Resident: Derek Nobrega
Title: Pulpal Therapy for Primary Teeth: Formocresol vs. Electrosurgery: A Clinical Study
Author: Nancy Rivera, Eleida Reyes, Soraya Mazzaoui, Alexis Morón
Journal: Journal of Dentistry for Children. 2003. Jan-Apr 70(1) 1-73
Main Purpose: To compare the post-op successes and failures following pulpotomies with formocresol and electrosurgery on primary molars of children.
Methods: 40 Children of both sexes between the ages of 4 and 7 with at least 2 primary vital molars referred for pulpotomies due to exposed pulps by caries were used. Subjects were excluded if they had one of the following: mobility, sensitivity to percussion, fistula(e), groove drainage, apical or internal resorption, fetid odor, or compromised furcation. Also excluded were patients with diabetes, cardiopathy, and renal alterations. Both molars were treated in each patient: 1 with formocresol (concentration 1:5 applied for 5 minutes) and 1 with electrosurgery (electrode placed to each orifice with current flow for 1 second, followed by 5 second cooling off period up to a maximum of 3 times/orifice). Teeth were then filled with ZOE at the entrance of the canals and filled the rest of the way with amalgam. PAs and a clinical exam were performed at 1, 3, and 6 months after treatment. A failure was noted if at least one of the exclusion criteria was met.
1. Of the 40 teeth that underwent formocresol pulpotomy, 3 were considered failures (7.5%).
2. The same number of failures (3) were noted with electrosurgical pulpotomies (7.5%).
3. No significant differences were found between both techniques at the end of the evaluation period.
4. Electrosurgery had 2 advantages: faster application and no risk of formocresol side effects.
5. None of the formocresol treated failures showed clinical signs of failure at any point during the evaluation. Failures were only noted on radiographic examination after 6 months.
Assessment: The sample size was small for statistical significance. Also, the evaluation period of 6 months was short. Furthermore, the amalgam restorations placed after pulpotomies were not ideal treatment. The electrosurgery failures were all noted clinically after 1 or 3 months, but the formocresol failures were noted only after 6 months radiographically, but not clinically. Overall, a good introductory study that indicates more research is required.