Wednesday, April 11, 2018

Sodium Hypochlorite Versus Formocresol and Ferric Sulfate Pulpotomies in Primary Molars: 18-month Follow-up


Sodium Hypochlorite Versus Formocresol and Ferric Sulfate Pulpotomies in Primary Molars: 18-month Follow-up
Department of Pediatric Dentistry
NYU Langone
           
Resident’s Name: Wayne Dobbins DDS MS                                            Date: 4/11/2018
Article Title: Sodium Hypochlorite Versus Formocresol and Ferric Sulfate Pulpotomies in Primary Molars: 18-month Follow-up
Author(s):  Farsi DJ, El-Khodary HM, Farsi NM, El Ashiry EA, Yagmoor MA, Alzain SM
Journal: Pediatric Dentistry
Date: 2015
Major TopicEndodontics
Type of Article:  Randomized Controlled Trial
Main Purpose: This study's purpose was to compare the clinical and radiographic success rates of 5.25 percent Sodium Hypochlorite(NaOCl) pulpotomies to Formocresol (FC) and Ferric Sulfate (FS) in decayed primary molars.
Key Points: No significant differences were noted in the success rates of NaOCL, Formocresol, and Ferric Sulfate as pulp dressing materials.

A pulpotomy medicament should ideally be bactericidal, be harmless to the pulp and surrounding structures, promote healing of the radicular pulp, and allow the physiological process of normal root resorption. Formocresol, ferric sulfate, and NaOCl are all commonly used pupal medicaments.

Healthy children, four to eight years of age, with restorable primary molars with deep caries but no spontaneous pain, no mobility, no pain on palpation or percussion, no fistulae, no swelling; and with normal periradicular tissues without widening of the PDL nor root resorption were selected. 81 teeth across 67 children were treated, and were randomly assigned to three groups of 27 teeth, each be treated with either formocresol, ferric sulfate, or NaOCl. All teeth were restored with (ZOE)  zinc oxide-eugenol and an SSC, and patients were re-evaluated at 6, 12 and 18 months for clinical failure. Clinical failure was defined as internal root resorption, periradicular radiolucency, and/or widened PDL; pulp canal obliteration was not considered a clinical failure.

RESULTS: 

At 6 months, clinical and radiographic success rates were 100 percent for each group (27/27). 


At 12 months, clinical success was 100 percent (24/24), 96 percent (24/25), and 95.7 percent (22/23) for NaOCl, FC, and FS respectively. The radiographic success was 95.8 percent (23/24) for NaOCl group, and 100 percent for FC (25/25), and FS (23/23). 


At 18 months, the clinical success was 83.3 percent (20/24), 96 percent (24/25), and 87 percent (20/23) for NaOCL, FC, and FS respectively. The 18 month radiographic success was 91.7 percent (22/24), 100 percent (25/25), and 95.7 percent (22/23) for NaOCl, FC, and FS respectively. 


No significant differences were found in clinical or radiographic outcomes between the three groups at six, 12 and 18 months.



CONCLUSION: The three pulpotomy medicaments yielded similar outcomes.


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