often its diagnosis is less accurate. Usually, pain is an indicator to the extent of pulp inflammation, but it can be compromised by age and behavior. There are different goals in the treatment of primary teeth that must be satisfied in comparison to the treatment of permanent teeth.

The life span of primary teeth is limited and if proper treatment is given according to the need of patient it becomes possible to treat the primary teeth in a better way.

Pulpotomy is regarded as an advantageous procedure in primary as well as permanent teeth. It is described as: A minimally invasive procedure that is performed in children, on a primary tooth with extensive caries but without evidence of root pathology followed by the placement of medicament that supports healing and preservation of radicular pulp with relief in pain.

When the coronal pulp is exposed due to trauma caries or any of operative procedures inflammatory changes occurs within the tissue due to infiltration of bacteria within that area. Here, the infected and inflamed area of the coronal pulp is removed by surgical excision leaving healthy pulpal tissue in the root canal.

Within this if therapeutic material is placed in direct contact with the pulp, it stimulates the tissue healing response.

The dressing material should be such that it should be nontoxic to pulp and surrounding structures with being bactericidal and also biocompatible. It should also support healing of radicular pulp, without obstructing in any of physiologic processes like root resorption that can have clinical, histological, or radiological outcomes.[3]

Pulpotomy therapy for primary teeth involves basically three steps:

  1. Devitalization
  2. Preservation and
  3. Regeneration.


In devitilization, the vital tissues are fixed by formocresol (FC) and electrocautery.

In regeneration, the dentinal bridge is stimulated by the action of MTA, bone morphogenetic protein, and bioactive glass (BAG).

Out of these regeneration is always said to develop most rapidly and most effectively.[2]

Thus, the study was undertaken to evaluate and compare FC, mineral trioxide aggregate (MTA), electrocautery, and BAG when used for pulpotomy in human primary teeth by clinical and radiographical method.


   Methods Top


Criteria for selection of teeth

Vital primary molars that were indicated for pulpotomy with deep caries without pulp exposure and healthy periodontium, with no history of spontaneous and persistent pain, the presence of 2/3rd of root length, no clinical or radiographic evidence of pulp degeneration, restorable crowns and readiness to appear for follow-up at 3, 6, and 12 months were included. Pre- and postoperative intraoral periapical X-rays were recorded for each tooth.

Materials used

  1. FC (Pharmadent Remedies Pvt Ltd, Gujrat, India) – A
  2. Electrocautery (Bonart ART E-1 India) - B
  3. MTA (ProRoot MTA, Dentsply, Tulsa Dental, OK, USA) - C
  4. BAG (PerioGlas, US Biomaterials, Alachua, FL) – D.



   Methodology Top


Parents/guardians were informed about the condition of the child's dentition and the procedure to be conducted. After obtaining written consent from the parent/guardian and clearance from the Ethical committee of Career Post Graduate Institute of Dental Sciences and Hospital, Lucknow, the selected children for the procedure were randomly divided into four groups according to the type of agent used as Group A, Group B, Group C, and Group D, respectively, having 20 teeth each.

The clinical procedure in all the teeth of four groups was performed step by step in one visit under local anesthesia and rubber dam. Following the establishment of cavity outline form, all caries were removed, and coronal access of the pulp was performed with a round bur with high-speed handpiece to expose the pulp chamber. A spoon excavator was used for coronal pulp amputation. Pulp was amputated up to the orifice of the root canal; sterile cotton pellet was used with pressure on the amputated pulp stumps to achieve hemostasis.

In each tooth of Group-A after amputation of the coronal pulp and achieving hemostasis FC (Pharmadent Remedies Pvt. Ltd., Gujrat, India) in 1:5 dilution was applied using a sterile cotton pledget and extra was dapped and placed for 5 min. After removal of the FC soaked cotton pledget a thick mix of zinc oxide eugenol cement was then placed into the coronal pulp chamber. Tooth was then restored with intermediate restorative material and permanent restoration with preformed stainless steel crown was given. The whole procedure was completed in one visit, and an immediate postoperative IOPA radiograph obtained.

In each tooth of Group B (Electrocautery) (Bonart ART E-1 India) after amputation of the coronal pulp, sterile cotton pellets were placed in the chamber with pressure to obtain temporary hemostasis. The cotton pellets were then removed, and the electrocautery dental heavy ball electrode (Bonart ART E-1) was immediately placed 1–2 mm above the tissue. The electrocautery unit power was set at 40%. The electrical arc was allowed to bridge the gap to the first pulpal stump for 1 s followed by a cool down period of 10–15 s. Heat was minimized by keeping the electrode as far away from the pulp stumps and the tooth structure as possible while still allowing electrical arcing to occur. This procedure was repeated up to three times at each pulpal orifice. To avoid heat build-up in any one area of the tooth, single applications of 1 s were performed to each orifice in a rotational sequence. After each current application, a new large sterile cotton pellet was placed with pressure on the next pulpal orifice to be electrocauterized to absorb any blood or tissue fluid before the next current application (i.e. pellet-electrode-pellet-electrode). Pulpal stumps were dry and blackened upon completion of the procedure. An intermediate restoration was then placed into the coronal pulp chamber followed by an permanent restoration with preformed stainless steel crown. The whole procedure was completed in one visit, and an immediate postoperative IOPA radiograph recorded.

In each tooth of Group–C MTA (ProRoot MTA, Dentsply, Tulsa Dental, OK, USA) after amputation of the coronal pulp and achieving hemostasis, using a stiff metal spatula MTA powder was mixed with distilled water (according to manufacturer's instruction) provided by manufacturer in 3:1 (powder :Liquid) ratio and then placed over the site with a plastic instrument. Then, the mixture was compressed against the amputated site with a moist cotton pellet. An intermediate restoration was then placed into the coronal pulp chamber followed by permanent restoration with preformed stainless steel crown. The whole procedure was completed in one visit, and an immediate postoperative IOPA radiograph recorded.

In each tooth of Group – D (BAG) (PerioGlas, US Biomaterials, Alachua, FL) after amputation of the coronal pulp and achieving hemostasis with cotton pellets, BAG powder was mixed on a glass slab (according to manufacturer's instruction) with a small amount of normal saline to make a creamy suspension and BAG was placed directly on the pulpal stump. Tooth was then restored with intermediate restorative material and permanent restoration with preformed stainless steel crown. The whole procedure was completed in one visit, and an immediate postoperative IOPA radiograph recorded.

In each tooth of all the groups, clinical and radiographical evaluation was done at 3, 6, and 12 months interval postoperatively. Clinically, the teeth were evaluated for the presence/absence of spontaneous pain, tenderness to percussion, mobility, abscess/sinus tract, whereas radiographically for the presence/absence of internal resorption, furcation radiolucency, and periapical radiolucency.

The data thus collected were tabulated and analyzed statistically for each group.


   Results Top


Clinical evaluation

Pain

The frequency distribution of pain in percentage of four groups at 3, 6, and 12 months posttreatments are summarized in [Table 1]. At 3 months, 2 (10.0%) cases had pain in FC group, 2 (10.0%) in EC group, 0 (0.0%) in MTA and 01 (5%) in BAG group. Comparing the pain frequency (%) of four groups at 3 months, Fisher exact test revealed similar pain frequency among the groups at 3 months (P = 0.747), i.e., not differed statistically. Similarly, at 6 months, 4 (20.0%) had pain in FC group, 4 (20.0%) in EC group, 0 (0.0%) in MTA group, and 2 (10.0%) in BAG group. Comparing the pain frequency (%) of four groups at 6 months, Fisher test further revealed similar pain frequency among the groups at 6 months (P = 0.157), i.e., also not differed statistically. Similarly, at 12 months, 8 (40.0%) had pain in FC group, 4 (20.0%) in EC group, 2 (10.0%) in MTA group, and 4 (20.0%) in BAG group. Comparing the pain frequency (%) of four groups at 12 months, Fisher test further revealed similar pain frequency among the groups at 12 months (P = 0.175), i.e., also not differed statistically.
Table 1: Distribution of pain of four groups over the periods

Click here to view


Overall clinical success rate

The overall clinical success rate (pain + swelling + sinus tract) of four groups at 3, 6, and 12 months posttreatments is summarized in [Table 2]. At 3 months, FC, EC, MTA, and BAG showed 13.33%, 10.0%, 0.0%, and 3.33%, overall clinical failure, respectively, with highest being in both FC followed by EC. Comparing the frequency (%) of overall clinical success rate of four groups at 3 months, the Chi-square test revealed similar overall clinical success rate among the groups at 3 months (χ2 = 7.768, P = 0.052), i.e., not differed statistically. In contrast, at 6 months, FC, EC, MTA, and BAG showed 20.0%, 16.670%, 0.0%, and 8.33% overall clinical failure, respectively, with the highest being in FC followed by EC, BAG, and MTA the least. Comparing the frequency (%) of overall clinical success rate of four groups at 6 months, the Chi-square test revealed significantly different and higher overall clinical success rate in both BAG and MTA as compared to both FC and EC at 6 months (χ2 = 11.81, P = 0.008). Conversely, at 12 months, FC, EC, MTA, and BAG showed 33.33%, 23.33%, 6.67%, and 16.67% overall clinical failure, respectively, with the highest being in FC followed by EC, BAG, and MTA the least. Comparing the frequency (%) of overall clinical success rate of four groups at 12 months, the Chi-square test revealed significantly different and higher overall clinical success rate in MTA as compared to other groups, especially FC and EC at 12 months (χ2 = 11.08, P = 0.0088).
Table 2: Distribution of patients according overall clinical success rate in four groups over period of time

Click here to view


Radiographic evaluation

Internal resorption

The internal resorption of four groups at 3, 6, and 12 months posttreatments is summarized in [Table 3]. At 3 months, EC, MTA, and BAG showed no internal resorption, giving 100.0% success while FC showed resorption in 2 case giving 10.0% success. Comparing the frequency (%) of internal resorption of four groups at 3 months, internal resorption among the groups at 3 months (P = 0.2405), i.e., not significant statistically. In contrast, at 6 months, FC, EC, MTA and BAG showed 5%, 20.0%, 0.0%, and 0.0% failure in internal resorption, respectively, with highest being in EC. Comparing the frequency (%) of internal resorption of four groups at 6 months, similar internal resorption among the groups at 6 months (P = 0.097), i.e., not significant statistically. Conversely, at 12 months, FC, EC, MTA, and BAG showed 40.0%, 20.0%, 5.0%, and 15.0% failure in internal resorption, respectively, with the highest being in FC and least in MTA. Comparing the frequency (%) of internal resorption of four groups at 12 months, similar internal resorption among the groups at 12 months (P = 0.109), i.e., also not significant statistically.
Table 3: Internal resoption of four groups over the period

Click here to view


Furcation radiolucency

The furcation radiolucency of four groups at 3, 6, and 12 months posttreatments is summarized in [Table 4]. At 3 months, all four showed no furcation radiolucency, exhibiting that here test was not applicable. In contrast, at 6 months, FC, EC, MTA, and BAG showed 30.0%, 20%, 0.0%, and 15.0% failure in furcation radiolucency, respectively, with highest being in FC followed by EC and both MTA and BAG the least. Comparing the frequency (%) of furcation radiolucency of four groups at 6 months revealed similar furcation radiolucency among the groups at 6 months (P = 0.053), i.e., statistically nonsignificant. Conversely, at 12 months, FC, EC, MTA, and BAG showed 40%, 30.0%, 0.0%, and 20% failure in furcation radiolucency, respectively, with the highest being in FC followed by EC and both MTA and BAG the least. Comparing the frequency (%) of furcation radiolucency of four groups at 12 months revealed being significant (P = 0.0077).
Table 4: Furcation radiolucency of four groups over the periods

Click here to view


Periapical radiolucency

The periapical radiolucency of four groups at 3, 6, and 12 months posttreatments is summarized in [Table 5]. At 3 months, EC, MTA, and BAG showed no periapical radiolucency, while FC showed periapical radiolucency in 2 case giving 10.0% success. Comparing the frequency (%) of periapical radiolucency of four groups at 3 months revealed similar periapical radiolucency among the groups at 3 months (P = 0.2406), i.e., nonsignificant statistically. In contrast, at 6 months, FC, EC, MTA, and BAG showed 30.0%, 20.0%, 0.0%, and 15.0% failure in periapical radiolucency, respectively, with the highest being in FC and least in MTA. Comparing the frequency (%) of periapical radiolucency of four groups at 6 months, Fisher test revealed similar periapical radiolucency among the groups at 6 months (P = 0.0529), i.e., not significant statistically. Conversely, at 12 months, FC, EC, MTA, and BAG showed 45.0%, 40.0%, 10.0%, and 25.0% failure in periapical radiolucency, respectively, with the highest being in FC and least in MTA. Comparing the frequency (%) of periapical radiolucency of four groups at 12 months, Fisher test revealed similar periapical radiolucency among the groups at 12 months (P = 0.06275) and is nonsignificant.
Table 5: The periapical radiolucency of four groups over the period

Click here to view


Overall radiographic success rate

The overall radiographic success rate (internal resorption + furcation radiolucency + periapical radiolucency) of four groups at 3, 6, and 12 months posttreatments is summarized in [Table 6]. At 3 months, EC, MTA, and BAG showed no radiographic changes, exhibiting 100.0% success while FC showed 4 failure giving 6.67% success. Comparing the frequency (%) of overall radiographic success rate of four groups at 3 months, yates Chi-square test revealed similar overall radiographic success rate among the groups at 3 months (χ2 = 7.12, P = 0.068). In contrast, at 6 months, FC, EC, MTA, and BAG showed 21.67%, 20.0%, 0.0%, and 10.0% overall radiographic failure, respectively, with the highest being in both FC and EC. Comparing the frequency (%) of overall radiographic success rate of four groups at 6 months, yath Chi-square test revealed significantly different and higher overall radiographic success rate in both BAG and MTA as compared to both FC and EC at 6 months (χ2 = 13.45, P = 0.003). Conversely, at 12 months, FC, EC, MTA, and BAG showed 41.67%, 30.0%, 5.0%, and 20.0% overall radiographic failure, respectively, with highest being in FC and least in MTA. Comparing the frequency (%) of overall radiographic success rate of four groups at 12 months, yath Chi-square test revealed significantly different and higher overall radiographic success rate in MTA as compared to other groups, especially FC and EC at 12 months (χ2 = 21.28, P < 0.001).
Table 6: Overall radiographic success rate in four groups over the period

Click here to view


Overall success rate

The overall success rate (radiographic + clinical) of four groups at 3, 6, and 12 months posttreatments is summarized in [Table 7]. At 3 months, FC, EC, MTA, and BAG showed 10.0%, 5.0%, 0.0%, and 1.67% overall failure, respectively, with the highest being in both FC followed by EC and both MTA and BAG the least. Comparing the frequency (%) of overall success rate of four groups at 3 months, the Chi-square test revealed significantly different and higher overall success rate in both MTA and BAG as compared to both FC and EC at 3 months (χ2 = 14.40, P = 0.0024) and is significant. In contrast, at 6 months, FC, EC, MTA, and BAG showed 20.83%, 18.33%, 0.0%, and 9.17% overall failure, respectively, with the highest being in FC followed by EC, BAG, and MTA the least. Comparing the frequency (%) of overall success rate of four groups at 6 months, the Chi-square test revealed significantly different and higher overall success rate in both BAG and MTA as compared to both FC and EC at 6 months (χ2 = 27.77, P < 0.001). Conversely, at 12 months, FC, EC, MTA, and BAG showed 37.50%, 26.67%, 5.83%, and 18.33% overall failure, respectively, with the highest being in FC followed by EC, BAG, and MTA the least. Comparing the frequency (%) of overall success rate of four groups at 12 months, Chi-square test revealed significantly different and higher overall success rate in MTA as compared to other groups especially FC and EC at 12 months (χ2 = 35.16, P < 0.001).
Table 7: Overall success rate in four groups over the period

Click here to view



   Discussion Top


The observations and results of the study are depicted in [Table 1], [Table 2], [Table 3], [Table 4], [Table 5], [Table 6], [Table 7], [Table 8], [Table 9]. This study showed best outcomes with MTA followed by BAG, EC, and FC. The participants included were healthy children in the age range of 4–9 years as children would be uncooperative below this age, full primary dentition erupts at the age of 3 years and above 9 years physiologic root resorption starts.
Table 8: Distribution of swelling in four groups over period of time

Click here to view
Table 9: Distribution of sinus tract in four groups over a period of time

Click here to view


Hundered teeth were treated with pulpotomy procedure out of which only eighty turned up for follow-ups and thus were selected in the study. Although histological methods are a better test to predict pulpal healing, followed by radiograhical and clinical methods, this study incorporated only clinical and radiographical evaluations as the teeth used were destined for the preservation in the oral cavity.

In the present study, clinical success rate was higher with FC which was 67% when compared to the radiographic success, i.e., 57%. This was comparable to the results of Havale et al. study who reported clinical 86.7% and radiographical 56.7%; also comparable to Srinivasan Daya study with clinical success of 91.3% and radiographic 78.26%; Magnusson reported clinical success 100% and radiographical 62%; Neamatollahi and Tajik observed clinical and radiographic success of 100 and 92.5%, respectively, which was in accordance with the present study. Previous studies have shown a gradual decrease in the success rate with time, as was noticed in the current study with FC which could be attributed to physiological resorption, accelerated root resorption, and the approach of the time for exfoliation of primary molars.[4],[10],[11],[12]

The most common failure finding in this study was internal root resorption like in Eidelman and Magnesson studies.[11] Internal resorption may be due to a chronically inflamed pulp, reversible fixative effect of FC, irritating pH, chemical and physical effects of ZOE on connective tissue to variation in the pulpotomy techniques used, or to lack of predentine.[7]

The present study showed interradicular radiolucency with FC group which may be due to smaller molecular size of FC with higher degree of penetrability and the potential to cause antigenic alteration in the pulp tissues can cause seepage into the apical region through the pulpal canals or into the furcation area through accessory canals or the pulpal floor, as it is thin, porous and permeable in nature, in deciduous molars, thereby increasing the probability of a periradicular and interradicular radiolucencies.[5],[9]

Clinical and radiographic success with EC in the present study was 77% and 70% with an overall success of 73% which was in accordance with Bahrololoomi Zehra et al. (2008) study with 100 and 96.8% clinical and radiographic success rates, respectively. In the study conducted by Mack and Dean, the success rate for electrosurgical pulpotomy was significantly higher than that for FC pulpotomy which is similar with the present study. El-Melgy et al. compared pulpal and periapical tissue reactions to electrosurgery FC pulpotomy in primary teeth of dogs and observed FC pulpotomy. Rivera et al. evaluated postoperative clinical and X-ray findings from 80 primary molars after FC and electrosurgery vital pulpotomy. They did not find any significant difference between the two techniques after 6 months of follow-up.[6]

In the present study, MTA clinical and radiographic success was 97 and 100% and overall success rate of 98% which was comparable to Eidelman et al. who compared MTA's effects to those of FC in 32 pulptomized primary molars during a follow-up evaluation from 6–30 months with clinical and radiographic success rate in MTA group was 100% while there was an internal resorption in one molar treated with FC. In the studies of Naik and Maroto et al., the clinical and radiographic evaluations were done at 6 months after pulpotomy in primary molars. Their studies also showed that MTA was a successful material which was in accordance with the present study.[13] Furthermore, in a study conducted by Agamy et al. 2004 reported that the clinical and radiographic success rate of pulpotomy was 100% for gray MTA and 90% for FC in a period of 12 months postoperatively. Holan et al. 2005 observed 97% success rate of pulpotomy for MTA which is close to the present study.[14] Furthermore, in a study conducted by Godhi et al. in 2011 observed 100% clinical success at 1, 3, 6, and 12 months, whereas radiographic success at 3 months for FC and MTA were 92% and 96% and at 6 and 12 months were 88% and 96%.[8] MTA pulpotomy had favorable success rates; it does not induce internal root resorption, which has been observed in teeth treated with calcium hydroxide and FC (Fucks, 2002; Peng et al. 2006). The study showed only one case of pain with MTA at 12 months follow up, routine radiographic evaluation revealed no periapical pathology. The patient was given symptomatic treatment for pain with systemic medication and thus was relieved. The probable reasons could have been food impaction and/or subclinical periodontal problems. The best results with MTA in this study could be attributed to its biocompatibility and tight seal. Salako et al. in a histological study on rat molars reported dentin bridge formation which continued over time and resolve inflammation leaving a healthy pulp, in this context Schwartz et al. (1999) reported cementogenesis.[15]

In the present study, clinical and radiographic success with BAG was 83 and 90% with overall success of 87%, respectively, which was second best. Salako et al. in a histopathological study on pulpotomized molar teeth of Spragu–Dawley rats with MTA, BAG, and FC and reported that BAG induces acute inflammatory responses of pulp at 2 weeks, with its resolution of the pulpal morphology, whereas MTA at 2 weeks showed some inflammatory response which has been discussed earlier in context with MTA.[1]

A PubMed searched for the use of BAG as a pulpotomy medicament in human primary teeth did not yield any references. Since no relevant literature could be found, so a retrospective comparison could not be made.


   Conclusions Top


The clinical results in this were in agreement with the previous studies that had compared different agents for pulpotomy. The success rates of MTA, BAG, and FC reflect their previously proved physical and chemical properties. These clinical findings need to be corroborated with histological findings of experimental study. For definitive conclusion, a larger sample size with clinical, radiographical, and histological investigations into the effects of chemical and physical pulpotomy agents or/are suggestive for future study. Since BAG is a recent development and its use and investigation in pulpotomy procedures for human primary teeth has not been previously studied and hence is recommended for a detailed investigation for further studies in pulpotomy in human primary teeth. Electrocautery pulpotomy is a nonpharmacological and easy technique, but the high cost of equipment is a drawback.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
   References Top

1.
Hiremath MC, Srivastava P. Comparative evaluation of endodontics pressure syringe, insulin syringe, jiffy tube, and local anesthetic syringe in obturation of primary teeth: An in vitro study. J Nat Sc Biol Med 2016;7:130.  Back to cited text no. 1
[PUBMED]  [Full text]  
2.
Ranly DM. Pulpotomy therapy in primary teeth: New modalities for old rationales. Pediatr Dent 1994;16:403-9.  Back to cited text no. 2
    
3.
McDonald RE, Avery DR. Treatment of deep caries, vital pulp exposure, and pulpless teeth in children. In: McDonald RE, Avery DR, editors. Dentistry for the Child and Adolescent. 7th ed. St. Louis: Mosby: 2015. p. 343-65.  Back to cited text no. 3
    
4.
Casas JM, Kenny DJ, Johnston DH, Judd PL. Longterm outcomes of primary molar ferric sulfate pulpotomy and root canal therapy. Pediatr Dent 2004;26:44-8.  Back to cited text no. 4
    
5.
Curzon ME, Roberts JF, Kennedy DB, editors. Kennedy's Paediatric Operative Dentistry. 4th ed. Oxford: Wright; 1996. p. 15-18, 159-161.  Back to cited text no. 5
    
6.
Rivera N, Reyes E, Mazzaoui S, Morón A.. Pulpal therapy for primary teeth: Formocresol vs electrosurgery: A clinical study. J Dent Child (Chic) 2002;70:71-3.  Back to cited text no. 6
    
7.
Raton B. Dentin and pulp. In: Mjör IA, editor. Reaction Patternsin Human Teeth. Boca Raton, FL: CRC Press; 1983. p. 101.  Back to cited text no. 7
    
8.
Godhi B, Sood PB, Sharma A. Effects of mineral trioxide aggregate and formocresol on vital pulp after pulpotomy of primary molars: An in vivo study. Contemp Clin Dent. 2011 Oct;2(2):296–301.  Back to cited text no. 8
    
9.
Ringelstein D, Seow WK. The prevalence of furcation foramina in primary molars. Pediatr Dent 1989;11:198-202.  Back to cited text no. 9
    
10.
Kuratate M, Yoshiba K, Shigetani Y, Yoshiba N, Ohshima H, Okiji T. Immunohistochemical analysis of nestin, osteopontin, and proliferating cells in the reparative process of exposed dental pulp capped with mineral trioxide aggregate. J Endod 2008;34:970-4.  Back to cited text no. 10
    
11.
Smith NL, Seale NS, Nunn ME. Ferric sulfate pulpotomy in primary molars: A retrospective study. Pediatr Dent 2000;22:192-9.  Back to cited text no. 11
    
12.
Vargas KG, Packham B. Radiographic success of ferric sulfate and formocresol pulpotomies in relation to early exfoliation. Pediatr Dent 2005;27:233-7.  Back to cited text no. 12
    
13.
Maroto M, Barbería E, Vera V, García-Godoy F. Mineral trioxide aggregate as pulp dressing agent in pulpotomy treatment of primary molars: 42-month clinical study. Am J Dent 2007;20:283-6.  Back to cited text no. 13
    
14.
Sirohi K., Marwaha M.et. al. Comparison of Clinical and Radiographic Success Rates of Pulpotomy in Primary Molars using Ferric Sulfate and Bioactive Tricalcium Silicate Cement: An in vivo Study Int J Clin Pediatr Dent. 2017 Apr-Jun; 10(2): 147–151.  Back to cited text no. 14
    
15.
Schwartz RS, Mauger M, Clement DJ, Walker WA. Mineral trioxide aggregate: a new material for endodontics J Am Dent Assoc 1999;130:967-75.  Back to cited text no. 15
    



 
 
    Tables

  [Table 1], [Table 2], [Table 3], [Table 4], [Table 5], [Table 6], [Table 7], [Table 8], [Table 9]



 

Top
 
 
  Search
 
    Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
    Access Statistics
    Email Alert *
    Add to My List *
* Registration required (free)  

 
  In this article
    Abstract
   Introduction
   Methods
   Methodology
   Results
   Discussion
   Conclusions
    References
    Article Tables

 Article Access Statistics
    Viewed322    
    Printed6    
    Emailed0    
    PDF Downloaded56    
    Comments [Add]    

Recommend this journal